Author

Cole Allick

Date of Award

1-1-2023

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Indigenous Health

First Advisor

Donald Warne

Abstract

American Indian and Alaska Native (AI/AN) Elders are rapidly aging and are a growing segment of Indian Country. Elders are critical to knowledge dissemination and enable the resiliency of Indigenous peoples through their teachings, wisdom, and guidance. There is a dire need to better understand and prepare for this rapidly aging population given that reliable data is limited or simply nonexistent. This dissertation in practice utilizes a framework inspired by Indigenous teachings of the Medicine Wheel and from the social ecological model to address the literature gap regarding Elders and healthy aging. This framework was created with intention that each of the three required products would relate to the levels found within the social ecological model including the personal, relational, community, and societal levels so that this dissertation in practice would provide a systematic view of the topic at hand. For the first product, I utilized quantitative methods to examine perceptions of cognitive decline, cognitive evaluation, and long-term support service (LTSS) preferences among AI/AN Elders and community members. 50 participants attending a breakout session in support of this dissertation in practice at the 2021 National Indian Council on Aging (NICOA) Annual Meeting received a 19-item survey. Participants indicated a concern for cognitive decline, limited knowledge, and a desire for Tribally led LTSS. For the second product, I utilized qualitative methods to conduct a listening session with Elders and community members in another breakout session at the 2021 NICOA Annual Meeting. Through a thematic analysis, participants indicated important themes of intergenerational solidarity, community education, protection of Elders, services for Elders, and relationality. For the third product, I created a LTSS chapter for an Indigenous health policy textbook. Currently, there is no overarching resource that illustrates the complex LTSS landscape that Elders, caregivers, and communities must navigate. This product is an intentional step towards creating more resources for scholars and community advocates who are looking to make a positive change in LTSS for AI/AN Elders. Taken together, these products address the gap in scholarly literature and provide opportunities for future work.

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