Mary Kate Dennis

“It's Bad Around Here Now”: Tobacco, Alcohol and Other Drug Use Among American Indians Living on a Rural Reservation

Using data about members of a midwestern American Indian reservation in eight focus groups that were conducted like “talking circles,” the authors describe the participants’ (N = 49) views of the current use and abuse of tobacco, alcohol, and other drugs. Results indicate that the use of tobacco is pervasive; that the use of alcohol and other drugs, especially marijuana and oxycodone, are problems on this reservation because they are detrimental to health and well-being; and appropriate, available, and accessible treatment is scarce, nonexistent, or underfunded. Culturally sensitive substance abuse treatment and increased funding for treatment are major health issues for this population.

Service Provider Views of Oxycontin Use on an Indian Reservation: Traumatic Effects on the Tribal Community

This qualitative research study on a Great Lakes Indian reservation used semistructured interviews of American Indian (n = 8) and non-American Indian (n = 2) providers of behavioral and physical health services to elicit views of Oxycontin use. We gathered data on existing substance abuse services including accessibility, cultural appropriateness, service strengths and weaknesses, barriers to treatment, and treatment needs. Results indicated a high prevalence of the use of Oxycontin, with traumatic effects on families and the tribal community such that the providers were overburdened with their dual role as service providers and caretakers in their own community. Implications for social work practice are discussed.

Ethical Dilemmas Faced by Hospice Social Workers

Ethical decision making is critically important in hospice social work. Through in-depth interviews, researchers explored ethical dilemmas faced by 14 hospice social workers and the processes they used to move toward resolution. The dilemmas were integrated into a framework focused on the sources of ethical conflict: the client system, the agency, and the profession. Processes involved in resolving ethical dilemmas included consulting with other professionals, weighing the pros and cons of options, and bringing about desired outcomes. Findings suggest that hospice teams should be provided with opportunities to meaningfully discuss ethical decision making. Further, the involvement of social workers in administrative leadership is recommended to increase the likelihood that discipline-specific perspectives are incorporated into formal policies and procedures that shape practice in ethically complex situations.

“It’s a generosity loop”: Religious and spiritual motivations of volunteers who glean produce to reduce food insecurity

ABSTRACT Food insecurity is a common social issue and households look to assistance from food pantries, which often have difficulty supplying fresh or nutritious food. A substantial amount of produce is left in the fields, which can be collected through gleaning. In a focus group with volunteer gleaners at a faith-based nonprofit organization that attempts to fill the gaps of food insecurity, the motivations, challenges, and benefits of volunteering were examined. Volunteering in gleaning generated a sense of collective purpose and community; it addressed deeply held religious and spiritual impulses; and it puts volunteers directly in contact with nature.

Rearing Generations: Lakota Grandparents’ Commitment to Family and Community

Disproportionately, American Indian grandparents assume the responsibility of raising their grandchildren. Few studies have examined the experiences of American Indian grandparents living on reservations. Utilizing Indigenous Methodologies and exploratory, in-depth interviews with 25 Lakota elders living on the reservation. This study explored the realities of raising grandchildren including: reasons they began caring for their grandchildren, challenges they face, and they reveal the care and concern for the broader community’s grandchildren within the cultural and social context of the reservation.

American Indian elders share personal stories of alcohol use with younger tribal members

ABSTRACT In this Great Lakes Indian reservation qualitative study we utilized focus groups in the form of talking circles to elicit tribal members’ views of alcohol use. We report on how the elder participants utilized the talking circles to inform the youth of the deleterious effects of alcohol use and abuse. Indigenous research methods were utilized so elder tribal members were consulted about the study; an elder was hired as a research associate; youth were hired as note takers/observers; and the 2-hour groups were led by a tribal community member. Demographic data were gathered, and a semistructured guide with substance use questions was utilized. Tribal members, 30 females and 19 males, age 12 to 78 participated in 8 talking circles (N = 49). Tribal elders unexpectedly utilized the format as an opportunity for cross-generational storytelling to convey their own oral histories of the harmful effects of alcohol use for the younger participants. They shared personal pathways to quitting or to a reduction in drinking with messages aimed at preventing the youth from initiating drinking. A shortage of American Indian (AI) substance abuse treatment programs that are culturally relevant exists. The widespread and renewed use of cross-generational talking circles could serve as an inexpensive substance abuse prevention and intervention treatment modality for AI youth. The elders’ stories highlight the need to rejuvenate traditional methods of healing among AIs to reduce the initiation and/or harmful effects of overuse of alcohol among AI youth.

Ways of Grieving Among Ojibwe Elders: “They’re All Around Us. They’re Always.”

Death, grief, and loss are common experiences for many individuals who identify as American Indian/Alaska Native, yet decidedly little is known about the lived experience of grieving in this population. To address this gap in the literature, researchers conducted a qualitative descriptive study exploring ways of grieving among 20 elders residing on a North American Ojibwe reservation. Findings derived via thematic analysis illustrate the variety of ways these elders respond to death: living through it, responding in Western or non-Traditional ways, drawing comfort from spirituality, and grieving as a community. Implications for culturally appropriate grief support for AI individuals and communities are provided.

“Just Let Me Go”: End-of-Life Planning Among Ojibwe Elders

Purpose of the Study Although advance care planning (ACP) is designed to promote person-centered end-of-life care, the principles underpinning it are at odds with the values and norms of many American Indian/Alaska Native (AI/AN) communities, contributing to low rates of ACP among AI/AN elders. The purpose of this study was to explore the apparent tension between Western approaches to end-of-life care, including its emphasis on ACP, and the expectations and wishes of one community of AI elders, in hopes of informing more culturally appropriate approaches to planning for end-of-life care. Design and Methods About 20 tribal elders living on a Great Lakes reservation participated in semistructured, face-to-face interviews. Participants were recruited through convenience and snowball sampling techniques. The interviews were analyzed using an inductive thematic analysis approach. Results Despite seeing little need for ACP, the elders were generally open to discussing the care they would want at end of life. Many were readily able to describe their wishes for a peaceful death and had already developed funeral and burial or cremation plans. Although establishing ones individual legacy was not a salient end-of-life concern for the elders, several found meaning in describing their contributions to preserving their families, the community, and their cultural lifeways. Implications A lack of formal ACP within AI/AN communities does not necessarily reflect a cultural aversion to discussing preferences for end of life. Efforts to increase ACP in tribal communities would likely be enhanced by acknowledgment of the spiritual and cultural significance of death and dying for many AI/AN individuals.

An urban American Indian health clinic's response to a community needs assessment.

Utilizing community-based methods, we assessed the behavioral and physical health needs of a Detroit metropolitan Indian health clinic. The project goal was to identify health service needs for urban American Indians/Alaska Natives and develop the infrastructure for culturally competent and integrative behavioral and physical health care. We conducted 38 semi-structured interviews and 12 focus groups with service providers and community members. Interview and focus group data indicated a need for 1) more culturally competent services and providers, 2) more specialized health services, and 3) more transportation options. We then report on the Indian health clinics and communitys accomplishments in response to the needs assessment.