It is important that enough time is allotted for discussing the contents of the document. Ideally, a health care provider who has rapport with the patient may be able to facilitate the decision-making process. The Alaska Native elder may prefer to consult with family members or a trusted member in the community before signing. To reduce anxiety over the process, verify whether a spokesperson for the elder is preferred. Towards the end of the interaction, ask the elder or spokesperson to summarize in his/her own words what was understood from the document. This approach may increase the elder’s trust on the health care provider. When possible, having a provider who is also an Alaska Native may help expedite the decision-making process.
For discussion on this topic, see End-of-Life Preferences. Death is accepted as a natural process of living. The Alaska Native elder recognizes there are preparatory tasks to be done such as passing on their knowledge and skills to the young. However, in this contemporary time, the younger generation’s acculturation process to mainstream culture and the pressure to mainstream themselves are perceived by many Alaska Native elders as a barrier to their ability to act on these tasks.