Robin Bonifas, PhD, MSW
Assistant Professor
College of Public Programs
SCHOOL OF SOCIAL WORK
Spiritual Values Among Older
Native American Adults 
Scott Kukar, Delitha Livingston,
Laurel Mallett, Veronica Nieto
Native Americans: Background
• 560+ federally recognized tribes
• 200+ languages
Native Americans: Background
• Likely to live in rural areas and in poverty
• Lower education level than other ethnic groups
• Heterogeneous population
Challenges
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False positives of cognitive impairment
Discounting background leads to false negatives
Alzheimer’s not treated if not viewed as problematic
Intertribal and intratribal variances
Suggestions
• Acknowledge different life experiences including
education.
• Establish rapport and show respect.
• Use bilingual family members as interpreters with
caution because they may not provide the most
accurate translations due to discomfort in translating
sensitive topics..
Nursing Homes
• A fraction of federally recognized tribes own and
operate nursing homes.
• In a study conducted in the Northern Plains,
paraprofessionals noted tribal language calmed
down “confused” residents.
• Staff believed residents became more culturally
traditional and monolingual as dementia progressed.
Activities
• Pow-wow music and traditional foods are important
for elder’s well-being but are not preventive or
corrective to behavioral issues.
Assimilation
• Among the Anishinaabe tribe, “traditional” is
measured by:
» being given an Indian name,
» fluency in native language
» participation in traditional activities
• Be aware of federal policies which affected tribes
(relocation, reservations, schools).
Navajo
• Religious healing forms:
» Traditional Navajo ceremonial healing
» Native American Church (NAC)
» Navajo Christian faith healing
• Accommodate ceremonies/practices to life (e.g.,
surgery on 5th day)
• Importance of family
White Mountain Apache
• Social workers at nursing homes
rely on family to communicate
spiritual needs of residents.
White Mountain Apache
• Some residents from the tribe have
adopted Christian religions.
White Mountain Apache
• Staff are made aware of resident’s preference for
participating/watching cultural demonstrations.
Tohono O’odham
• Time outdoors and privacy are very important.
Tohono O’odham
• Traditional music and food are comforting.
Tohono O’odham
• Communicating with ancestors is
normal.
• A traditional healer may be helpful, if
resident is distressed about
something.
Summary: Cultural and Spiritual
Considerations
• Interpreters are needed for those who speak limited
English.
• Being in unfamiliar surroundings can be frightening
and connecting with nature can help.
• Family inclusion is very important.
• Traditional food and music are comforting.
• Keep an open mind when Native American clients
appear to be “isolating,” “talking to themselves” or
eating lightly.
• Consult with family and traditional healers whenever
possible.
• Realize you are all part of the “healing circle”.