Changing demography (people living longer and large cohorts aging) is a global phenomenon. American Indians are among the transitional groups with the proportion of elderly expected to double in the next 50 years. The excess burden of illness and health-status disparities between American Indians and the general population are well documented and have consequences affecting health status and functional abilities of American Indians. Health problems and functional limitations intensify the need for home- or community-based long-term-care services among older American Indians. Important considerations in providing these services include understanding historical and cultural influences on their family life, role expectations across generations, and aging as part of human development in contemporary life. In addition, poverty and changing federal policies influence how elders view health and health care delivery on reservations. This article provides an overview of the cultural influences and policy issues related to health care for American Indian elders on reservations.
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