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1.

Recommendation for Action

*Federal funds should be made available directly to Indian tribes or organizations for the design, construction, and operation of these facilities on the local level.

Problem or Need

Nursing Homes and Alternatives

1.

*Nursing homes or sheltered care facilities are urgently needed by Indian people. However, due to present funding systems for such facilities, Indian people have very little chance to obtain these facilThe following examples pinpoint ities.

some specific problem areas.

*(a) Some states refuse to license nursing
homes on reservations due to a question
of jurisdiction and at the same time Fed-
eral funds will not be authorized unless
the facility is licensed by the State.

*(b) Hill-Burton Funds are only made available to States for these projects. The States in turn establish advisory groups which dictate the use of such funds. Most advisory groups are composed of urban non-Indians with little or no sympathy for Indian projects, thereby making nursing homes or sheltered care facilities almost impossible to obtain by Indian people.

Indicates statement

or recommendation submitted at the 1971 White House Conference on Aging the 1976 National Indian Conference on Aging. and reaffirmed at

NATIONAL INDIAN CONFERENCE ON AGING - 1976

Subject:

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Personal Environment

Problem or Need
Nursing Homes and Alternatives (continued)

Some elderly Indian people live alone and
are too incapacitated to live in existing
private dwellings regardless of whether the
home is adequate and modernized. Existing
nursing homes and related facilities have
not taken into consideration the social
and emotional needs of the Indian people.

*Indian Health Services are not governed by State regulations, and nursing homes or sheltered care facilities are similar in nature to Indian Health Service Hospitals.

This

Many Indian elderly suffer emotional
shock in nursing homes far from their
familiar environment and integrated with
patients from other ethnic groups.
often accelerates health problems and
may lead to premature death due to a
feeling of isolation from loved ones
who are too far away to pay regular visits.
(Aged Indians often state that they

"want to die at home"!)

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Recommendation for Action

*(a) That on-site paraprofessional service staff be made available to assist the elderly Indian.

*(b) That sufficient funds be provided for adequate ing homes. care for Indian individuals in custodial or nurs

tained for elderly care. *(c) A system of advocacy be established and main

*Indian nursing homes or sheltered care facilities on reservations should not have any State controls imposed on them, but Federal regulations should govern these facilities similar to the Indian Health Service Hospitals.

Nursing homes must be established on the individual reservations or at least in close proximity, staffed by Indians with a local cultural background.

*Indicates statement or recommendation submitted at the 1971 White House Conference on Aging

and reaffirmed at the 1976 National Indian Conference on Aging.

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Nursing Homes and Alternatives (continued)

5.

Increasingly, more Indian elderly are being left alone in their homes without being fed or cared for and without access to emergency services.

5.

A system of advocacy for elderly in need of special services must be established and maintained.

(a) For those elderly persons who are well enough to remain in their own homes,

should be provided as follows:

(1) shopping services

(2) house cleaning

(3) laundry

homemaker services

(b) They should also be included in

(1) visits by home health aides

(or Community Health Representatives) (2) congregate feeding programs

or "Meals on Wheels"

(3) Escort service to medical and other services

(4) reassurance and protection through contacts by tribal

or project staff and regular (tribal) police patrols

(5) telephone service where available

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Mileage allowances must be realistic in relation vide comprehensive outreach. to actual distances which must be covered to pro

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Day Care Centers (including 24-hour care as needed) under the administration of Indian tribes or organizations must be made available and accessible to the Indian elderly in their local areas. Multi-purpose Indian Senior Citizen Centers should be established in Indian communities and staffed to provide comprehensive services.

6.

Mileage allowances for outreach staff are often insufficient to reach every home. Geographic distances and isolation on Indian reservations are frequently not understood in Washington.

6.

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Housing

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*(a) A large percentage of elderly Indian
people do not have sufficient income to
cover housing and utility costs of exist-
ing programs along with the other neces-
sities of life.

(b)

Indian elders on a fixed income
(Social Security and Supplemental Security
Income) can't meet rise in rents and some
have to pay back-rent for several years.

*Indian Senior Citizens have too little to
say about the design, location, and con-
struction of their homes and other types
of living facilities.

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*That program policies governing housing not be re-
strictive but adaptable to the elderly housing
needs and the financial condition of individual
Indian people and, wherever necessary, no cost
housing should be provided.

*(a) That full local participation of elderly
individuals and organizations be assured in the
designing, location, and construction of elderly
Indian Housing projects.

*(b) That all organizations dealing with elderly
Indian projects have adequate representation of
elderly Indians on their decision-making boards.
*(c) Changes in Indian housing policy should not
be accomplished without consultation with Indian
people.

(d) Housing should be designed to preserve the
Indian heritage and architecture.

* Indicates statement

or

and

the 1971 White House Conference on Aging recommendation submitted at on Aging. Conference Indian 1976 National the reaffirmed at

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