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Ethnogeriatrics

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Definition of Terms

American Indian

Many older American Indians prefer the term “Indian” to “Native American”, believing that anyone born in the United States is a “Native American”, and that the term “Indian” reflects the language used in treaties with the federal government.

There is no one legal definition for the term “Indian”. Courts have used a two part definition for being Indian, in the absence of definition by Congress:

That the person must have some identifiable Indian ancestry
That the Indian community must recognize this person as an Indian

At the tribal level, each tribe determines the criteria for enrollment, and there is considerable concern about the dilution of Indian blood through intermarriage. The issues of being Indian, at an individual level, center around the artificially imposed concept of “blood quantum” levels – i.e. how much ancestry is needed to enroll in a given tribe; 1/2, 1/4, and 1/8 “Indian Blood” are fairly standard measures, but it varies from tribe to tribe. (The Cherokee Nation accepts anyone whose ancestor’s name appears on any one of several rolls, including the Dawes Roll. The Dawes Roll is a list drawn up by the federal government during the Allotment Era, of Indians receiving a 160-acre “allotment” of land as their portion of the Indian Territory in Oklahoma). The U.S. Census category includes anyone who self-identifies as “Indian.”
American Indian Elder

The term “elder” in the Indian community denotes a position of leadership, based on experience, spirituality, and community service, rather than on chronological age. There are elders in their 40s and 50s, and many Indian grandparents in their late 30s. Therefore, “elders” are distinguished from “old Indians” and the term “elderly” is used in many American Indian communities to denote those who are frail or not as healthy as others. In addition, Indian elders are considered those 55 years of age and older by most Indian Health Service agencies; however, many tribes consider 50 years of age and older, and Medicare and social security consider 65 years, to be the age of eligibility for benefits.
Indian Country

The term “Indian country” refers to all reservation lands (there are 278 federally recognized reservations), dependent Indian communities, and all-Indian allotments within the borders of the United States. In a social context, due to the geographic dispersment of American Indians to urban centers, with maintenance of strong ties to ancestral tribes and lands, “Indian Country” is also considered “a state of mind”. As Indians were not confined to “reservations” before contact with Europeans, many Indian people consider the entire United States to be Indian country, and continue to hold sacred many sites that are not on reservations or on tribally held lands (for example, the Black Hills area of South Dakota).
Euro-Americans

Refers to colonizing groups of non-Indians or non-Natives, who arrived from overcrowded European countries and created the myth of “discovery” to justify the claiming of Indian land. (Calloway, 1999, pp.67–98)
Tribal Sovereignty and the Unique Relationship
to the Federal Government

In general, states have no legal jurisdiction in Indian country, and therefore tribal and federal law govern in both criminal and civil cases. Divorce, inheritance, taxation, and contract disputes often get mired in this complicated legal system. The American Indian experience is different from other ethnic minority groups in that: 1) American Indian nations were colonized by Europeans and did not immigrate from other places within the last 700 years; 2) health care, education, and social programs were bought and paid for with ceded land by treaty; and 3) each elder is defined by the experience of the tribe (or tribes) to which he belongs (whether officially enrolled or not) and that tribe’s relationship with the federal government. The term tribal sovereignty refers to this unique relationship by which Indian tribes/nations maintain the right (by treaty) to negotiate directly with the federal government as independent nations.

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American Indian

  • Description
  • Learning Objectives
  • Introduction and Overview
    • Demographics
      • Overview
      • Geography
      • Living Arrangements
      • Tribal Groupings
      • Age Groups
    • Historical Influence
    • Self-Determination
    • Religion
    • Spirituality and Healing
    • Definition of Terms
  • Patterns of Health Risk
    • Data Quality
      • Mortality
        • Leading Causes of Death
      • Morbidity and Functional Status
        • Heart Disease and Diabetes
      • Mental Health

Culturally Appropriate Care

  • Fund of Knowledge
    • Cohort Analysis
      • Cohort Experiences
      • Case Studies for Discussion
    • Impact of Historical Events
    • Conflicting Expectations
  • Assessment
    • Respect and Rapport
    • Communication
    • Language Assesment
    • Assesment Domains
      • Client Background
      • Clinical Domains
      • Problem-Specific Information
      • Intervention-Specific Data
      • Outcome Criteria
  • Delivery of Care
    • Health Promotion Strategies
    • Treatment and Response
    • informed Consent
    • Surgery
    • Advance Directives
    • Medications
    • Chronic Pain Management
    • Dementia and Caregiving
    • End-of-life Care
    • Biomedical Vs Traditional

Access & Utilization

  • Needs Vs. Utilization
  • Managed Care

Learning Resources

  • Learning Activities
    • 1: Historical Events
      • B.C. to 1799
      • 1800 to 1849
      • 1850 to 1899
      • 1900 to 1949
      • 1953 to 1969: Policy of Termination and Relocation
      • 1970s
        • Short Answer/Essay Questions
      • 1980s to Present
    • 2: Cultural Values
    • 3: Case Study, Dementia
      • Discussion Questions
  • Instructional Strategies
  • Student Evaluation
    • Essay Question
    • Post Test
      • Multiple Choice
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