LTSS Newsletter—October 2019

Funding opportunities, news, events, and resources for tribal and urban Indian LTSS programs
Upcoming LTSS webinar: October 23
Long-Term Services and Supports

Technical assistance for culturally competent care
October 2019
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LTSS Technical Assistance Center
Visit the online LTSS TA Center for videos, best practices, toolkits, a resource library, and a step-by-step planning roadmap.
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Aging in place

There are quite a few variables to consider in deciding whether an elder can safely age at home.

The National Aging in Place Council created Act III: Your Plan for Aging in Place (PDF, 871 KB, 24 pp), a workbook for patients, their families, and providers. It accounts for health, physical ability, financial costs, support systems, and where the patient would prefer to live.

Additionally, the article, Aging Parents at a Distance Who Aren't Really 'Just Fine,' has important information for families who may not live near their elders. It provides information on what signs to look for to determine whether aging in place can be an option even if the elder lives a good distance away.

For elders who are able to stay home, the article, Finding Support for Seniors Facing Challenges Living Alone, provides advice on how to make sure their independence includes physical and emotional health support services

A man brings food to a table with two older women


Providing long-term care


Aging in place is not always the best option, and elders may find it best to relocate to an assisted living facility. The LTSS TA Center's information library on the CMS website includes resources to help facilities ensure they are meeting the health needs of their patients in culturally appropriate ways.

Resources are geared toward tribal leaders looking to learn about providing long-term services and supports for their communities and program examples that review successful practices.

To get started, the planning section provides a step-by-step walk-through to create a new or expanded LTSS program for elders and adults with disabilities.




Connecting Generations in Senior Housing: A toolkit by LeadingAge

Connecting generations can result in many benefits for elders and youth. Learn how to create these connections in senior housing programs with LeadingAge's new toolkit, Connecting Generations in Senior Housing: A Program Implementation Toolkit (PDF, 8 MB, 87 pp).

An elderly woman in a wheelchair and a toddler play with a large parachute in an image on the cover of the Connecting Generations toolkit

"Research suggests that engagement in high-quality intergenerational programs and in meaningful cross-age relationships can decrease social isolation among older adults while increasing their feelings of belonging, self-esteem, and well-being."

– Connecting Generations toolkit

The toolkit includes cultural considerations and information on program evaluation, planning, partnerships, and training. Ultimately, the goal of this toolkit is to see intergenerational programming become a part of every housing community.

Planning ahead for changes in mobility

Physical changes that make driving and walking more difficult can pose barriers to aging in place. Elders who plan ahead for such changes are more likely to maintain their social connections and quality of life.

MyMobility Plan (PDF, 4.6 MB, 4 pp) is a free downloadable worksheet with tips for staying safe at home and staying active in the community. Developed by the U.S. Centers for Disease Control and Prevention, the worksheet contains checklists to help elders:

  • increase strength and balance,
  • prevent and manage chronic conditions that could hinder mobility,
  • decrease the risk for falls, and
  • find alternative transportation in case the current options for getting around are no longer realistic.

First page of MyMobility Plan, a free downloadable worksheet

End-of-life considerations for AI/AN cancer patients

Compassionate, culturally appropriate care for those approaching the end of life is a common long-term care need.

The Partnership for Native American Cancer Prevention recently published a fact sheet for caregivers and families of AI/AN cancer patients who are nearing the end of life. This resource includes information on how to support their physical, emotional, and spiritual comfort.

The CMS LTSS TA Center also provides a variety of resources for delivering culturally sensitive end-of-life care, including examples of hospice programs in Indian Country.

Caregiver's corner: Promote elder happiness

Cultural traditions activate the happy hormone

A 2018 study by the National Resource Center on Native American Aging (PDF, 181 KB, 4 pp) found that even though American Indian, Alaska Native, and Native Hawaiian elder populations are more likely to suffer from depression, participation in cultural and traditional activities may help counter their risk.

The study shows direct correlations between participation in cultural activities and happiness and resilience. As the Happiness and Calmness vs. Cultural Participation chart shows, the more activities elders participate in, the happier they are.

A chart shows levels of happiness and calmness follow the same upward trends when elders participate in cultural activities

A chart from the fact sheet, "Participation in Cultural Traditions Promotes Happiness and Peacefulness Among American Indian, Alaska Native, and Native Hawaiian Elders," by the National Resource Center on Native American Aging

What does this mean for long-term care? Beyond elders' physical health, facilities that provide opportunities for their residents to participate in cultural and traditional activities are better able to support elders' emotional and mental health.

Funding opportunities 

Dementia care: Home- and community-based services

Optional letter of intent due: January 3, 2020
Application due: February 3, 2020

View the dementia care funding opportunity.

The National Institute on Aging will support research on the need for home- and community-based services (HCBS) among persons with Alzheimer's disease and Alzheimer's disease-related dementias. Projects that will improve data collection are of particular interest.

Join the conversation on LinkedIn

Want to learn more about or discuss LTSS in Indian Country? Looking to connect with others working in the same field? Join the Tribal Affairs Group on LinkedIn and join the conversation.

Upcoming webinar 

LTSS webinars

Wednesday, October 23

The LTSS webinars guide American Indian and Alaska Native audiences in planning and implementing LTSS programs to care for their elders and people with disabilities. Webinar topics range from financing to elder abuse prevention to culturally appropriate dementia care.

Do you have an LTSS topic you would like these webinars to cover? Email

Save the date:

Additionally, save the date for the November LTSS webinar on Wednesday, November 13.


Please note your
location's call-in time:

8 a.m. Hawaii
10 a.m. Alaska
11 a.m. Pacific
11 a.m. Arizona
12 p.m. Mountain
1 p.m. Central
2 p.m. Eastern

Send Us Your News

Do you have news to share about LTSS in Indian Country? Send it to, and we'll include it in a newsletter. Contact us with other comments or feedback, too.

About the Newsletter

Long-Term Services and Supports Solutions is published monthly by the CMS Division of Tribal Affairs to share information, funding opportunities, and resources with LTSS planners, tribal leaders, and supporters.

Centers for Medicare & Medicaid Services Indian Health Service Administration for Community Living