Communication: Verbal and Non-Verbal
Alaska Native older adults will easily pick up on uninterested, unfocused, and preoccupied caregivers. Calming your thoughts and emotions can enhance the quality of the interaction with the Alaska Native elders who often use traditional medicines in addition to Western medicine but will not disclose this if they suspect the caregivers are not respectful of these practices. Healthcare workers who are sensitive and diplomatic with regards to the use of traditional medicines can establish trust and rapport with the older adults.
There are twenty-two different Alaska Native languages. Ascertain the elder’s proficiency with the English language. The tables on cross communication in Section III, Culturally Appropriate Geriatric Care: Fund of Knowledge provide examples of communication patterns that may help the non-Alaska Native, English speaking provider appreciate the complexity of the communication process among various tribal communities. Because of the scarcity of trained interpreters in these languages a family member or friend may step into this role when it is needed. In this situation, it is advisable to have an adult in this role.
Pace of Conversation
An Alaska Native elder may speak with a specific cadence which may require a healthcare provider to slow down. Matching the provider’s conversational pace with that of the older adults is critical to the flow of information and to building trust and rapport. Allow the older adult individual ample time to express themselves without interruptions. Health care workers should listen more than talk, giving the older adult individual total attention.
Language and Literacy Assessment
Assess the language(s) spoken, especially the language the Alaska Native older adult uses to learn new information. There is much diversity in the indigenous languages in Alaska, although only 5.2% of Alaskans speak one of the twenty-two languages. Many Alaska Natives reside in remote villages and communities which poses major challenges to providing health information in a timely manner. While the boarding schools may have provided access to formal basic education, being informed about health matters occur mostly through the Village Health Aide or by word of mouth. Many rural Alaska Native older adults do not speak English fluently and some do not speak English at all. The older adults often speak indirectly, in metaphors and stories that could be mistaken for lack of understanding of the information received. Assess the literacy level to determine the most useful approach to talking about health care issues such as use of metaphor, story telling, illustrations, etc.
When some Alaska Native older adults nod their heads they are indicating that they hear what is being said, and when they raise their eyebrows, they are indicating that they agree. They may furrow their brow to indicate they disagree with what is being said, and when they sigh they are communicating that they are bored. When they hold their arms tight to their body they are communicating that they want to maintain a distance, and when they avoid eye contact they are indicating respect for the person.
Because health care providers are held in high regard, it is customary not to look directly at them while listening intently to what they are saying. This practice comes from the belief that health care providers have the gift of healing.