Part One, Section E: Family First in Indian Country
Family and community is of great importance among American Indian and Alaska Native people. The original Savvy training document included family issues as part of Class Session 6. We include a section about family here, before Class Session 1, because family issues are inseparable when it comes to caregiving in Indian Country.
Use the following “Headlines” about family as important points for you to consider as a Savvy trainer in order to put caregiving in the context of the American Indian and Alaska Native family. You may (1.) become familiar with these points so that you can put them into your discussions and teachings to caregivers, and (2.) you may also share these points directly with them.
Role of the Native Family in Caregiving to Elders with Memory and Thinking Loss
Elders with memory and thinking loss do not have a pill that will cure their problems. But, experienced and well-trained caregivers know that people are the best medicine! Caregivers dispense love, concern, security, a familiar place, familiar people, and constantly wrap the elder in a blanket of assurance that they will be given the honor they deserve.
Caregiving at home is long, hard work for a long-term disease. Families can be very helpful in spreading-out the hard work so that one person does not get burned-out. Families who help each other with caregiving to an elder may often find that it strengthens bonds that hold the family together. Caregiving is another way of honoring elders.
The family approach to caregiving can have stresses, too. Sometimes a family member may think that they are doing most of the hard work. That may be true. One thing to do if this happens is to say that more help is needed. That is, communicate in a compassionate way so that others will respond well. Families often have young adults and teenagers that can help with caregiving and learn important life lessons.
American Indian and Alaska Native families often have life practices that cut across age groups and tie the generations together. The example of grandparents serving as parents to their grandchildren is frequent in Indian Country. This type of caregiving is “intergenerational.”
Intergenerational caregiving can also apply when grandchildren provide care to their elder grandparents. This is a type of “role reversal” that can be very appropriate and helpful. The family today is more likely to have several generations alive at one time than ever before because people are living longer now. Younger people can experience caregiving as a way to honor their elder loved-one.
American Indian and Alaska Native families often have family members living nearby. Reservation communities, trust land patterns, and sharing land and housing space contributes to this pattern. This way of life helps to make family caregiving more likely than if family members were far away. Some families can share caregiving so completely that the elder has “24-7” caregiving coverage.
Small Communities as Caregiver Partners
American Indian and Alaska Native people often live in small communities. One benefit is that many people know each other. Families coping with an elder with memory loss and thinking problems are often well-known in the community. If the elder is seen outside the home and is distressed, most people will know exactly who they are and where they live. Assisting the elder to return to a safe place can be done by taking them there if the elder is accepting or getting in touch with the elder’s family members who can then correct the problem. In this way, community members can be caregivers, too.
Spiritual Element Present
Spirituality can be a source of strength for caregivers. All across Indian Country there are many ways of spiritual belief and practice. If caregivers are comfortable with discussing spirituality, let it be an important part of of nurturing caregivers and elders with dementia. There may also be American Indian and Alaska Native families that keep to older beliefs of their tribe, too. They may believe the elder’s changed way of being is a sign that they are communicating with the “other side” or preparing to go to the “other side.” Such beliefs can be a more positive way of understanding the changes that are taking place with the elder. Caregivers may see themselves as involved in a much larger life experience than the ordinary tasks of caregiving alone.
Teach Family, Friends, and Other Community Members
No one is born knowing about the facts of dementia. Tell your caregivers that they will learn many things in this Savvy caregiving course. Tell them to share their new knowledge with others. They will be glad to understand what is happening to the elder and feel more motivated to be helpful in the caregiving process, even if it is just to teach their family and friends the facts of memory and thinking losses. To help your caregivers to get started discussing and answering questions about dementia for your family and friends, the next page can be removed and given to caregivers as an informational handout.
For Our Family, Friends, and Community: Some Facts about Memory and Thinking Loss for Natives
American Indians and Alaska Natives have always respected their elders. This is more important now than ever before. More and more American Indians and Alaska Natives are living into old age. This means many good things for families. It also means living into the ages in which some elders appear confused and forgetful. Some people believe that the odd behavior is due to the elder preparing for another world.
Also, medical doctors may consider confusion and forgetfulness as signs of possible dementia. Either way, family and friends want to be sure that their elders are feeling comfortable and secure. Many native people combine expert advice of traditional healers and medical doctors to find out if their elder’s confusion and forgetfulness is caused by problems that can be cured or treated from both ways of healing. In order to provide the best possible care for the elder, you as a friend and community member should:
- Keep a calm spirit yourself and among your family and friends.
- Listen to the elder talk of days gone by, their history, and recollections.
- Keep the elder safe from harm while still assisting them to do as much for themselves as possible.
- Make sure the elder eats properly and regularly and uses Title III and VI nutrition programs of the Older Americans Act.
- Make sure the elder is healthy in all ways, mind, body and spirit.
- Try to understand if the elder’s odd talk may simply be a different way of telling you that he or she is hungry, in pain, or lonely.
- Determine if a pet would work as an additional source of comfort to the elder, even if others had to help with the pet’s feeding and health.
- Show respect for yourself by keeping yourself healthy. That way you will be able to provide help for your elder loved-one or friend as long as possible.
- As the circle of life continues its march, show respect for your elders in the community by caring for them when they are dependent.
- Above all, show them that you love them. This can never be overdone, especially when the elder is forgetful and confused.