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 American Indian 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 (Hendrix, 1999).
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 American Indian elders.
