Guidelines for interacting with Native Americans and their families

• The Creator’s Spirit is alive and in all things in the universe. Everything that can be seen or
touched is “alive” with the spirit, or breath. The Creator’s Spirit actively affects human lives
in ways that can be both good and bad. Mother or Grandmother Earth’s spirit nourishes
and sustains life, and it is there that people return after death. Mother or Grandmother
Earth is to be respected and given thanks for the life it gives to sustain creation. All forms
of life depend on all others. The words Mitakuye’ Oyasin expresses this thought which
means all of creation are my relatives, we are all one, “we are all connected and whatever
happens to the Earth it will happen to the children of the Earth.” (Chief Seattle). Lakota
Holy Man Black Elk states, “Peace…comes within the souls of men and women when they
realize their relationship, their oneness, with the Universe and all its powers, and when they
realize that at the center of the Universe dwells Wakan Tanka, and that this center is really
everywhere. It is within each of us.”

• Each individual is called to “walk in the sacred way or to walk in beauty”. This means to
live in balance and harmony with the universe and spirit world. Each person finds their own
sacred way by seeking the sacred through traditional teachings, prayer, vision quests and
or dreams.

• Morals, ethics, values, beliefs, culture, customs, religious and sacred traditions are passed
on through an oral tradition and through ceremonies. Cultural identity, understanding and
bonding takes place through rituals developed by tribes over many centuries. Some of
these may include dancing, singing, drumming, prayer, worship, feasting, purification rites,
fasting and physical ordeals. An example of this would be a singer coming to the hospital
with a hand drum in order to sing a prayer song.

• There are medicine men and women, singers, shamans, and healers who have been given
a special gift by the Great Spirit to help mediate between the spirit world and the earthly
world for healing, spiritual renewal and for the good of the community.

• Humor is an important part of the sacred way because two-leggeds (people) need to be
reminded of their own foolishness.

• The theme of “One Mind” is one that runs through many Native American tribes.

• Decisions will be put off if agreement cannot be reached. Dissention will dictate that one
needs to proceed with caution and take time to reflect in order for everyone to come to “one
mind”, “one accord” and/or “one decision”.

• Community and relationships are important. Family includes many extended family
members and friends and/or an entire clan. Elders are respected and listened to when

should see beautiful things around you. Beauty means to live in balance. This balance
includes a circle containing our parts – body, mind, heart and soul. Another circle of Beauty

would be community, family, plants and animal, brother & sisters. And yet another circle
with all so we may Walk in Beauty again.

Circumcision of male infants is infrequent.

Sanctity of life is a high value but abortion practices vary.

Maintaining a terminal patient on artificial life support for a prolonged period in a vegetative
state is not encouraged. At the end of life, prayers may be said and family is encouraged to

be present.

• Patients may deny their pain, or decide not to talk about it because it is hard to accept that
their bodies are failing them.

• Patients may also be afraid of becoming addicted or be sensitive to medicines. Take time
to explain healing can be quickened if pain is managed.

• Talk with the patient to find out their preference for managing their pain; pain management
can be managed at the hospital and/or at home.

• If the patient is dying they may want to go to the Creator with a clear and open mind.

• Patients may not believe in medication due to their belief that the Creator will heal them
through traditional healing practices.

Elders are respected and treated with honor within the Native American society. They are
respected as teachers, the purveyors of tribal history and lore, and for their advice. They are
seen as people who have a great amount of wisdom and knowledge, which they share with
others of all ages. Their presence is not taken for granted or just tolerated but relished and
enjoyed. This is a natural part in all Societies. The Native Americans take this special attitude
and use it to its fullest extent. Caring for the elderly in their homes is seen as important and as
a necessary part of life. The children are then given a gift of wisdom, love and the freedom to
play and dream with a person who does not care how foolish they act for only they can see
how wonderful and sometimes short life can be. Children and Elders are supposed to be
together. It is through our Elders that individuals are taught the full circle of life, which includes
death.
If the patient needs care at home after being in the hospital, family members should be trained
to take care of the patient. Time should be taken to explain the procedures, utilizing hands-on
experience in order for the family member to make sure they fully understand the process.

