Emerging LTSS Issues
Older American Indians and Alaska Natives (AI/ANs) are a rapidly growing population group. Overall, AI/AN populations experience some of the highest rates of chronic disease and disability in the United States.1 Due to a growing elder AI/AN population and a high level of tribal members with disabilities, tribal communities need to increase the long-term services and supports (LTSS) available for these community members.
Emerging LTSS Issues in Indian Country
This report provides an overview of three LTSS topics and related issues within Indian Country—LTSS funding for home- and community-based services, adult family homes, and Alzheimer’s and dementia.
- Emerging LTSS Issues in Indian Country: Executive Summary (PDF) (PDF, 588 KB, 3 pages)
These papers offer snapshots of additional LTSS topics.
- LTSS Research: Improving Care for Adults with Disabilities in Indian Country - Highlights from the Field (PDF)(PDF, 1 MB, 9 Pages)
- LTSS Research: Improving Care for Adults with Disabilities In Indian Country - Highlights from the Literature (PDF) (PDF, 1.5 MB, 10 pages)
- Emerging LTSS Issues in Indian Country: Diabetes in Indian Country, Annotated Literature Review (PDF) (PDF, 818 KB, 34 pages)
This report provides background information about diabetes in Indian Country, including the prevalence of diabetes among AI/ANs, and sociocultural aspects of the disease, discusses the heightened LTSS concerns of older AI/ANs with diabetes and comorbidities due to possible increases in functional disability, outlines the importance of diabetes self-management and the challenges to successful self-management in Indian Country, describes sources of funding and support for diabetes LTSS needs in Indian Country, and provides key take-aways for tribes interested in developing LTSS for individuals with diabetes in their communities. *The best practices are the 5 program documents (Urban Inter-tribal center, Navajo Nation, Riverside San Bernardino, Choctaw, and Confederate Salish Kootenai)*
- Best Practices: Cognitive Assessment Tools (PDF) (PDF, 687 KB, 8 pages)
- Emerging LTSS Issues in Indian Country: Cognitive Assessments (PDF) (PDF, 962 KB, 13 pages)
A report that examines the available literature on cognitive assessments, cognitive tools and their use in Indian Country. This report reviews background information on cognitive assessments, the need for improved cognitive assessments in Indian Country, challenges with using cognitive tools in Indian Country, cognitive assessment tools that may hold promise for use in Indian Country and recommendations for tailoring and developing culturally appropriate cognitive assessment tools for use in Indian Country.
- Emerging LTSS Issues in Indian Country: Rebalancing LTSS Funding for HCBS (PDF) (PDF, 1.05 MB, 16 pages)
Reviews current information on efforts to rebalance LTSS funding for HCBS in Indian Country that breaks down Medicaid funding information and provides insights from two current programs
- LTSS in Indian Country: Issues Affecting American Indians and Alaska Native Consumers with Disabilities (PDF) (PDF, 798 KB, 23 pages)
(PDF)Discusses the challenges AI/AN people with disabilities face in seeking LTSS and highlights three tribal LTSS programs that serve people with disabilities
- Emerging LTSS Issues in Indian Country: Adult Family Homes (PDF) (PDF, 777 KB, 10 pages)
Discusses adult family homes as a viable home- and community-based care option for providing culturally appropriate, affordable, long-term care to elders or others in need of such services while keeping tribal members in the community
- Emerging LTSS Issues in Indian Country: Alzheimer’s and Dementia (PDF) (PDF, 888 KB, 10 pages)
Highlights current information about Alzheimer’s disease and dementia in Indian Country, barriers that prevent diagnosis, and recommendations for tribal communities to take proactive measures to address challenges
- Offering and Funding Home- and Community-Based Services in Indian Country (PDF) (PDF, 473 KB, 17 pages)
Reviews ways that AI/AN communities provide home- and community-based care, including common funding sources, five program profiles, and recommendations from program administrators
- Emerging LTSS issues in Indian Country: Caregiver Training (PDF) (PDF, 775 KB, 14 pages)
- Emerging LTSS issues in Indian Country: Disability and Housing (PDF) (PDF, 726 KB, 14 pages)
- Emerging LTSS issues in Indian Country: Assisted Living (PDF) (PDF, 1.2 MB, 17 pages)