1. Who are we as Indian People? The original inhabitants of this country Diverse people from many tribes Distinct history, languages, cultures, traditions, social networks, governments Dual citizenship in any one of many different tribes May have red or blonde hair, be blue or green eyed, look like another ethnic race, as well as having the prevailing stereotypical characteristics

2. DIVERSITY! Indian people have differing: Identity: tribal, cultural, bi-cultural, non-traditional orientation Cultures, values, and practices; Language/communication styles; Lifestyles; geography; Incomes, employment rates, education; Health & illness beliefs; Family structures/kinship relationships; Spirituality & religious customs

3. General Native American Values Show Respect to Others - Each Person Has a Special Gift Share What You Have - Giving Makes You Richer Know Who You Are - You Are a Reflection on Your Family Accept What Life Brings - You Cannot Control Many Things Have Patience - Some Things Cannot Be Rushed Live Carefully - What You Do Will Come Back to You Take Care of Others - You Cannot Live Without Them Honor Your Elders - They Show You the Way in Life Pray for Guidance - Many Things Are Not Known See Connections - All Things Are Related

4. Importance of Spirituality Spirituality Ritual Dreams Healing Practices Inter-Tribal Celebrations

5. Cultural Considerations Religion/Spirituality Presiding religious/spiritual official Ceremony (may be a blending Christianity & Traditional Spirituality) American Indian Symbols– the use & practice of: Tobacco Eagle Feathers Medicine Bag Sweat Lodge Cedar Sacred Pipe Smudging Indian Names

6. Our Voice Language Stories –Oral Tradition Drum and Song

7. The Next Generation View of Children –Blessing/Gift Number of Children Child Care Customs –Experiential learning Role of Parents/Grandparent/ and Extended Family –Woman’s role as family caregiver

8. Native American Concepts Wellness/Health Results from harmony with nature Is a balance between mind, body, emotions, & spirit/soul, not the absence of disease Relationships are an essential component Spirituality/religion & medicine are inseparable The spirit existed before it came to the body & will exist after the body dies Each of us is responsible for our own health “Life-ways” are necessary to maintain health

9. Native American Concepts Healing Healing of one realm can bring about healing in another Spiritual realm is the most important Total treatments heal the mind, body, emotions, & spirit/soul Life comes from the Great Spirit from which all healing begins Mother Earth contains numerous remedies for our illnesses Traditional healers can be either men or women, young or elder, recognized by their community

10. Native American Concepts Disease Damage to mind, body, emotions, &/or spirit can produce disease in same or different realm Illness is an opportunity to purify one’s soul Natural un-wellness is caused by the violation of a sacred or tribal taboo Unnatural wellness is caused by evil Dis“ease” is felt by the individual & their family

11. Native American Concepts Traditional Indian Medicine (TIM) Openly practiced until 1887 when the Dawes’ Act was passed by the US Congress making TIM illegal Today, a majority of the 2 million Indians consult traditional healers 70% of Urban and 90% of Reservation based Indians use TIM

12. Cultural Considerations Traditional Native Healers What traditional healers do best & different from contemporary clinicians: Pray, Listen, Time Native patients often go to traditional practitioner before seeking contemporary medical care Native patients seldom reveal their use of traditional healing methods and medicines Native patients value the healer’s advice over the physician’s if a disagreement arises Working with traditional healers

13. Cultural Considerations in Clinical Practice Native American and Euro-American Cultural Values and Behaviors Please review handout comparing Native American and Euro-American Culture and Behaviors

14. Cultural Considerations Language and Communication (verbal & non-verbal) Bilingual &/or Interpreter-translator What is not said is also important Word Phrasing – words have power to shape reality Individual speech style/pattern

15. Guidelines for Health Care Professionals Understand the culture of the people you’re caring for Understand your own cultural beliefs & biases Listen, be open-minded, avoid labeling Be respectful, courteous, & have a cooperative attitude Know your own & patient’s communication style Cultural Considerations

16. Guidelines for Health Care Professionals Develop supportive cultural policies & educate all staff Respect the therapeutic partnership of traditional healers & medicines with contemporary medicine Always ask, seldom assume Don’t assume one American Indian speaks for all American Indians or tribal governments