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Alaska Native elders’ cultural beliefs, practices, and values: The case for culturally informed holistic dementia care
Author(s) -
Crouch Maria Christina,
Rosich Rosellen M
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.051895
Subject(s) - psychosocial , dementia , grounded theory , spirituality , psychology , photovoice , health care , reflexivity , gerontology , population , qualitative research , medicine , disease , sociology , psychiatry , social science , political science , alternative medicine , pathology , economics , economic growth , environmental health , law
Abstract Background Alaska Native (AN) people are projected to experience Alzheimer’s disease and related dementias at an increasingly high rate in comparison to other US races. However, due to colonization among AN tribes and the subsequent institutionalization of modern medicine , cultural practices and values that greatly impact holistic health and dementia care have been overshadowed and in some instances eradicated. Thus, more can be known about the psychosocial factors that have and can contribute to optimal dementia care for a population that experiences health disparities (e.g., heart disease, chronic lower respiratory diseases, cerebrovascular diseases) and barriers to care (e.g., language, rurality, access to resources). Method In order to understand precolonial and present cultural practices that comprise optimal dementia care for AN people, a grounded theory, exploratory study was conducted. Twelve semi‐structured interviews with AN Elders assessed the etiology, course, treatment, caregiving, and the culturally derived meanings of memory function, loss, decline, and disease. Result Qualitative analyses revealed eight culturally grounded and salient themes: 1) Traditional Knowledge Systems and Values; 2) Caregiving Networks; 3) Memory Function; 4) AN Spirituality; 5) Stories, Generative Sharing, and Healing; 6) Historical Change; 7) Connection, Communication, and Compassion; and 8) Assisted Living. These themes are best understood through AN lifecycle theory, which is a holistic representation of the culturally specific psychosocial protective factors, disease preventive, and caregiving practices that comprise an AN caregiving model. Conclusion This study highlights the overall themes of continuity, connectedness, spirituality, intergenerational transmission, history, and belief systems, which emerged as a result of investigating cultural practices that comprise optimal dementia care for AN people. The culturally adaptive and congruent representations that AN Elder’s utilize in understanding memory functioning, loss, decline, and disease (i.e., forms of dementia) both explain and transcend Western biomedical models. Further, more meaningful beliefs are the outcome of an internalization and lived expression of the AN lifecycle. This AN lifecycle theory provides proscriptions for living life holistically, with a strong connection to land, and provides a fulcrum that allows one to understand the complexity of dementia caregiving as it relates to AN culture, history, and traditions embedded within the current sociocultural context.