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 Culture And Familiarity Matter To Elders

An Alaskan nursing home brings native traditions and cultural artifacts to its residents.

 

Native Alaskan resident
As the country faces a rapidly growing population of older adults, with a majority of them being ethnic minorities, the numbers requiring long term and post-acute care will also increase.
 
Recognizing this growing need among its own residents, the Denali Center in Fairbanks, Alaska, incorporates unique architectural style, plants, animals, and multigenerational interaction to bring a true sense of community to those who call it home.
 
Denali is an Eden Alternative site that operates from an elder-centered approach by identifying what is important to its residents, a majority of whom are Alaska Natives.

Honoring Culture

Alaska Natives have a strong connection to their cultural practices and traditions, and just because they are in a facility does not mean they should leave this part of themselves behind.

Denali management understands the importance of culture to its residents and has incorporated cultural activities into facility care as a way to honor the Alaska Native residents and make them feel more at home. The foundation of these activities came from knowing that honoring the culture of the Alaska Native residents is important to their health and well-being and realizing the importance of establishing and building rapport before providing care.
Native Alaskan culture
The communication patterns of Alaska Natives are different; it takes time and patience to gain their trust to provide quality care, and the cultural activities have assisted in this process for both residents and staff.

Many of the activities at the center focus on Alaska Native culture, and the sharing of culture includes the following: traditional native music and dances; videos, such as village documentaries, celebrations, the World Eskimo-Indian Olympics (WEIO), and the Athabascan fiddle festivals; native news from villages, regional corporations, and Denakkanaaga (an Alaska native elders organization); traditional native foods, such as moose, caribou, salmon, dried meats, and berries; and participation in cultural activities in the community, such as WEIO, the Festival of Native Arts, potlatches (a gift-giving festival and primary economic system practiced by Alaska Natives), and the North American race.

The purpose of these cultural activities is to support residents in their transition to placement, nourish their bodies and souls, and to celebrate cultural wealth.

Listening to the residents, it became apparent that many of them miss home, family, native foods, and their familiar environment. One can imagine the challenges associated with moving from a home where they have lived all their lives to an unfamiliar facility. The inclusion of these activities is one way to ease the transition and help the residents feel connected culturally, as well as provide them native foods and activities that previously brought them joy and pleasure.

The center incorporated these cultural activities with the aim of improving the health and well-being of the residents, but also to celebrate the cultural diversity that exists among the residents and across the state of Alaska.

The activities implemented at Denali incorporate various aspects of Alaska Native cultures familiar to the residents; they bring back memories of their families and communities and help them maintain their cultural identity.
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Residents Respond Positively

As testimony to the importance and benefit of these activities for the center, residents have expressed their appreciation with the following quotes: “I really enjoy the food they serve. It is just like I had growing up.” “I like dried meat mixed with fat and moose or caribou on the bone so I can have the marrow.” “I feel like I was at a real native meeting. It always feels like we are family.”

One resident summarized the feelings of the native residents: “I really like the activities; it reminds me of back home.”
Native Alaskan culture
The center began incorporating these activities because it recognized that the loss of culture and community ties increases isolation, boredom, and grief.

Based on testimony from the Alaska Native residents, the response to these well-attended activities has been positive. Providing these cultural activities has increased satisfaction with placement; increased involvement in the activities, including participation in local events and sharing stories and recipes; and strengthened relationships between residents, family, and staff.

The family members of these residents are also happy with their loved ones’ involvement in the activities; they no longer view their family members as sick and dependent, but as active and healthy.

In addition to improving their health, the support for these activities is positive because they are low cost and provided by the residents, family members, and community, which highlights the generosity of the community.

Denali is supported in the provision of these services as a majority of them are donated, in both money and time, and the activities department and residents council also fund some activities.

Throughout the year, family and community donate food, such as moose, caribou, duck, salmon, whitefish, muskrat, beaver, and berries.

The residents receive newsletters from regional native corporations, and the native videos are either purchased or donated to keep the residents abreast of tribal news, politics, and celebrations in their respective regions.
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Visits Home Boost Satisfaction

As a skilled nursing facility, Denali is home to elders who cannot live at home by themselves and require some type of nursing care. The Leave of Absence program enables residents to return to their home communities for memorial potlatches, holiday events, family celebrations, tribal meetings, subsistence activities, or an extended weekend visit.

A volunteer or trained staff member who is able to attend to physical needs accompanies elders on their trips home. Being able to return to the village and participate in cultural events removes the stigma of being a “sick person” or patient, which is the dominant thought often associated with nursing homes or long term care facilities in urban Alaska. Airfare or gas money for some of these trips is usually provided by the elders themselves, and additional support has come from families, guardians, or a regional native corporation.

The story of “Jake” illustrates the importance of these trips and the reasoning behind Denali’s support of these events.

Jake was given the opportunity to go home to visit his family in a rural village in Interior Alaska. During the visit, his family was reminded of his physical limitations that his family could not provide for in the village, but they also saw that he appeared to be healthy and doing well.
aerial view of Alaska
Jake enjoyed his visit home, as did his family, but they realized he needed more care than they could provide and understood he had to return to the center.

According to the social worker who coordinated the visit, Denali staff saw the joy this visit brought to Jake and realized the value in this particular activity, which continues to this day.

Today, the traditional foods have now become full meals on a weekly basis for the residents and are fully embraced and accepted by Denali staff. These activities started with a vision and have become a fully supported and respected program that has benefited numerous residents, families, and staff.

Denali is one example of a nursing home that sees firsthand the benefits and importance of integrating cultural activities and traditional foods.

It is the hope of the center that it can serve as an example of how long term care and skilled nursing facilities can incorporate cultural activities for the residents that will improve their quality of life and honor their cultural identity, language, values, and customs.
 
Jordan Lewis, PhD, MSW, is Aleut and a postdoctoral fellow at the University of Washington School of Medicine. He can be reached at: (907) 328-8984 or dr.jordan.lewis@gmail.com. Don Thibedeau is the Denali Center social worker. He can be reached at: (907) 458-5166 or Don.Thibedeau@bannerhealth.com.
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