The purpose of this study was to involve Indian health professionals, Indians and non-Indians specializing in gerontology, and consumers, in a purposeful dialogue regarding the health problems and concerns of elderly Indians. The aim of the study was to benefit the elderly Indians who have often been left alone as their children leave the reservations. Ideas were presented which Tribes may elect to utilize in promoting quality long-term living for all Indian elderly. The ultimate goal is provision of quality living for all elderly Indians along a continuum of health and psychological needs. Two meetings were held in preparation of this paper, one was comprised of professionals, both Indian and non-Indian, to contribute ideas and the second involved Indian elders and potential consumers. This paper incorporates content from both meetings. This study concluded that there is a lack of consideration for the cultural needs of elderly Indians in terms of health care services. It is important that all organizations and agencies responsible for the health care of elderly Indians recognize the uniqueness of their patients. It is imperative that these organizations tie directly into the tribes' programs for meeting the needs of the elderly. There is also a need to work in collaboration with the individual and family in determining the needs of the patient. Conclusions: The recommendations of this study are: 1) there needs to be provisions for quality living for all elderly Indians with a continuum of health and psychological needs, while at the same time addressing the individual, community, reservation, and tribally identified needs; 2) individual tribes should review the range of services feasible, as a guide to deciding what is appropriate to address their needs; 3) combined homemaker-home health care programs can accommodate the cultural expectations and practices of the Indian communities; 4) needs of people confined to their dwellings should be considered; 5) changes in the individual over time need to be measured and the measurement standardized; 6) receipt of direct funding from the Federal government would enhance the tribe's capabilities for community programs; 7) provision of day care services is an important component of the long-term care continuum; 8) centers could run a variety of culture-specific programs and provide a place for the elders to teach tribal crafts, lore, language, etc. 9) tribes should be encouraged to construct, renovate and operate nursing homes on reservations; 10) training should be provided so that all administrators of services to the elderly, including family and tribal members, are involved from the planning stage through implementation and evaluation; 11) health workers need to be aware of tribal healing rituals; 12) a need to develop planning methodologies that can be used by Tribes to document their long-term needs; 13) consideration should be given to establishing an Indian gerontology research center.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-50).
Contract report on alternatives for planning a continuum of care for elderly American Indians. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-50). 1978