Aurelia Nehoitewa was interviewed by Dale Bell.
The Hopi Caregivers Service has been in existence for about 3 years. It is a fairly new program; once a Hopi family has been determined eligible, the family is entitled to have a provider, and this provider will do personal care services, some housekeeping services, socialization, and also helping the clients with making appointments in the healthcare center.
When a person is assigned to a family, that person goes into the home and performs personal care services. In a family care situation, a family member is assigned and certified to become a caregiver to a family member. In that case, a family member will provide care for the mother, the father or other family member. They are compensated under the Arizona Long Term Care Service. We do have a contract with the Native American Community health center, based out of Phoenix, who do the case management, but they are paid under Arizona Long Term Care, the State of Arizona program.
I think it is fairly unique; I don't hear of too many tribes having the home community-based services, but as I said before, this started three years ago, and before that, a lot of out elders and people in need of care were placed in nursing care facilities and long-term care facilities in off-reservation towns. But now that we have the home-based service, we have many elders residing in their own homes, and the caregiver is going into the home to provide the services they need.
The caregivers would help with their bathing, dressing and some exercises. If the client is needing some physical therapy, they would help with some exercises, massages, and also socialization. A lot of times the client is at home alone, so the Hopi Caregiver is going into the home and socializing with the client.
We have 35 Hopi members who are in the program. The Hopi population? I think at the last census, we were averaging 10,000, total Hopis living on the reservation and off the reservation. Going by some of the statistics that I have, in 1999, we had a total of 28 nursing home placements. And this year, 2001, we have 17, so that's a decrease of 11. So we have less people in nursing homes as a result of this Hopi Caregivers Service.
The goal of caregiving is to have our elders remain at home. That is a part of our culture, that we take care of our own people, and that is our basic goal -- to have our elders remain at home. The Hopi caregiver has always been in our culture. I think we were raised with that. Our families tell us that: you take care of Grandma, you take care of Grandpa, so that's always been with us. I think previously, it fell on the women. But now I'm finding that more men are taking care of their fathers. A lot of times, males prefer to have a male doing the personal care services. Times are changing.
Honor to a Hopi family goes back to pride. We have our elders, and we have that sense of responsibility where we should take care of them. We want to take care of them. But as the times are changing, we have the men and the women that are sometimes working, and it's sometimes not possible. But we still want to have our elders at home, because here they have their culture; they have their native foods, and their family. Whereas, if they go into a long-term facility, everything's different. Even the food is different; they have to be on a diet that they are not used to. They are not accustomed to eating chicken or hotdogs, fish, that is not a part of our diet. They want to eat the kinds of foods that we have here, and I find that's one of the biggest complaints of people in nursing homes.
I guess honor to me would mean putting my elders on a pedestal. That's how much respect I have for them. They are our teachers, and they are our treasures, and that's why I have a lot of honor for our elders. They've taught us everything. I do go in and do some cultural sensitivity training in long-term facilities. I'll ask: we're having some problems with one of our Hopi residents, would you please come in and explain to me what is going on. It could be something as simple as putting a Hopi and Navaho together in the same room, and you know our land differences; and all they would have to do is move them out, and that takes care of the problem.
When a child is born, they go through a 20-day naming cycle, and they do not see the sunlight for these 20 days. On the 20th day, the mother and the maternal grandmother go out, and the child is given the Hopi name. And they also tell the child, as its going through the naming cycle, "til old age, will you have a long and prosperous life." And I guess that is what we look at when we take care of our elders. We want them to have a long, healthy life. And if they are stricken with an illness, we still want to take care of them here in our homes and on our reservation.
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