Health Promotion Strategies: Long Term Care

Care at home by family and friends is preferred by Alaska Native elders for cultural, social, and economic reasons. Some Alaska Native communities are creating community-based home care programs while others negotiate partnerships with existing home care and continuing care facilities.


When a nursing home placement is necessary, the staff needs to include in the care plan opportunities for the elder to interact with the local community such as local Native groups or non-Native groups for cultural, social, and learning activities. It is important to prevent cultural isolation. Support for the spiritual/religious beliefs of the elder and the family may include allowing time for ceremonial dancing, singing, praying, and/or storytelling. In some villages, there are trained members of the Alaska Native community who can assist elders and their families with tasks in their homes. This may be a paid service or a community service to honor and respect the elder. It has been a tradition in Alaska Native families to help older Alaska Natives when they require assistance. However, it is becoming more difficult for Natives to act on this cultural value because of the numerous demands on their time and resources. In these cases, there are several services available in regional communities that can assist with the care giving of older individuals.

Therapeutic Cultural Environment

Day care, residential, and nursing homes can be rendered culturally friendly with ethnically appropriate food which is found to be important for health and healing of older Alaska Natives. Subsistence food may be provided at holiday celebrations or fruit and vegetables specific to the seasons.

Certain colors and images that tell stories of hunting, fishing, birth, marriage, or seasonal events may be displayed on walls, furniture fabric, bed covers, etc. Traditional Native clothes may be offered to elders to wear at meal times, or the family may be encouraged to bring them to the nursing home or hospital. Story telling circle in the Native language with an English translator may enhance cognitive function for elders with dementia. Providers can collaborate with a “culture guide” such as local Alaska Native groups to design culturally acceptable activities and décor for various types of long-term care environments.