Lori L. Jervis

Historical Consciousness Among Two American Indian Tribes.

American Indians have endured numerous significant historical events, including epidemics, warfare, genocide, relocation, and for many, confinement to reservations. These events often are thought to be the root cause of contemporary physical and mental health problems within this population. Yet despite the presumed force of history in shaping their contemporary lives, there has been surprisingly little empirical examination of the extent to which Native people contemplate their history or understand it in relation to their present lives. This article explores attitudes toward and knowledge of significant historical events using a representative, community-based sample drawn from two tribes, one in the Northern Plains culture area and the other in the Southwest. Taken as a whole, findings suggest that the past continues to have meaning for contemporary American Indians and is related in important ways to identity and formal education.

American Indian Family Caregivers’ Experiences with Helping Elders

In recent years, a vast literature has accumulated on the negative effects on family caregivers of providing care to elders, while relatively little research has explored caregiving as a positive experience. Only a handful of studies have examined any aspect of informal caregiving among American Indians. This mixed methods study explores the negative and positive aspects of providing elder care among 19 northern plains American Indian family members. These caregivers described low levels of burden and high levels of reward, attributable to cultural attitudes toward elders and caregiving, collective care provision, strong reciprocal relationships with elders, enjoyment of elders, and relatively low levels of care provision. Caregiving manifested as part of a complex exchange of assistance rather than a unidirectional provision of assistance from the family member to the elder. That caregiving emerged as such an overwhelmingly positive experience in a community faced with poverty, alcohol disorders, trauma, and cultural traumatization is testimony to the important roles that elders often continue to play in these communities.

American Indians/Alaska natives and dementia

Although the Native elder population continues to expand, very little is known about how dementia of any kind affects this group. This article reviews what is and is not known about dementia among American Indians/Alaska Natives. Specifically, it examines prevalence, assessment and diagnosis, cultural understandings, family caregiving, formal services, and abuse/neglect. It concludes that much work remains to be done on dementia in the Native population, and suggests directions for future research.

Need for, Availability of, and Barriers to the Provision of Long-Term Care Services for Older American Indians

Based on a nationwide survey of 108 federally recognized American Indian communities, this paper describes the perceived need for and availability of long-term care services for older Natives who live in rural areas. Sources for the provision and funding of such services are identified, as are the barriers that prevent older American Indians from receiving services and tribes from offering them. Although the need for a wide variety of long-term care services was great, overall this need was only partially met. Many services were reported to be unavailable in Native communities. Bureaucratic requirements made services provision difficult and discouraged older American Indians and their families from using those services that were available.

Performance on the mini-mental state examination and mattis dementia rating scale among older american indians

Optimal methods for assessing cognitive impairment among older American Indians have not been established. This study sought to examine the cultural relevance and performance of two common cognitive screening measures, the Mini-Mental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS), in one American Indian population. One hundred forty American Indians ages 60 to 89 were assessed; nearly 11% scored more than 2 standard deviation points below performance expectations on the MMSE, as did 27% to 81% on the MDRS. Complex relationships were found between gender, health conditions (with possible effects on cognitive functioning), and MMSE and MDRS scores. The authors discuss implications and future directions.

Disillusionment, Faith, and Cultural Traumatization on a Northern Plains Reservation

Many American Indian people experience traumatization related to their postcolonial status that extends beyond the individual. This article explores experiences of cultural traumatization among 44 Northern Plains American Indians who were part of a population-based psychiatric epidemiological study. Of special interest were the ways in which cultural trauma was expressed in this communitys sociality and worldview (e.g., disillusionment with community leaders, grief about perceived culture loss) and the complex connections between traumatization at the level of the individual and the community. Spirituality/religion served as a primary means for reconnecting with traditional culture, which proved crucial in peoples attempts to cope with community traumatization. The uneasy coexistence of disillusionment, grief over culture loss, and faith cautions against embracing simplistic notions of Native reactions to cultural trauma.

