Dr. John Saari of IHS is requesting articles for the May issue of the IHS Primary Care Provider, which is the annual Elders issue. This is a great forum for sharing what Tribal organizations are doing for elders, or having elders themselves write from their perspective. Historically, both technical and research articles have been included, as well as programmatic and the story of Faye, the first enrollee in Cherokee PACE. 

The National Indigenous Elder Justice Initiative (NIEJI) was created to address the lack of culturally appropriate information and community education materials on elder abuse, neglect and exploitation in Indian Country. Some of the undertakings of the initiative will include:

• establish a resource center on elder abuse to assist tribes in addressing indigenous elder abuse, neglect, and exploitation
• identify and make available existing literature, resources and tribal codes that address indigenous elder abuse
• develop and disseminate culturally appropriate and responsive resources for use by tribes, care providers, law enforcement and other stakeholders.

Save the Date Conference Invitation

for the 2012 American Indian and Alaska Native Long Term Services and Supports Conference

FOR IMMEDIATE RELEASE
Thursday, December 22, 2011

Contact: HHS Press Office
(202) 690-6343

HHS releases more than $845 million to states to help low-income households with energy costs

More than $845 million is being released today by the U.S. Department of Health and Human Services (HHS) to states to help low-income households with their heating and home energy costs under the Low Income Home Energy Assistance Program (LIHEAP). The continuing resolution currently in place allows HHS to release these funds to states, territories, tribes and the District of Columbia.

“Even as the economy shows signs of improvement, many Americans are struggling to make ends meet,” said George Sheldon, HHS acting assistant secretary for children and families. “We are making funds available today to help vulnerable families and seniors pay their heating bills and stay warm during this holiday season and into early 2012.”

LIHEAP assists low-income households, including families with children and seniors, with their home energy needs such as heating in the winter, cooling their homes in the summer, and insulating their homes to make them more energy efficient and reduce their energy costs. The $845 million in block grant funds released today is in addition to the $1.7 billion released to states since October 2011. Including the funds released today, states will have received a total of $2.581 billion in LIHEAP block funds for Fiscal Year 2012.

“There are low-income families, children and seniors across the country that need help paying to heat their homes,” said Jeannie Chaffin, director for the Office of Community Services. “We recognize the importance of getting these funds out quickly so that families can get the help they need during the winter.”

For a complete list of additional funds available to states today please visit: http://www.acf.hhs.gov/news/press/2011/2012LIHEAP845K.html

Individuals interested in applying for energy assistance should contact their local/state LIHEAP agency. For more information, go to: http://www.acf.hhs.gov/programs/ocs/liheap or http://www.acf.hhs.gov/programs/ocs/liheap/brochure/brochure.html.

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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news
 

Corporation for National Community and Services (CNCS) is currently seeking External Peer Reviewers for the 2012 Grant Competition. Please click here to obtain more information or go to go to the Become a Review Participant website to learn more about the application process.

More than 4 million people in the United States identify themselves as either American Indian or Alaska Native (AI/AN), a diverse group of people who come from more than 500 tribes. Access to quality health care by AI/AN is often compromised by poverty, lack of health insurance, and the fact that many live in isolated regions. Although as a group, AI/AN have a lower incidence of most types of cancer than non-Hispanic white Americans, they are more likely to be diagnosed with late-stage disease, and their cancer survival is generally poorer than that of other groups. Yet despite this burden, their access to palliative care, hospice, and end-of-life services lags behind the rest of the nation.

The AI/AN populations need these services not only for cancer patients, but also for patients with other diseases that are more common in the AI/AN population than the white population—diseases such as diabetes, tuberculosis, pneumonia and influenza, and gastrointestinal and heart conditions.

“Palliative care and end-of-life services are poorly available yet critically needed,” said Dr. Judith Salmon Kaur, a Choctaw/Cherokee who is the medical director for the Mayo Clinic Hospice and for the Native American Programs of the Mayo Comprehensive Cancer Center. For a dozen years, a number of partners and collaborators have been working on an educational approach designed, Dr. Kaur said, “to bring these services to people who often face desperate situations with limited resources, options, and hope.”

