support for those family members most affected. Ceremony and healing The Elders also addressed questions surrounding Elders and healers. They explained that Elders are integral to providing support and guidance to the family. They noted that ceremonies and healing are special gifts given by the Creator and, like languages, there are also many different healing methods used among Aboriginal peoples. Individuals who have special gifts of healing (e.g., Elders, healers, ministers, community members) may be requested by the family in their time of need. Healers, Medicine Men and Medicine Women facilitate communication between the ill person and the spirit world through ceremonies, prayer and so on. Moreover, sacred and ceremonial items are integral to many peoples’ healing processes. Common healing sacred items include feathers, tobacco, sweetgrass, cloth, special stones and bundles, as well as medicines in the form of teas. The Elders explained that even though a person may be dying, s/he may be doing the most mental, emotional and spiritual healing that s/he has ever done, and the Elders or healers and the ceremonies they perform are essential to that healing. The Elders also spoke forthrightly about how the sacred items must be treated with respect. If a health care practitioner or hospital staff member needs to move an item, s/he must discuss this with the patient and/or family members. Many items are blessed and therefore people are asked to respect that blessing and refrain from handling such items. In addition, women who are on their moontime (menstrual cycle) are asked not to handle sacred items or even be in the same room as the items. This is because menstruation is a very powerful time for women. It is viewed as a gift from the Creator that must be respected and protected. In many Aboriginal societies, women refrain from participating in FALL 2017 ceremonies or touching traditional medicines and spiritual items because they are so powerful that they actually will draw that energy to themselves instead of the family member in need. Building trust Initially, the OT worked towards building trust with Angela while engaging both parents in a process of consent. She scheduled a meeting in which the treatment approach was outlined to Angela’s parents in writing. She described the risks and benefits of the recommended approach, and explained that some of Angela’s inability to chew and safely swallow solid food at this point meant that Angela would be at risk of aspirating. In addition, she felt it was uncertain how much this approach might compromise the child’s trust in her relationship with parents and in the therapeutic process. The OT maintained that harm of this approach would likely outweigh the possible benefits. While acknowledging the underlying conflict between the parents, the OT emphasized to them that informed consent for Angela’s treatment would require their agreement. Eventually, the parents provided their proxy consent. Debriefing after the video In addition to the video, the DVD includes a taped PowerPoint slideshow as presented by two research team members. This taped presentation was created because the team could not keep up with the demand to show the video and facilitate the PowerPoint slideshow in person. The taped presentation delves more deeply into some of the concepts explained in the video, provides time for self-reflection and provides the framework for a question and answer period. For example, after the video, we ask a series of self-reflective questions for participants to consider (although they do not have to share their answers): • Think about customs or things that are unique to your family when someone approaches the end of life. Are these things cultural? • What is my cultural background, how might it have influenced my values, beliefs, and ways of being, living and working? • How might my own culture influence the way I feel about illness, death and loss, and how I express my feelings and thoughts about these important transitions? • How might my own cultural beliefs interfere with my ability to provide compassionate whole-person care to my Aboriginal patients and their families. www.rehabmagazine.ca 23 It is common for large extended families to gather when there is a health crisis within a family. “ ” these interventions will feel intrusive or coercive to their daughter. The father wanted to discuss the option of allowing Angela to go hungry until such time as she has no other choice but to eat solid food. The OT explained how, as a regulated health professional, she must ensure that treatment will provide the desired health benefits while reducing or avoiding risk or harm. From an ethics perspective, the risks must be minimized and the likely benefits must outweigh both the risks and harm to the client. Although the OT was familiar with the method described by Angela’s father, her opinion was that it was not suited for Angela.