To “age in a good way” is putting a spin on the idea of “growing older” thanks to new insights from American Indians and Alaska Native Elders.

As the aging population of Alaska Natives over the age of 65 continues to grow, many are able to live on their own and remain healthy – wishing to stay in their communities for as long as they are able. In Indigenous culture, Elders play an essential role in successful aging by passing down their wisdom and experiences to ensure a healthy future for younger community members. Yet, many rural, Indigenous communities face the challenge of providing the necessary healthcare services, and Elders are, then, faced with the difficult decision to leave their homes to receive specialty care. 

In this spirit, advancing the boundaries of health equity on aging, the Memory Keepers Medical Discovery Team (MK-MDT), located at the University of Minnesota Medical School’s Duluth Campus, is driven to improve patient experiences for Native people and those from rural reservation settings. Sharing this same passion, MK-MDT faculty investigator, Jordan P. Lewis, PhD, MSW, (Unangax, Native Village of Naknek), a professor in the Department of Family Medicine and Biobehavioral Health, joined the team in early 2020. As a leader in Indigenous dementia care research among Alaska Natives, Dr. Lewis has contributed significantly to discussions on culturally safe approaches to successful aging. 

“From my upbringing in Naknek, Alaska, and confirmed by a decade of research on aging, we know Alaska Natives view aging from a holistic perspective,” Dr. Lewis said. “It’s an approach not typically discussed or honored in our modern healthcare systems or pathways to aging studies.” 

Heading these efforts, Dr. Lewis and his team are embarking on a three-year research project, supported by a $1 million grant from the National Science Foundation (NSF) through the Office of Polar Programs - Arctic Social Sciences. His team will focus on the urgent need to advance the quality of life and to define what it means to “age in a good way” through the lessons and wisdom of Alaska Native Elders. 

The novel concept of “Indigenous cultural generativity,” developed by Dr. Lewis and colleague, James Allen, PhD, incorporates Native culture with individual and community wellbeing through meaningful engagement in Indigenous practices, beliefs and values. This concept will be at the forefront of their project and is becoming increasingly essential for culture-specific approaches toward developing a successful aging model for Alaska Natives facing Alzheimer’s Disease and Related Disorders (ADRD). 

“Generativity in our work has a clear, cultural element, patterned on being a role model for future generations, and through this, passing on one’s Alaska Native culture to the next generation,” Dr. Lewis said. “We have also learned that achieving Eldership, or Elder status, is not determined by reaching a certain age, but instead is designated when an individual has demonstrated wisdom because of the experiences he or she has gained throughout life and being provided opportunities to pass this on to youth.” 

The team is looking at the development of intergenerational programming with Elders volunteering in the classroom to teach their Native language, arts or offering a cultural demonstration. 

“It is important to note that these recommendations do not solely focus on physical health and wellbeing, but rather provide opportunities to share their knowledge, experiences, lessons learned and cultural practices,” Dr. Lewis said. “Through this, their families can learn how to live ‘life in a good way,’ regardless of age or location.”

To ensure representation of the diversity that exists within the unique regions of Alaska, the research team will work with Elder participants located in the interior and southeast Tribal communities of the Yup'ik Eskimo, Athabaskan, Haida, Tsimshian, Eyak and Tlingit Peoples. The team will also be partnering with each of their respective Tribal Councils and four long-term care facilities – two in each region. Throughout the three-year project, the research team will conduct roughly 100 interviews, encompassing a maximum of 15 interviews with Elders aged 50 years and older, who their Tribal Councils nominate, and selected residents from the long-term care facilities. 

Dr. Lewis and his team will focus on coordinating virtual meetings during the first year of the study to provide input and guidance to community leaders during the COVID-19 pandemic with plans for in-person conversations on the matured analysis in year two. To ensure the accuracy of the team’s findings, the Tribal Council members and regional Tribal health corporations will review the recommended aging well resources in the third and final year of the project. 

“My goal is to build upon the Alaska Native model of successful aging and develop a measure of success to be tested in a future study,” Dr. Lewis said. “Using the model of successful aging, and emphasizing generative acts and behaviors of dementia caregivers, we can develop support programs and encourage intergenerationally and peer-to-peer engagement as a cultural protective factor against health disparities.”