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Upcoming Webinar: Tribal Nursing Homes:
Best Practices and Challenges, Part 2

Long-Term Services and Supports

July 2015
A monthly newsletter developed through a partnership with the Centers for Medicare & Medicaid Services, Indian Health Service, and the Administration on Community Living.
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In this issue: LTSS News | Upcoming Webinar | Featured Video | Featured Resource
Elder suffering from heat stroke
Heat Sickness and Medication Side Effects: Implications for Elders
As summer temperatures climb, it is important to make sure our elders are safe in the heat. Why are elders more susceptible to dehydration and heat-related illnesses? As we age, our bodies have a harder time adjusting to the environment. Medical conditions and certain medications can further aggravate the issue. Being aware of possible medication side effects, especially those that affect the body’s ability to regulate temperature and stay hydrated, can help elders avoid heat-related illnesses.
For example, diuretics—often used to treat high blood pressure, heart-related problems, kidney and liver problems, and glaucoma—cause the body to lose water and salt. Other medications can result in decreased thirst. Combined, the two can make an elder susceptible to dehydration. Checking with medical providers to see if certain medications cause either of these issues can help prevent heat sickness.
What may start as dehydration can quickly lead to a heat exhaustion, which, if untreated, can result in heat stroke—a life threatening condition. The Centers for Disease Control and Prevention (CDC) list the following signs of and first aid responses to heat exhaustion and heat stroke:
Heat exhaustion:
  • Heavy sweating
  • Weakness
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Fainting
What You Should Do:
  • Move to a cooler location
  • Lie down and loosen clothing
  • Apply cool, wet cloths to as much of the body as possible
  • Sip water
  • If the person has vomited and it continues, seek medical attention immediately
Heat stroke:
  • Body temperature above 103°F
  • Hot, red, dry, or moist skin
  • Rapid and strong pulse
  • Possible unconsciousness
What You Should Do:
  • Call 911 immediately—this is a medical emergency
  • Move the person to a cooler environment
  • Reduce the person's body temperature with cool cloths or even a bath
  • Do NOT give fluids
Secrets to Successful Aging from Alaska Native Elders
“Aging [is] where you feel good about yourself. You’ve completed the circle, back to the drum handle.” – an Alaska Native elder
Alaska Native elders have shared that their secret to aging successfully is reaching the status of elder within their communities. Dr. Jordan Lewis from the Center for Alaska Native Health Research studied Alaska Native elders’ perspectives on aging. The elders he worked with reported four important elements for eldership and successful aging:
  1. Having a positive outlook and staying emotionally balanced
  2. Getting involved in the community
  3. Involving spirituality in daily life
  4. Promoting physical health through being active and eating traditional foods
Read more of Dr. Lewis's interview with Alaska Native elders about aging.
Upcoming Webinar
Tribal Nursing Homes: Best Practices and Challenges, Part 2
Part 2 of this webinar series explores tribal nursing homes’ services, challenges, and projects, including the possibility of a new collaborative. Join us July 22 to learn about:
  • three tribal nursing homes and the services they offer
  • exciting projects within tribal nursing homes
  • the challenges tribal nursing homes encounter
Valdeko Kreil
Utuqqanaat Inaat, Maniilaq Association, Kotzebue, AK
Cathy Keene
Morning Star Care Center, Shoshone Tribe of Wind River Reservation, Wyoming
Wayne Claw
Chinle Nursing Home, Navajo Nation, Arizona
A New Tribal Nursing Home Collaborative
This national webinar sets the stage for the beginning of a new Tribal Nursing Home Collaborative. Are you interested in sharing experiences, educating one another, and championing culturally relevant best practices with other long-term care leaders? Join the webinar to learn more.
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Featured Video
What Works for Us: Culture and Community
Many tribal LTSS programs have reached success by reflecting their unique cultures and involving their communities in the services they provide. Learn more about the strategies that worked for these programs by watching the LTSS Technical Assistance Center’s video, “What Works for Us: Culture and Community.”
New LTSS Video Series
Featured Resources
Medicaid Managed Care
CMS hosted an All-Tribes Call on June 25 to discuss the proposed rule released on May 26, 2015, which is intended to update managed care regulations. The call provided an overview of the proposed rule, including the tribal specific provisions. Learn more about the rule, watch a recording of the recent All-Tribes Call, and learn how to submit comments. Comments on the proposed rule are due by July 27, 2015.
LTSS Resource Library
The LTSS Resource Library offers many resources to help you start, support, or improve LTSS in your community. Each month, we feature a tool from the library.
Medicaid managed care is an important issue for LTSS providers, because Medicaid is the primary funder of LTSS and because so many states are beginning to use managed care systems to provide Medicaid.
The LTSS Financing section addresses these and related questions:
Join the conversation on LinkedIn by becoming a member of the CMS Tribal Affairs group.
About the Newsletter
The Long-Term Services and Supports Newsletter is published monthly by the Tribal Affairs Division of CMS to share information, funding opportunities, and resources with tribal leaders, LTSS health planners, and supporters.

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