Fasting is a traditional part of preparation for rite of passage ceremonies and for spiritual
discernment. Although a person who is ill should be encouraged to eat, family members and
others may be fasting on behalf of the person. Sometimes fasting is a part of body healing, as
a cleansing of toxins.
Native Americans have preference for certain traditional foods during ceremonial times. These
may be requested, especially particular teas. When preparing a special diet, (such as for
diabetics or heart conditions), utilize traditional food recipes and then adapt or change recipes
to fit the dietary requirements.

As children come into this world it is recognized that this is the beginning of the cycle of life.
Throughout the child’s life each will go through the cycle of life, such as: birth, naming,
childhood, adolescence, marriage, child rearing, old age, and death. All stages of life are
valuable. There are a vast number of rituals that mark the passages from one stage of life to
another help to keep the individual on the path and to bind them to their family and their
community. The path of life is a spiritual journey, not just a physical one. The ceremonies
marking life’s passages vary widely from tribe to tribe, however most groups value each stage
of life and mark it with ritual and celebration. At the beginning of life there are a variety of
traditions and these may include:

• The use of herbs and teas during labor.

• The help of a midwife.

• The presence of family members, spiritual leaders.

• The saving of a length of the umbilical cord, which is then added to a sacred bundle. This
bundle is kept by the child for a lifetime as a connection to the mother and to mother earth.

• Saving of the placenta.

• Singing a special song to the child at time of birth.

• Burning incense and smudging the newborn.

Native Americans do believe that death is natural and necessary in the circle of life. They may
vary the beliefs as to how long it may take for ones souls to travel from ones body here on
earth to the final joyous reunion with our Creator. There may also be various beliefs as to what
if any objects are needed to make ones Spirit journey and what needs to be done to the body
left behind.
A patient who is nearing death often reports visits and conversations with deceased relatives.
Usually the patient will request traditional foods and it is very important that the family obtain
these foods for the patient so that they are ready for their journey. Native Americans use food
to honor the dying and deceased where other people may use flowers. Patients may also
request special prayers from their tradition and if they are Christian they may also want to have

Fasting is a traditional part of preparation for rite of passage ceremonies and for spiritual
discernment. Although a person who is ill should be encouraged to eat, family members and
others may be fasting on behalf of the person. Sometimes fasting is a part of body healing, as
a cleansing of toxins.
Native Americans have preference for certain traditional foods during ceremonial times. These
may be requested, especially particular teas. When preparing a special diet, (such as for
diabetics or heart conditions), utilize traditional food recipes and then adapt or change recipes
to fit the dietary requirements.

As children come into this world it is recognized that this is the beginning of the cycle of life.
Throughout the child’s life each will go through the cycle of life, such as: birth, naming,
childhood, adolescence, marriage, child rearing, old age, and death. All stages of life are
valuable. There are a vast number of rituals that mark the passages from one stage of life to
another help to keep the individual on the path and to bind them to their family and their
community. The path of life is a spiritual journey, not just a physical one. The ceremonies
marking life’s passages vary widely from tribe to tribe, however most groups value each stage
of life and mark it with ritual and celebration. At the beginning of life there are a variety of
traditions and these may include:

• The use of herbs and teas during labor.

• The help of a midwife.

• The presence of family members, spiritual leaders.

• The saving of a length of the umbilical cord, which is then added to a sacred bundle. This
bundle is kept by the child for a lifetime as a connection to the mother and to mother earth.

• Saving of the placenta.

• Singing a special song to the child at time of birth.

• Burning incense and smudging the newborn.

Native Americans do believe that death is natural and necessary in the circle of life. They may
vary the beliefs as to how long it may take for ones souls to travel from ones body here on
earth to the final joyous reunion with our Creator. There may also be various beliefs as to what
if any objects are needed to make ones Spirit journey and what needs to be done to the body
left behind.
A patient who is nearing death often reports visits and conversations with deceased relatives.
Usually the patient will request traditional foods and it is very important that the family obtain
these foods for the patient so that they are ready for their journey. Native Americans use food
to honor the dying and deceased where other people may use flowers. Patients may also
request special prayers from their tradition and if they are Christian they may also want to have