Developing Trust, Awareness, and Respect

“Each tribe has unique traditions, customs, and beliefs,” explained Dr. Kaur, “and within each tribe both families and individuals may interpret these differently, especially as they confront issues of mortality.”  She said that a number of studies have reaffirmed the critical role of cultural sensitivity, understanding, and consideration in devising successful palliative care programs for American Indians and Alaska Natives.

Researchers have found that it is important to develop trust in order to establish a successful palliative care program. There is no shortcut. “You need to take time to learn the unique customs, religious beliefs, and practices of the people services are directed to.  This frame of culture will determine how patients and families receive information, make decisions, and try to find meaning and direction in the face of potentially life-limiting or end-of-life situations,” she said.

Awareness of how each patient and family may experience and open up to palliative and end-of-life care is a first principle, but there are themes that may cut across tribes and regions.

Hospice programs, which often encourage talking directly about death and dying, need to be sensitive to the fact that such direct discussion may be uncomfortable for many American Indians and Alaska Natives. It can sometimes be useful to develop a “code” for such communication. For example, in one hospice program, at the Fort Defiance Indian Hospital on the Navajo Nation in Arizona, the social workers devised a gentle, indirect statement that addresses advance directives, which patients and families can read and sign.

Patients receiving palliative care may prefer a hospital setting to their home, although preferably a hospital on tribal land. The challenge comes in trying to establish a setting that reflects their culture and creates an atmosphere in which they can die in peace and with dignity.

Training Trainers To Build the Programs

About half of all American Indians and Alaska Natives receive health care through the Indian Health Service (IHS), a government-funded program on 163 reservation and urban sites serving 332 tribes. In 2005, an NCI-funded study of IHS tribal health directors found that a majority of Native American communities were not receiving pain management services, advanced care planning, physical therapy, traditional medicine, bereavement support, care for the dying and hospice care.

Meanwhile, the National Cancer Institute had developed a comprehensive educational curriculum for health care providers, known as EPEC-O, or Education in Palliative and End-of-Life Care for Oncology. In 2006, the IHS and NCI partnered to modify EPEC-O to target the AI/AN population and to re-fashion it for use by an interdisciplinary team of health providers that includes physicians, nurses, social workers, chaplains, pharmacists, nursing assistants, and cultural liaisons. In 2007 and 2008, the partners provided three train-the-trainer seminars for 89 physicians and healthcare providers from IHS service units throughout Indian country.

The training has proved successful. Four out of five of those trained said they had used what they learned and incorporated these palliative care principles into their practice settings. About half were planning to train others, and more than half had started new palliative services, such as consultations about advance planning, grief and loss, pain management, and palliative services—often recruiting interdisciplinary teams of care providers from within their health centers to deliver these services.  The program has even been enhanced by specific hands-on training at the Mayo Clinic in Rochester, MN, with development of an “intensive case-based palliative care program.”

The CD-ROM and DVD for EPEC-O with American Indian and Alaska Native Cultural Considerations is available from NCI. November is National American Indian and Alaska Native Heritage Month. NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI web site at www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). More articles and videos in the culturally relevant Lifelines series are available at www.cancer.gov/lifelines.

Read more:http://indiancountrytodaymedianetwork.com/2011/11/21/a-look-at-end-of-life-care-issues-for-native-americans-63942 http://indiancountrytodaymedianetwork.com/2011/11/21/a-look-at-end-of-life-care-issues-for-native-americans-63942#ixzz1eO3y1v4a

AoA welcomes Ms. Cynthia LaCounte as the new Director for the Office for American Indian, Alaskan Native and Native Hawaiian Programs. She will begin her new position mid-January 2012. What a wonderful way to start the New Year!

Ms. LaCounte has over 34 years of experience working with Tribes and Tribal aging programs, and she has a strong background in the needs of Tribal elders and their caregivers in the delivery of services in Indian Country. She started her career in the field of aging in 1977 where she worked as an Area Agency on Aging Director for their Tribal Elders Program in Fort Belknap, MT. In 1981, she was the Aging Programs Coordinator at the Great Lakes Inter-Tribal Council in Wisconsin working with 11 Wisconsin reservations providing assistance to Tribes to include program development, management training, and technical assistance. From 1992 to 1999, Ms. LaCounte worked at the Trenton Indian Service Area as a Community Health Representative/Aging and Transportation Programs Coordinator. She was then elected as the Trenton Indian Service Area Chairperson/Administrative Officer in 2001 and served in this capacity until 2005. Also in 2005, Ms. LaCounte was selected as one of ten Indian Delegates for the White House Conference on Aging. Currently, she serves as a Program Manager at Kauffman & Associates, Inc. (KAI) for our AoA contract to provide assistance with Title VI grantees nationally. She is also currently on the steering committee of the National Resource Center for American Indian, Alaska Native and Native Hawaiians through the University of North Dakota, on the Advisory Committee for the Elder Care Locator through n4a, and on the Northern Plains Tribal Chairman’s Association Epidemiology Center Advisory Committee.

