Traditional values and roles of elders need to be incorporated into program designs
In planning the forum, the American Indian Research and Policy Institute sought to shed light on the struggles and needs of American Indian elders. Research staff studied the existing literature, slim as it was, and prepared summaries of seven areas where elders had pressing needs and were significantly underserved. These areas included transportation, housing, elder abuse, mental health, nutrition, health care services and long-term care. The forum was to provide elders an opportunity to discuss these issues.
However, in a preplanning meeting with a group of about 25 elders, they indicated that this was not how they wanted to approach the subject. The needs of elders can't be separated from the needs of the Indian community as a whole because of the critical roles elders play in Indian society.
While many programs for American Indian elderly are undertaken with the best of intentions, many of these programs exhibit two major flaws. First is the failure to consider traditional American Indian cultures and beliefs, and the second is a failure to consider the roles of elders.
The failure to consider traditional American Indian cultures and beliefs leads to an under-utilization of services because elders do not believe the programs are designed to meet their needs. Robert John, writing in the Journal of Minority Aging, echoes the concerns of many when he says that the single most important barrier to the realization of the goals of the Older Americans Act, which has specific provisions for meeting some of Indian elders needs, is the cultural ethnocentrism that pervades all aspects of the law. "The continued existence of this problem is all the more curious because Native Americans have repeatedly and forcefully stated the philosophical basis of their social organization and a desire to maintain their cultural integrity. This lack of understanding of Indian culture effectively diminishes the success to which the programs authorized by the Older Americans Act can aspire."
More and more, researchers are evaluating programs in light of how successfully they incorporate American Indian culture and beliefs. John Red Horse, a professor at the University of Minnesota in Duluth, has continually emphasized the importance of understanding Indian family structure and development before planning and implementing social service programs. Red Horse believes social service delivery should be grounded in two basic assumptions. First, an understanding of the characteristic structure among American Indian extended family systems. Second, the inseparable linkage that exists between family and culture, individual mental health and the sense of self that is derived from a historic culture transmitted through the family. Failure to understand these crucial links will lead to programs ill-suited to the needs of American Indian elderly.
The belief that traditional family relationships and cultural patterns can be incorporated into service delivery is not new. There have been many successful examples of programs focusing on integrating culture into service delivery. For example, several American Indian nursing homes have attempted to accommodate traditional family relationships in the care of elders. They do so by offering an open environment where the family is encouraged to visit. Such programs emphasize intergenerational contact and connection, believing both young and old have something to offer each other. Provision of a caring environment with attention to cultural beliefs and patterns makes it easier for elderly to live in nursing homes.
While there have been successful programs, they do not comprise the majority of programs offered to American Indians. A 1993 study conducted by the Minnesota Board on Aging found there are many gaps in providing culturally sensitive services to American Indian elderly. This cultural gap in service provision hinders full use of services.
Just as many programs fail to consider traditional values when developing programs for American Indian elders, so too do they forget to consider traditional roles elders play in American Indian society. To truly understand and integrate traditional American Indian family values into service delivery programs, there must be an understanding of the role of elders in family life.
Traditionally, elders are held in high esteem within family and tribe. Elders are important in caring for children, passing on traditions and culture, acting as religious and political advisors, promoting and encouraging cultural pride and identity among the young and instructing the young. The testimony of elders participating in the forum confirms the high value they place on traditional ways and being able to interact with younger Indians.
Recognition of these traditional roles can help explain cultural behaviors not found in many non-Indian communities. For example, a 1981 National Indian Council on Aging study found that 26 percent of elderly cared for at least one grandchild. This intergenerational contact and connection are more accepted and even expected in many cases. Failure to accept and respect the traditional family network not only threatens its existence, but also renders social services ineffective.
To fully comprehend the flaws with current programs and service delivery systems, the traditional roles of Indian elders must be addressed and incorporated into these programs. The concerns expressed by elders about language, traditional ways and intergenerational relationships should be used as catalysts to strengthen social programs and tribal governance. Non-Indians working in social policy development and service delivery areas have a responsibility to understand these issues if they intend to create and deliver effective programs. This means truly listening to elders and then finding ways to make the connections between programs for transportation services, housing and nutrition and American Indian traditions, community structures and the roles of elders.
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