End-of-Life Care in Nunavik, Quebec: Inuit Experiences, Current Realities, and Ways Forward.
Increasing longevity for Inuit living in Nunavik, northern Quebec, has resulted in heightened rates of cancers and chronic diseases necessitating complex treatments. Consequently, end-of-life (EOL) care, once the domain of Inuit families and communities, has come to include professionalized healthcare providers with varying degrees of awareness of factors to consider in providing care to Inuit populations.



To better understand the factors shaping EOL care in Nunavik to support the development of a sustainable model of care.



Using focused ethnography, we conducted participant observations and informal and semistructured interviews with 103 participants (community members, healthcare practitioners, and administrators) across Nunavik and in Montreal, the affiliated tertiary care center. Data domains included the following: care trajectories; patient and family experiences receiving and providing EOL care; local and urban resources and challenges; and ways forward.



Sociocultural, historical, and geographic factors shape EOL care in Nunavik, presenting a complex set of challenges for Inuit patients, families, and healthcare providers. A sustainable model of EOL care requires building on shared initiatives, capitalizing on the existing strengths in communities, and attending to the multiple bereavement needs in the region.



Building a sustainable model of EOL care requires respectful collaboration among governing structures, healthcare institutions, and community members. It must centrally value local knowledge and initiatives. To ensure Inuit families and patients are supported throughout the dying process, future initiatives must centrally include local stakeholders in both the design and evaluation of any changes to the current healthcare system.
1 Department of Psychoéducation, Université de Montréal , Montréal, Québec, Canada .
Shawn Renee
SR
Hordyk
2 Oral Health and Society Research Unit, Faculty of Dentistry, McGill University , Montreal, Quebec, Canada .
Mary Ellen
ME
Macdonald
3 Department of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University , Montreal, Quebec, Canada .|4 Centre for Clinical Epidemiology, Jewish General Hospital , Montreal, Quebec, Canada .
Paul
P
Brassard
D005260:Female; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D004930:Inuit; D008136:Longevity; D008297:Male; D036301:Qualitative Research; D011792:Quebec; D013727:Terminal Care / Q000458:organization & administration; D035502:Trust
Inuit; end-of-life care; sustainability