LTSS Newsletter—March 2020

Long-Term Services and Supports

Technical assistance for culturally competent care

March 2020

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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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Person-centered care for people with dementia

Providing meaningful engagement opportunities to residents of long-term care facilities is a crucial part of person-centered care. According to a recently published white paper (PDF, 2.4 MB, 9 pp), resident engagement can help slow the rate of cognitive decline, decrease negative behaviors, and improve quality of life.

Engaging with residents means helping them live each day with purpose through activities they enjoy and opportunities to interact with caregivers, other residents, or loved ones.

For AI/AN residents, incorporating culture is an important consideration for meaningful engagement. The report, Tribal Nursing Home Best Practices: Cultural Sensitivity (PDF, 4.1 MB, 11 pp), describes how tribal long-term care facilities approach culturally appropriate care.

Dementia care resources

The CMS LTSS TA Center offers resources on providing person-centered dementia care in Indian Country.

The CMS LTSS webinar recording, Tribal Nursing Home Stories – Improving Dementia Care discusses strategies to overcome common care challenges in nursing home settings.

The report, Tribal Nursing Homes: Best Practices for Patients with Dementia and Alzheimer’s Disease (PDF, 311 KB, 10 pp), highlights the importance of:

  • one-on-one time with new residents to help familiarize them with their surroundings
  • training for staff on how to interact with patients at each stage of dementia

Coronavirus and long-term care facilities

With the spread of COVID-19 (the novel coronavirus), there is growing concern about the safety of long-term care residents.

The Centers for Disease Control and Prevention has compiled community-specific plans, updates, and age-specific guidance to help social distancing efforts, including strategies for long-term care facilities.

Additionally, long-term care facilities who suspect a resident or staff member may have COVID-19 should contact their local or state health department for guidance.

To help advocate for resources for tribes to help protect citizens, tribal health providers can participate in the National Indian Health Board’s brief survey to assess the COVID-19 prevention and response capacity in Indian Country.

HIV/AIDS screening for elders

An infographic that states, 'You can be at risk of HIV if you: have sex without a condom, receive unsafe blood transfusion, or are exposed to contaminated injecting equipment. HIV can also be transmitted from mother to child.'

March 20 is National Native HIV/AIDS Awareness Day. According to the National Institute on Aging, nearly half of people living with HIV/AIDS in the United States are age 50 and older. HIV places elders at increased risk for other diseases like heart disease and dementia.

However, many elders are not screened for it. Symptoms that may stand out in a younger person could be mistaken for the aches and pains that go along with aging, and the more serious symptoms can take 10 years to appear after infection. Anyone can get HIV/AIDS at any age, so it is important to promote awareness of who could be at risk, such as by sharing this infographic from the World Health Organization.

Indian Health Service is partnering with Native communities to end the HIV epidemic and prevent hepatitis C infection in Indian Country. Learn more about the initiative, Eliminating Hepatitis C and HIV/AIDS in Indian Country.

HIV/AIDS screening for elders

Deadline: March 26, 2020

The Ryan White HIV/AIDS Program is offering up to 60 Part C Capacity Development Program grants to increase access to high-quality primary health care services for low-income, uninsured, and underserved people with HIV. View the capacity development funding opportunity.

Upcoming webinar

LTSS webinar cancelled: Money Follows the Person – Tribal Initiative, Part 2

The March 25 webinar, Money Follows the Person Tribal Initiative, Part 2, is cancelled. Several of the speakers are impacted by the COVID-19 situation and are focused on preparedness and response activities in their tribal communities. The webinar will be rescheduled as soon as possible.

Caregiver's corner

Connecting with those who have dementia

People who care for others with dementia, including caregivers, family and friends, and care facility staff, must often learn new ways to connect.

This photo essay from Kaiser Health News explains how memory cafes helped one husband learn how to entertain and engage with his wife who has dementia.

Linked Senior, an organization that supports person-centered care for people with dementia, recently published a webinar recording that presents stories from people who are experienced in engaging with long-term care residents who have dementia.

New resources from CMS

DREAM Toolkit promotes high-quality sleep

As many as 7 in 10 adults with dementia have sleep-related difficulties, which can speed up dementia symptoms. Poor sleep can also weaken immune systems, cause loss of balance, and increase pain sensitivity.

To help staff of long-term care facilities promote high-quality sleep for people with dementia, CMS recently released the Developing a Restful Environment Action Manual (DREAM) Toolkit (zip folder with 5 PDFs, 3 MB).

Highlighting practical approaches, the toolkit includes an implementation guide for leadership, a 4-minute video for all staff, a pocket guide for clinical teams, and more.

H2T Toolkit helps protect against infections

Improving routine hygiene practices can help caregivers protect against some infections. To that end, CMS offers the Head-to-Toe Infection Prevention (H2T) Toolkit (zip folder with 7 PDFs, 10.7 MB).

The comprehensive toolkit includes several resources, such as:

  • a handbook with mouth, skin, and urinary care tips for bedside staff
  • a checklist for customizing assistance with activities of daily living
  • an observation guide for nurse aides and licensed nurses
  • a fact sheet for nursing home residents and their visitors
Funding opportunities

USDA Rural Business Development Grants

Application deadline: May 14, 2020

Learn more about the transportation grant

The U.S. Department of Agriculture (USDA) Rural Business Cooperative Service is currently accepting applications for rural transportation systems that serve federally recognized tribes. Applicants can either:

  • operate a rural transportation system or
  • provide technical assistance to a rural transportation organization

Applications must be submitted to the USDA Rural Development State Office where the project will be located. Find your local office USDA Rural Development State Office.

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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. If you are a member of the group already, you can access it by clicking the group name under Groups on the left side of your LinkedIn landing page.
About the TA Center

The LTSS Technical Assistance Center provides a roadmap for American Indian and Alaska Native communities who are planning and implementing LTSS programs to care for their elders and people with disabilities.

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.

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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.

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