Again, we welcome Ms. LaCounte and look forward to working with her in the years to come.

Hello Friends and Family,

• Be registered in the CCR prior to submitting an application;
• Maintain an active CCR registration with current information at all times during which it has an active Federal award or an application under consideration by an agency; and
• Provide its DUNS number in each application or plan it submits to the agency. CCR registration must be updated annually and can take up to one month to complete, so complete the registration as soon as possible to avoid possible delays!

Grants are now available through the National Institutes of Health to develop, adapt, and test the effectiveness of health promotion and disease prevention interventions in Native American (NA) populations. http://grants.nih.gov/grants/guide/pa-files/PAR-11-346.html

Title VI grantees have the option of using some portion of their Native American Caregiver Support Program funds to provide respite and supplemental services to grandparents and relative caregivers.  

 On August 23, 2011, the Administration on Aging announced that $761,000 were awarded to two National Center on Elder Abuse Grantees.

Through a network of community resources providers, this program helps caregivers on Montana’s Blackfeet Reservation find resources and referrals, and provides caregivers training, talking circles, health and wellness information and cultural awareness. In developing the program, the Title VI program used the Medicine Wheel as a guide and adapted the National Family Caregiver Support model to the culture and traditions of the Blackfeet. The Medicine Wheel is a traditional symbol of all things working endlessly together. The program offers respite services and two support groups. Grandparents Raising Grandchildren and Elder Family Caregivers.

The Tribal Law and Order Act which President Obama signed into law on July 29, 2010, works to promote and improve justice, safety and health within American Indian and Alaskan Native communities.  In particular, the law calls for the creation of the new office to coordinate alcohol and substance abuse efforts among the American Indian and Alaskan Native communities and federal agencies.   

The National Center on Senior Transportation and the National Rural Transit Assistance Program developed a report entitled, Crossing Great Divides: A Guide to Mobility Resources and Solutions in Indian Country.  This guide highlights the importance of mobility options for AI elders.

You may want to take a look at the guide by Clicking Here and see if you find it helpful.  Copies can be downloaded from the site.

The December issue of the The Rural Connection - The Quarterly Newsletter of VHA Office of Rural Health has been released. 

Click here for the full newsletter

Agriculture Secretary TomVilsack and Secretary of the Department of Health and Human Services (HHS) Kathleen Sebelius today announced the release of the 2010 Dietary Guidelines for Americans, the federal government's evidence-based nutritional guidance to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity.

Click here for more information

On February 1, the Department of Veterans Affairs launched a toll-free National Caregiver Support Line housed at the Canandaigua VA Medical Center campus in Canandaigua, New York. The toll-free number is 1-855-260-3274. This support line will serve as a primary resource/referral center to assist caregivers, Veterans and others seeking caregiver information to help in the care of our nation's veterans. Calls to The National Caregiver Support Line will be answered by VA employees who are licensed clinical social workers. The support line is also available to respond to inquiries about caregiver benefits associated with Public Law 111-163, Caregivers and Veterans Omnibus Health Services Act of 2010. 

The Year of the Family Caregiver November 2010 - November 2011 and marks the 10th Anniversary of the Native American Caregiver Support Program (NACSP). In Tribal communities, caregiving of one’s elders and grandchildren has always been part of the culture. For ten years, the Native American Caregiver Support Program has provided services to assist the unpaid, informal caregiver in caring for grandparents, parents, spouses and children who cannot care for themselves. 

The National Resource Center on Native American Aging, at the University of North Dakota, has compiled a current list of Tribal Elder Abuse Codes.  They have also added to their web site a listing of elder abuse resources such as fact sheets, organizations and model codes.  Please go to the link below to learn more. 

http://ruralhealth.und.edu/projects/nrcnaa/tribalcodes.php