Gut Microbiome Diversity among Cheyenne and Arapaho Individuals from Western Oklahoma

Existing studies characterizing gut microbiome variation in the United States suffer from population ascertainment biases, with individuals of American Indian ancestry being among the most underrepresented. Here, we describe the first gut microbiome diversity study of an American Indian community. We partnered with the Cheyenne and Arapaho (C&A), federally recognized American Indian tribes in Oklahoma, and compared gut microbiome diversity and metabolic function of C&A participants to individuals of non-native ancestry in Oklahoma (NNIs). While the C&A and NNI participants share microbiome features common to industrialized populations, the C&A participants had taxonomic profiles characterized by a reduced abundance of the anti-inflammatory bacterial genus Faecalibacterium, along with a fecal metabolite profile similar to dysbiotic states described for metabolic disorders. American Indians are known to be at elevated risk for metabolic disorders. While many aspects of this health disparity remain poorly understood, our results support the need to further study the microbiome as a contributing factor. As the field of microbiome research transitions to therapeutic interventions, it raises concerns that the continued exclusion and lack of participation of American Indian communities in these studies will further exacerbate health disparities. To increase momentum in fostering these much needed partnerships, it is essential that the scientific community actively engage in and recruit these vulnerable populations in basic research through a strategy that promotes mutual trust and understanding, as outlined in this study.

Assessment of elder mistreatment in two American Indian samples: psychometric characteristics of the HS-EAST and the Native Elder Life-Financial Exploitation and -Neglect measures.

Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empirical knowledge of this phenomenon among American Indians remains quite limited, especially with respect to measurement. The Shielding American Indian Elders (SAIE) Project used a collaborative approach to explore culturally informed measurement of elder mistreatment in two American Indian elder samples (a Northern Plains reservation and a South Central metropolitan area). The project sought to investigate the performance characteristics of the commonly used Hwalek-Sengstock Elder Abuse Screening Test (HS-EAST), as well as to examine the psychometric properties of a new measure developed to capture culturally salient aspects of mistreatment in American Indian contexts—the Native Elder Life Scale (NELS). Using methods and samples comparable to those in the literature, the HS-EAST performed adequately in these Native samples. The NELS also shows promise for use with this population and assesses different aspects of elder mistreatment than does the HS-EAST.

Aging, health, and the Indigenous people of North America.

Although the articles for this special issue on Native North American elders cover a diversearray of topics, approaches, and geographical areas, this issue was motivated by a singledesire: to gather together in one venue a collection of varied disciplinary approaches tocontemporary social and cultural research with older American Indian, Alaska Native, andFirst Nations people. These Native elders constitute a relatively small, but rapidly growing,population (John 1996). The importance of elders to Native communities, however, beliesthese small numbers. Elders have traditionally been leaders, keepers of history and culturalknowledge, and socializers of the younger generation (Red Horse 1983; Red Horse 1980;Weibel-Orlando 1989). In many communities, these roles continue, although they may bechallenged in the face of contemporary pressures. Despite elders’ symbolic and practicalimportance in many tribal communities, current empirical research with this group remainslimited. Indeed, there are many important elder-related topics that have received scantresearch attention, although they are of keen interest to communities themselves. Thisspecial issue is one step toward rectifying that discrepancy.Most of the manuscripts here were presented as part of the 2009 Association forAnthropology and Gerontology Annual Conference held at the University of Oklahoma.The theme of the meeting was “Aging and the Indigenous People of North America.” Theconference brought together a variety of scholars and researchers working in this area. Asdemonstrated below, much of the research currently being conducted focuses on healthissues. Given the many health disparities faced by Native people in general and olderNative people in particular (Dixon and Roubideaux 2001), it is not surprising that health-related issues are an especially pertinent aspect of the aging experience for Native elders.These disparities and systemic health system inadequacies may be further exacerbated whenWestern biomedical constructs come into conflict with indigenous illness conceptualiza-tions, potentially posing challenges for elders, traditional healers, and biomedically orientedhealth care practitioners (Kleinman 1980).Two articles in this special issue concentrate on Native elders’ perspectives on healthissues. Henderson focuses on an urgent problem in many Native communities, the diabetes

Nursing home satisfaction, biography, and the life worlds of psychiatrically disabled residents

Abstract The stereotype of nursing home life as a uniformly dismal experience is pervasive in American culture, but this examination of the attitudes of psychiatrically disabled residents calls this generality into question. Residents in this study exemplified a range of opinions about the nursing home — some were clearly satisfied or dissatisfied, but most were ambivalent. In this paper, I explore the relationship between nursing home satisfaction and individual interpretive activity through the biographies of three residents. I find that how residents made sense of their lives was powerfully linked to their perspectives on nursing home residence. In particular, satisfaction was linked to how each resident viewed his or her illness, institutionalization, and life purpose. Understanding the phenomenological contributors to the meaning of nursing home life is essential to appreciating how it is that residents in the same environment can have vastly different outlooks on their surroundings.