Cultural sensitivity is a fundamental competency for clinicians and caregivers working in the Community Care Center (CCC), a nursing home in California. American Indians/Alaska Natives are vulnerable to culturally unresponsive care because their background emphasizes traditional healing practices that have been overshadowed by modern medicine. The lack of culturally sensitive care has caused an increase in chronic conditions like Type I diabetes. Therefore, physicians must incorporate cultural awareness into preventative care when dealing with Alaska Natives. Review of Policies Policies targeting Native Americans aim to improve healthcare coverage, which is substantially low for the group. Notably, the Affordable Care Act provides special policies to improve healthcare affordability. For instance, members of federally recognized Native American cultures can enroll in Marketplace coverage and change plans as they wish, as frequently as once per month (National Indian Health Board, n.d.). Natives are exempt from any deductibles, coinsurance, or copays when they receive care from Indian healthcare providers for zero or limited cost-sharing plans. Households at 300% of the federal poverty level (FPL) can enjoy a zero cost-sharing or limited cost-sharing plan option. Above all, Native Americans enjoy special monthly enrollment status exclusively available for natives. Interaction with the Healthcare Industry The interaction between Alaska Natives and the healthcare industry has not been productive. The maltreatment of Native tribes stems from colonial suppression in which the 3 federal government tried to assimilate Natives and extinguish their culture (Halverson et al., 2002). For instance, Congress has persistently underfunded the Indian Health Service (IHS), an organization tasked with providing medical care for over 560 recognized native tribes. Consequently, healthcare among Natives is very different from mainstream healthcare. Additionally, modern providers disregard Native American culture when developing treatment options. Clinicians’ lack of cultural humility frequently emerges during treatment. Consequently, Native patients may lose faith in modern medicine because they are not accommodated. Best Practices Best healthcare practices should marry traditional practices with modern medicine. Treatment approaches should accommodate the patient’s attitudes, beliefs, and preferences and be community-focused. Before commencing treatment, clinicians should determine any elements of treatment that might conflict with patients’ beliefs. If a patient prefers their Native language during treatment, clinicians should look for a Native caregiver or interpreter to facilitate treatment. Instead of making assumptions, clinicians should ask natives about their availability and preferences regarding medical programs. In some cases, professionals can modify the name of a program to make it culturally relevant. For example, Wisdom Warriors is a model recognized by the National Council on Aging (2021), offering culturally appropriate incentives to encourage elders to be faithful to chronic disease management. Additionally, healthcare experts should integrate healthcare programs with local cultural practices. During group therapy, clinicians can provide care alongside activities like singing, humming, and drumming. Clinicians should start and end every treatment session with a blessing to show their recognition of the spiritual side of life. Additionally, providers should incorporate cultural traditions into the class setting through storytelling, narrative sessions, or allowing individuals to eat together before the session begins. Furthermore, talking circles can help to increase participant engagement during group therapy. 4 Internal Resources Internal resources to enable the provision of culturally sensitive care include interpreters, cultural competence trainers, culturally diverse staff, and linguistically diverse materials. Cultural competence trainers can work with caregivers and clinicians to ensure culturally sensitive practices in CCC. Henceforth, the human resources department should emphasize the recruitment of diverse staff, underlining the need for more Native American workers. Additionally, clinicians should partner with Native physicians to create linguistically diverse materials and culturally responsive programs for Alaska Native patients. Important Organizations Organizations to help increase cultural sensitivity in CCC include the National Indian Health Board (NIHB) and Indian Health Service (IHS). NIHB provides recognized Natives with coverage and health benefits not provided in other mainstream health programs. NIHB can partner with CCC to determine at-risk individuals and target them for special services. Similarly, CCC can work with IHS to improve the quality of healthcare by emphasizing all facets of care, such as mental, physical, and spiritual wellness. 5 Refer
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