Communities across Canada will receive a Training Manual and video that will make up the Coming Full Circle training package. The Coming Full Circle literature review and community consultation results form the basis of the training manual and video. The information collected in the different communities in Canada showed NIICHRO how to focus the training. CHRs will deliver the training to the frail elderly in their communities.

Through the Coming Full Circle training, NIICHRO will fill in some of the gaps that prevent the Aboriginal frail elderly from living healthy lifestyles in their older years. However, NIICHRO cannot address every barrier encountered by the frail elderly. Such issues as lack of adequate housing, transportation or the legacy of residential school abuse are unfortunate parts of life. These issues, while important, cannot be addressed in this training package. The individual interviews and focus groups showed several areas to concentrate on to develop effective targeted training. Based on the literature review and community consultation process, NIICHRO is currently in the process of developing the Coming Full Circle training using the information gathered.

The literature review and community consultation showed that isolation plays a major role in aging. There are several kinds of isolation: social, physical and emotional. The community consultations showed clearly that the Aboriginal frail elderly suffer from feeling emotional isolation from their loved ones. Due to their remote living locations, some had family far away. The families could not visit as often as their elderly relative would have hoped. However, several elderly people interviewed did have family close by, but claimed that they did not make time for them. The CHR and caregiver consultations confirmed that their roles often eclipsed that of the family and that they often have to do even the simplest tasks for their community's elders. The caregivers interviewed felt strongly that the family can and should do more for their grandparents, parents or elders - especially those who are frail and cannot get out and do things for themselves. It was recommended that the training package focus positively on the many gifts and wisdom elders bring to the lives of the younger generations. The training should show the need for increased family involvement in the Aboriginal frail elders' lives.

The community consultation process presented evidence that healthy living training would not work if the target audience were solely the Aboriginal frail elderly. While NIICHRO still wants to target this group, it was discovered and confirmed by the caregiver consultations that the caregiver or CHR should be the person to deliver the training. It was therefore recommended that the training be developed for and delivered by CHRs or caregivers. The training will concentrate on motivating elders to continue moving and staying active by offering Aboriginal elderly role models and specialized active living guidance. We must link the Aboriginal frail elderly with the CHRs and caregivers who are reaching out to them on a regular basis.

"Coming Full Circle" is a metaphor for the continuum of life. All lives are a circle with a beginning and an end - each end is a beginning. All parts of the circle are equally important to healthy living. It was recommended through the research NIICHRO conducted that the training manual be written with respect to the circle of life and use the holistic perspective of the mental, social, spiritual, and physical aspects of each person.

Therefore, the training will be divided into four sections: MIND, SOCIAL, SPIRITUAL, and BODY. Although still in production, the Training Manual will follow an outline as follows:

The MIND section of the Training Manual will include such topics as:

ESSENCE OF THE MIND/BODY CONNECTION
AWARENESS OF THE MIND/BODY CONNECTION
PSYCHOLOGICAL - SELF-ACCEPTANCE / SELF-ESTEEM
GROWING OLD / BODY ACCEPTANCE
LIFE REVIEW
REMINISCING
CONNECTEDNESS TO THE LAND
MOTIVATION
HOW TO INCREASE ACTIVITY AMONG FRAIL ELDERS
THE BENEFITS OF REGULAR PHYSICAL ACTIVITY
EMOTIONAL ISSUES - DEPRESSION, DESPAIR
LIVING WITH PAIN
PAIN MANAGEMENT
MOVING THROUGH THE PAIN
ACTIVITIES PROMOTING THE MIND/BODY CONNECTION

The SOCIAL section:

IMPORTANCE OF SOCIALIZATION
TRANSPORTATION
ISOLATION
ISOLATED SENIORS
MAINTAINING INDEPENDENCE
THE FAMILY AND ISOLATION
LAUGHTER
TEASING - HISTORICAL CONTEXT OF HUMOUR IN ABORIGINAL CULTURE
LAUGHTER - BEST MEDICINE FOR MIND, BODY, SPIRIT
LAUGHTER THERAPY

The SPIRITUAL section:

WHAT IS SPIRITUALITY?
HOW DO DIFFERENT PEOPLE BELIEVE?
SPIRITUALITY AND HEALTH
HOW IS SPIRITUALITY RELATED TO HEALTH?
HOW CAN PEOPLE IMPROVE THEIR SPIRITUAL HEALTH?
TRADITIONAL MEDICINE AND SPIRITUAL BELIEFS VS. WESTERN MEDICINE
LIFE HISTORY AND ITS EFFECT ON SPIRITUALITY
RESIDENTIAL SCHOOLS
CONNECTEDNESS TO THE LAND
MEANING NOW AND AT THE END OF LIFE
HOPE
PRACTICAL APPROACHES TO HELPING SENIORS FIND HOPE
BARRIERS TO SPIRITUALITY
TECHNIQUES FOR USING SPIRITUALITY IN HEALING
LEGACIES
CULTURAL TEACHINGS TO PASS DOWN - AN ORAL HISTORY PROJECT

The BODY section will include many practical and safe movement and activities for the frail elderly.

COMMON AGE-RELATED DISEASES AND AILMENTS
HOW MOVEMENT IS AFFECTED BY CHRONIC DISEASE
YOUTH INVOLVEMENT - A HEALTHY LIVING LEGACY
MOVEMENT AND DIABETES
NUTRITION
DETERMINE YOUR NUTRITIONAL HEALTH
INJURY PREVENTION
USING MOBILITY DEVICES
INCREASE IN ACTIVITY HELPS WITH INJURY PREVENTION
FALLS AMONG THE ELDERLY
THE RISK FACTORS (THE THREE S'S)
SEEING
STAIRS
SLIPPING
FEAR OF FALLING
MEDICATION AND ITS EFFECTS ON FALLING
HEARING AND BALANCE
RECOGNIZING RISK FACTORS
WHAT ARE THE BENEFITS/RISKS OF ASSISTIVE DEVICES?
WHAT ASPECTS OF FOOTWEAR ARE IMPORTANT TO CONSIDER?
ACTIVITY-BASED MOVEMENT
SAFE MOVEMENT ACTIVITIES
"INTERDEPENDENCE"
MIND BODY SOCIAL SPIRITUAL - COMING FULL CIRCLE CONCLUSION

The Training Manual will be completed by January 2003. NIICHRO will hold a "Train the Trainers" session using the Coming Full Circle Training in April of 2003. CHRs will be trained using the Coming Full Circle Training at the Annual General Meeting in Ottawa in June 2003.