Full version Native American A Cultural Diversity

Native American A Cultural Diversity

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Category: Miscellaneous

Autor: reviewessays 01 March 2011

Words: 1363 | Pages: 6

The American Indian is a very unique and integral part of Amreican history,with a very rich and beautiful cultural background.There are over 558 federally recognized tribes in America right now,and another 126 who have applied for federal recognition.At the time of first contact with Europeans, the United states was fully occupied by Indian Nations and some 300 Indian languages existed,approximately 106 of which are still spoken.The diversity and hetrogeneity of the American Indian community cannot be overstated.

According to the 2000 Census there are 4.1 million people who identify themselves as Ameican Indian (either alone or in combination with other races)in the United States.About half the of the Indian population 60 years and older lived 5 states in 2000:Olahoma(18%),California

(13%),Arizona(9%),NewMexico(9%),and North Carolina(5%).The other states with a large number of American Indian elderly are Alaska, New York, Texas, Washington, and Michigan. The 2000 census identified 27% of AI/AN women, and 18% of AI/AN men, age 60 and over, living alone.Also there are now more people who identify themselves as Indian in urban areas (62%)than on reservations and other rural areas, according to the 2000 Census. In this urban Indianism, individuals from many different tribal backgrounds band together to preserve their cultural heritage and develop culturally relevant services, programs and activities(this is referred to as Pan-Indianism) .The 2000 Census also indicated that: 84% of American Indian elders reported income of less than $20,000( the highest percentage of any ethnic group) ,19% of American Indian elders receive Supplemental Security Income (SSI), (also proportionately higher than any other ethnic group), one in ten American Indian elders reports some mobility limitation but not self-care limitation; one in five American Indian elders lives in housing without a telephone; and one in every eight American Indian elders received less than a fifth grade education .

The lives of today's Indian elders are likely to have been influenced by the history of oppression, repression, intergenerational anger, and intergenerational grief, experienced since North America was colonized by Europeans.The extermination of tradition,the broken treaties, the forced marches of the 18th and 19th centuries were all part of the context of the world and family experiences in which many spent their childhood.Also there were specific events that made dramatic impacts on individual lives. One of the most powerful influences was that of the Indian boarding schools(see handout). Many boarding school graduates and their descendents are Christian, since the boarding schools were run predominantly by Christian missionaries.Therefore, the Christian denomination of the region may still be the religion of preference for many Indian families, and denominational support is often solicited at the time of family crisis or serious illness .A survey conducted by the Indian community in 2002 indicated that 35% of the adult Indian respondents considered themselves "Christian", 27% stated that they followed both traditional American Indian and Christian religion, and 16% stated that they followed only an Indian religion; 22% are unknown .

Spiritual belief is a pervasive aspect of Indian culture, although belief systems vary widely between tribes/nations and geographic areas. Most Indian traditions teach that the "interconnectedness" of all things leads to a relationship between man, Creator/God, fellow man, and nature. In many Indian traditions, healing, spiritual belief or power, and community were not separated, and often the entire community was involved in a healing ceremony and in maintaining the power of Indian "medicine." (The term "medicine" is often used to denote actions, traditions, ceremony, remedies, or other forms of prayer or honoring the sacred)In some tribes/nations causes of illness were considered to be an "imbalance" between the spiritual, mental, physical, and social interactions of the individual and his family or clan.Healing is considered sacred work and in many Indian traditions cannot be effective without considering the spiritual aspect of the individual. Many contemporary Indians use "white man's medicine" to treat "white man's diseases." For example, diabetes, cancer, and gallbladder disease, and use Indian medicine to treat Indian problems (pain, disturbed family relationships resulting in physical symptoms, or sicknesses of the spirit, which may include mental illness and alcoholism).In addition, many Western pharmaceuticals were actually based on Indian herbal medicines (for example, aspirin is derived from willow bark).

American Indian elders have lower rates of death than whites for the top four leading causes of death (heart diseases, malignant neoplasms, cerebrovascular diseases, and chronic obstructive lung disease), but higher death rates for all other causes of death.The 4 leading causes of deaths reported among older American Indians are for tuberculosis, diabetes, pneumonia, and cirrhosis These causes of death have implications for the health care providers and educators, as most are preventable to some degree and could be addressed by culturally congruent intervention programs.American Indian males over 65 reported higher proportions of diabetes (1.5 times), gallbladder disease (1.4 times), and rheumatism (1.3 times) than older men in the general population. American Indian women over 65 had 2.4 times the rate of diabetes as older women in the general population. In comparison with all Americans, American Indians had a lower prevalence of cancer, but higher prevalence of diabetes and gallbladder disease.

Culturally appropriate interventions depend upon the elder's individual tribal affiliation, level of traditional beliefs, and acculturation to Western biomedical health care system. Most American Indians have had some exposure to allopathic medicine through Indian Health Service units, or care in urban clinics or military settings. Many older AI/AN exhibit a basic distrust of the Western health care system based on historical abuses and belief that this system is based on "greed" rather than care for the individual.It is important to again emphasize the importance of obtaining a detailed history in a respectful manner in order to understand as much of the tribal and cohort influence on the individual elder as possible, given the heterogeneity of responses among AI elders.

American Indian cultural standards are different from the non-Indian community.It has been said that one cannot understand the American Indian without developing an appreciation of the unique relationship between the Indian and the federal government. Historical events, such as attendance in Indian boarding schools experienced by a high percentage of the current cohort of older American Indians, play a very important role in their daily lives. As a colonized people, these events have become a way of defining who one is in place and time, as well as those who went before. Intergenerational grief and anger may be based on these events, as well as intergenerational acceptance and survival. The health care professional working with elderly AI/AN should have this information, but also not assume cultural knowledge or practice by the older AI/AN.

There are several key points to showing respect and establishing a rapport .Listening is valued over talking by most older AI; calmness and humility are valued over speed and self-assertion or directiveness. Avoiding the "invisible elder" syndrome, and asking for the elder's help in understanding the current situation and in planning the components of further care are important aspects of showing respect for the elder's experience. Questions should be adapted to age and acculturation level. It is important for the health care provider to slow down when communicating with an Indian elder, especially during initial encounters, and when explanations of treatments/medications/health care decisions are being given. Questions should be carefully framed to convey the message of caring, and not indicate idle curiosity about the culture or cultural practices. Physical distance: several feet is usual comfort zone,Eye Contact: not direct or only briefly direct, gaze may be directed over the shoulder,Emotional expressiveness: may be controlled, except for humor,Body movements: minimal,Touch: not usually acceptable except a handshake are all culturally apprpriate ways to act when dealing with a with AI/AN elders.

As a nursing professional there will only be a very few deeply cultural AI/AN elders that you will ever have as a patient,this is due to the fact that many of the Indian communities have their own Indian Health Care Systems,(or will travel great distances to utilize IHC services).Those Indian elders who have adapted to a more westernized culture are usually Christians(Catholic,Protestant),and the only nursing interventions with these patients would be disease specific.