A Tribal Perspective on Aging & Disability Services within the Reservation/Community Introduction

Terrance Manuelito, Lac Courte Oreilles Tribal Aging & Disability Services Director, Tribal Veteran Service Officer [email protected] , (715) 957-0077 UW Oshkosh, B.S. Human Services, 2020 LCOCC, A.A. Human Services Leadership, 2017 Have worked with the Department since 2012, Have been employed with LCO Tribal Government since 2006 LCO Housing Authority Board, Vice Chair LCO Am Vets Post 1996, 1st Vice WI Tribal Aging Unit Chairman LCO Tribal Member Introduction

Rosalie Gokee, Tribal Dementia Care Specialist [email protected] (715) 558-7944 I am a member of the Lac Courte Oreilles Band of Chippewa Indians. I am the Tribal Dementia Care Specialist and have been in this position since March 1, 2021. I have had the opportunity to serve on the Lac Courte Oreilles Tribal Governing Board from 2015 to 2019. During my tenure, I advocated for Dementia Care Specialists for all eleven tribes in the State of . My goal as Dementia Care Specialist is to create an awareness about Dementia and build a Dementia Friendly Tribal Community. DEPARTMENT OVERVIEW

Tribal Aging & Disability Services Director Tribal Elder & Disabled Services Terrance Manuelito Coordinator Doreen Wolfe

Elder Nutrition Program Tribal Aging & Disability Tribal Dementia Care Specialist Tribal Elder Transportation • Alberta Stone, Nutrition Mgr Resource Specialist Rosalie Gokee Services • Kitchen Staff Diana “Di-Z” Cross Robert Trepanier • HDM Volunteer drivers Nutrition Program

STAFF Phone #: 715 865-3379 . Alberta Stone, Nutrition Manager Fax #: 715 865-3377 [email protected] . Carole Bartold, Lead Cook . Aaron Braddix, Cook . Temporary Kitchen Staff Workers Two Meal Delivery Vans with Volunteer Driver’s and Runner provide (HDM) Home delivered meals to over 120 community members Monday through Friday. Clients are tasked with completing a nutritional assessment survey and other resources and materials are sent out throughout the year. Funding is provided by the State of WI GWAAR for Title III, and also Federal ACL – Administration for Community Living, Title VI Funding, as well as a tribal fund match of 10%. LCO TADRS – Tribal Aging & Disability Resource Specialist

Diana “Di-Z” Cross, 715 957-0076, Diana.Cross@lco- nsn.gov • The TADRS has an important role at the Aging & Disability Services Center as she provides a welcoming place where elders and adults with disabilities can go for information, advice and help in accessing services. • Helps individuals apply for and access programs, community resources, and benefits such as Medicaid, Medicare, Social Security Benefits, and provides Long- Term Care Options Counseling. • Promotes health, prevention and early intervention. LCO Tribal Elder & Disability Services/Elder Transportation Services

Robert Trepania, Elder Transportation Driver, 715 699-3529 [email protected] – Provides non-medical client transportation locally within the LCO Community & Sawyer County – Coordinates monthly transportation events – GLNAEA, Chippewa Federation, Etc. – Tasked with ensuring all department vehicles are maintenanced LCO DCS – Dementia Care Specialist

Rosalie Gokee, (715) 558-7944 [email protected]

. The Dementia Care Specialist “DCS” is to create an awareness about Dementia and create a Dementia Friendly Tribal Community. . The DCS shall collaborate with and provide dementia-capable training; offer and provide information, care consultations, options counseling and referrals for individuals with dementia and family caregivers. . The DCS shall provide community outreach and promote public awareness of services and supports available to people with dementia and family caregivers. . The DCS shall implement programs that will create opportunities for tribal members with dementia to remain living safely in their own homes. LCO Elder Services Coordinator

Doreen Wolfe, (715) 957-0027 [email protected]

. The Elder Services Coordinator provides oversight of the following services to qualifying LCO tribal member elder and disabled individuals in the community such as: . Home Repair/Modification . Car Repair . Lawnmowing . Snowplowing . Distribution of LCO Recycling Center punch cards for equipment disposal . Distribution of LCO Recycling Center garbage bags . Firewood Allocation Historical Indian Policy Timeline

1850- Sandy Lake Tragedy 1887 – Dawes Allotment Act (dividing up Indian land, much of About 400 lost their lives 1830 – Act (TRAIL which was lost because couldn’t 1890 – Wounded Knee Massacre Pre-1800’s – extermination, of TEARS) after the federal government pay taxes on lands). Government manipulation & colonization of failed to provide food and rations determined tribal roles and Indians as promised. memberships

