Part of the Transforming Life as We Age Special Report
Born on the Pine Ridge Indian Reservation in South Dakota, Kathy Janis was taught to revere the elders in her Oglala Sioux Tribe.
“I was raised to consider every one of them to be a relative. Respect is instilled in us,” she said. “My parents didn’t tell it, they lived it and showed us.”
That’s why Janis prioritized the needs of her older relatives while serving on the Tribal Council. More than a decade ago, the governing body began laying the groundwork to build a nursing home specifically for the tribe’s members. An early step was visiting tribal elders who were scattered in facilities around the country to see if they would be interested in a nursing home on tribal land.
“When we spoke to our people, the refrain was, ‘Did you come to take me home [to our land]?’” she said. “There was a lady at a nursing home in Texas who was so homesick that she stopped eating. She passed away there. We brought her home for burial, but we couldn’t bring her home to be with her family at the end. That bothered me.”
Last September, the 60-bed Oglala Sioux Lakota Nursing Home — on tribal land adjacent to the reservation in Whiteclay, Neb. — opened its doors. The facility offers state-of-the-art care to keep residents healthy and comfortable, and the sun-drenched space is specifically designed to honor their unique culture and spirituality.
A Place to Call Home for Native Elders
It is one of a growing number of nursing homes and assisted living centers created to meet the needs of specific populations, like the Oglala Sioux. Proponents say that being in an environment with familiar foods, traditions and spiritual practices can be life-changing for residents.
Like older adults at other facilities, the residents at the Oglala Sioux Lakota Nursing Home vie for prizes during bingo games. But they also enjoy traditional beadwork in the craft room. They tend a garden with raised beds and grow squash, beans and pumpkins, as they did at home. Artwork created by native artists adorns the walls and a room dedicated to ceremonial prayer.
Dieticians supplement meals with traditional foods — fry bread, wild turnips and taniga, a soup prepared with buffalo tripe.
But the easy access to family is the most important asset for the newly arrived residents, who are all enrolled members of a federally recognized tribe.
“Their children and grandchildren couldn’t travel to visit them. Now they see them all the time and can be with them at the end of their lifespan,” said Janis, now chair of the Oglala Sioux Lakota Nursing Home board of directors.
It took years to get to groundbreaking for the $16.5 million facility. When the tribe began making plans to construct the nursing home on their reservation in South Dakota, that state had a moratorium on nursing home beds. So the tribe adjusted its vision and built the home in Nebraska, one state south.
“There are a lot of pieces to the puzzle for a tribe that wants to own a nursing home, and nothing happens fast. The tribal council has to have a working relationship with state and federal government and Indian Health Service,” said Ron Ross, president of Native American Health Management, a consulting firm.
His company, based in Lincoln, Neb., manages the Oglala Sioux Lakota Nursing Home, which Ross calls “the way of the future” for Native American communities.
Others Follow Suit
Currently, the Prairie Island Indian Community, a federally recognized Mdewakanton Sioux Tribe in Minnesota, is building a 38,000-square-foot assisted living center on tribal land. The Tohono O’odham Nation operates a comprehensive elder care campus on its reservation along the Arizona-Mexico border. Tribal elders there can access traditional healing practices offered alongside Western medicine in the assisted living, skilled nursing, memory care and hospice facilities.
“We’re sitting down and visiting with a number of other tribes around the U.S. about how they can meet the long-term care needs of their elders,” said Ross.
Impact on Employment and Language Preservation
With chronic high unemployment on the Pine Ridge reservation, the Oglala Sioux Lakota Nursing Home is a welcome source of jobs for the Oglala Sioux tribe. Eventually, up to 100 people will staff the 24-hour facility, including nurses, administrators, security, maintenance, laundry, food service and support service workers.
“Right now, 90 percent of the employees are enrolled tribal members and that is a big deal. These are good jobs with benefits and so it helps the tribe as well as the elders,” Ross said.
There are other benefits that extend to the community. The staff that works with the elders often communicates in their native Lakota, which strengthens the fluency of the younger speakers and will help keep the tribe’s language alive.
It’s not just Native Americans who are finding advantages in culturally specific care for older adults. Other communities are also embracing distinctive housing and services.
“We’re seeing more affinity groups converging to provide services in their aging populations, whether it’s for LGBT elders, a faith-based community or even an alumni group,” said Mary Meehan, an analyst for Panoramix Global, which advises Fortune 500 marketers on consumer and cultural trends. “In their senior years, people can become vulnerable and isolated. Primal needs become more important. It’s a great comfort for people in this stage of life to be with, and be served by, those who share their values and common traditions.”
‘A Peaceful Passing’
The windows at the Oglala Sioux Lakota Nursing Home look out on the pine trees, valleys and prairie of the Great Plains, allowing residents to gaze at a familiar landscape as they live out their final months.
“Four of our elders have crossed over since we opened. They were all surrounded by their people and by staff that really love them,” Janis said. “They knew they were coming to the end and they had a peaceful passing. That’s what we all want.”
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