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Native Americans and Nursing Care Strategies


The older population in the United States has become more diverse than it was decades ago. Thus, nurses need to learn more about backgrounds, experiences, values, and visions of different cultural groups with the focus on the specifics of working with older people. Native Americans, including American Indians and Alaskan Natives, are among those ethnic and cultural groups which require the additional attention in order to determine effective practices to be followed by gerontological nurse practitioners. The purpose of this discussion is to describe demographic and cultural characteristics of Native Americans and present nursing strategies of providing culturally competent care.

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Demographic and Cultural Characteristics of Native Americans

Native Americans represent about 6 million people, and it is a minority group in the U.S. population. The percent of older people among these representatives is comparably low, less than 10% (Roh et al., 2015). The reason is that the median age of Native Americans is lower than it is in other ethnic groups of the United States. The socio-economic status of those Native Americans who live in reservations or urban areas of the country is different. The unemployment rate among these individuals is high, and economies of reservations usually do not provide Native Americans with opportunities to improve their status (Roh et al., 2015). However, access to healthcare can be discussed as good when analyzing the situation in reservations because of the realization of national health programs.

The health status of Native Americans significantly depends on their visions and beliefs. Native Americans believe that problems in their health are results of losing balance in their relations with nature. Spiritual rituals and the use of herbs instead of medications are typical of this group. Furthermore, Native Americans pay much attention to older people in their communities, and the social status of these persons is usually high (Simonds, Goins, Krantz, & Garroutte, 2014). The focus on traditions, family, spirituality, and the role of older people in a community influences Native Americans’ attitudes to health care, and they can face such risks as the lack of care because of rejecting assistance of professionals, the language barrier because of using local dialects, and the spread of diseases which were not previously typical of this ethnic group.

Nursing Strategies to Provide Culturally Competent Care

In order to provide Native Americans with culturally appropriate care, it is important to pay attention to their traditions and beliefs. The history of relations between White Americans and Native Americans explains the absence of trust in healthcare providers among the older population in the group. As a result, nurses need to develop relationships based on trust and respect to demonstrate that opinions of older Native Americans are valued and taken into account.

To address this goal, it is necessary to show respect when conducting the nursing assessment of a patient, involve older Native Americans in the decision-making process regarding the selection of therapies, and put emphasis on the use of herbal medications when it is possible (Simonds et al., 2014). Furthermore, it is also important to pay more attention to older people’s personal histories in order to learn more about patients’ backgrounds. The focus on the history of this cultural group is also essential to provide competent care. Moreover, after developing trusting relationships with older patients, it is also necessary to provide them and their families with education regarding hypertension, the rheumatoid disease, and cancer prevalent among Native Americans.


The growing number of diverse older people creates a range of challenges for gerontological nurse practitioners who need to work with these populations and provide culturally competent and appropriate care. In order to succeed while working with Native Americans, nurses need to learn more about their culture and demonstrate respect. The focus is also on valuing the role of older persons in the community and their visions regarding health and spirituality.


Roh, S., Burnette, C. E., Lee, K. H., Lee, Y. S., Easton, S. D., & Lawler, M. J. (2015). Risk and protective factors for depressive symptoms among American Indian older adults: Adverse childhood experiences and social support. Aging & Mental Health, 19(4), 371-380.

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Simonds, V. W., Goins, R. T., Krantz, E. M., & Garroutte, E. M. (2014). Cultural identity and patient trust among older American Indians. Journal of General Internal Medicine, 29(3), 500-506.

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