1934- Indian Reorganization Act: the “Indian NEW DEAL” allowed 1968- Indian Civil Rights Act- 1953- Termination Policy – 1924 – The Snyder Act: until this tribes to establish elected tribal imposed regulations on tribes in attempted to abolish federal 1950’s-1970’s – Sterilization of act, not considered a citizen of governments. Traditional chiefs, order to guarantee individual supervision of Tribes. Termination Native women U.S. & couldn’t vote. headmen, and medicine men are Indians similar rights in tribal of tribes had a devastating impact. not recognized by the matters. government.

1970- Self-Determination Policy – 1978- Indian Child Welfare Act – 1978- American Indian Freedom of 1960’s- (AIM, ALCATRAZ, Richard Nixon condemned the assures preservation of Native Religion Act – reversed the 1883 Wounded Knee Standoff, federal termination policy and extended homes by placing Native children Religious Crimes Code Act (Court buildings takeover) more control of Indian affairs to in adoptive Native homes and of Offenses) Indians themselves. families Historical Trauma & Cultural Competency

1. Historical Trauma: Is the cumulative, multigenerational, collective experience of emotional and psychological injury in communities and in descendants.

2. Intergenerational Trauma: Is historical trauma that is passed from generation to generation due to forced relocation, land dispossession, loss of spiritual practices, language and culture. Research shows that individuals can inherit gene changes from trauma that our parents and grand parents experienced.

3. Some symptoms of Historical Trauma include: Sleep Disorders, Food Insecurity/Obesity, Substance Abuse (Including Alcohol and Smoking), Loss of Concentration, Shame, Violence, Fear and Distrust, Anger, Isolation and Anxiety.

4. Cultural Competency: Is the basic knowledge about a tribe’s history, customs and traditions. Health Disparities  Today one of every five American Indians and Alaska Native adults age 45 and older reported experienced increased difficulty in thinking or remembering over the past year which can be a precursor to dementia.  Between 2014-2060, the number of American Indian and Alaska Natives aged 65 and older living with memory loss is projected to grow over five times.  Older adults living with Alzheimer’s disease and related dementias increasingly depend on caregivers and community resources as they become less able to care for themselves. Currently one in three American Indian and Alaska Natives are caregivers.  American Indians and Alaska Natives born today have a life expectancy that is 5.5 years less than the U.S. all races population (73.0 years to 78.5 years, respectively).  American Indians and Alaska Natives continue to die at higher rates than other Americans in many categories, including chronic liver disease and cirrhosis, diabetes, unintentional injuries, assault/homicide, intentional self-harm/suicide, and chronic lower respiratory diseases.  As of 2014, cancer is the leading cause of death for American Indians & Alaskan Natives, followed by heart disease.  American Indians and Alaska Natives face higher rates of obesity and diabetes than the general population. What is Dementia?

Dementia IS… A group of symptoms that affect thinking, memory, reasoning, planning, language, and/or social skills to the point that it affects everyday life.

*Dementia is NOT a part of normal aging!* 10 Early Signs & Symptoms of Alzheimer’s

1. Memory loss that disrupts daily life 2. Challenges in planning or solving problems 3. Difficulty in completing familiar tasks 4. Confusion with time or place 5. Trouble understanding visual images and spatial relationships 6. New problems with words in speaking or writing 7. Misplacing things and losing the ability to retrace steps 8. Decreased or poor judgment 9. Withdrawal from work or social activities 10. Change in mood and personality Risk Factors for Dementia

Heart Diabetes Age (65+) Disease

Head Obesity DEMENTIA Injury

Low Physical Smoking Activity Alcohol Tribal Sovereignty and Building Relationships

Demonstration of Sovereignty: • The ability to operate a Tribal Aging & Disability Services Program and offer culturally relevant services within the tribal community is a demonstration of Tribal Sovereignty.

Building and Fostering Relationships: . The Tribe and it’s Tribal Aging & Disability Services Program realizes the importance of building and fostering relationships that will benefit those individuals served. . Working together with partnering agencies is important to bridge gaps in services. . Sharing information through a release of information or through a Memorandum of Understanding will ensure that a client has completed processes and their needs are being met. . The Tribal Aging & Disability Services Program is willing to assist partnering agencies to meet the needs of tribal members and community. Questions and Feedback