Indigenous Knowledge Informed Comprehensive Dementia Care Project - In response to Notice of Funding Opportunity HHS-2025-IHS-ALZ-0002, Seattle Indian Health Board (SIHB) proposes to implement an Indigenous Knowledge informed comprehensive dementia care initiative that encompasses all five primary drivers of care. The two-fold purpose of our request is to increase the availability of culturally attuned, timely, and comprehensive dementia care and to share lessons learned and promising practices with Urban Indian Organizations (UIOs), Tribes, and Tribal Organizations. SIHB is a Federally Qualified Health Center and a UIO with a service area of Seattle-King County, the most populous county in Washington State. We care for over 6,000 unduplicated people each year, about half of whom identify as American Indians and Alaska Natives (AI/AN), representing 215 different tribal nations. Our project will respond to the needs of Urban AI/ANs in Seattle/King County who are impacted by or caring for a loved one with dementia. The project includes the following five objectives, which align with each of the five primary drivers of comprehensive dementia care: (1) Awareness and recognition: By the end of the project period, SIHB will have integrated awareness and recognition dementia trainings and materials to reach diverse AI/AN audiences to include Elders, caregivers, youth, providers, and multidisciplinary team members; (2) Timely and accurate diagnosis: By the end of each 12-month period, SIHB will expand primary care screening and diagnosis for dementia; (3) Interdisciplinary assessment: By month 6, then ongoing, 6 MSWs and other designated staff will complete comprehensive assessments with relatives who are diagnosed with or at risk of dementia.; (4) Management and referral: Throughout grant implementation, SIHB will maintain a workflow for relatives with dementia symptoms/risk factors that encompasses internal and external care coordination for dementia care, specialty care, primary care, dental, Traditional Indian Medicine (TIM), behavioral health, Elders services, and human services.; and (5) Caregiver support: By the end of YR 1, then ongoing, SIHB will build on our Urban AI/AN specific caregiver support model. SIHB will report outcomes, to include: (1) the number of AI/AN relatives in SIHB’s care who receive at least one resource about dementia awareness and recognition; (2) year-to-year percentage increase of AI/AN relatives in SIHB’s care who receive dementia screening and/or diagnosis as part of primary care, or who have a pre-existing dementia diagnosis; (3) percentage of relatives diagnosed with dementia or at risk who have documented interdisciplinary assessments in our Electronic Medical Record (EMR); (4) percentage of AI/AN relatives connected to/retained in appropriate care; (5) number of caregivers supported annually; and (6) impact on caregiver’s quality of life while/after attending caregiver support services. Throughout the project, we will share lessons learned and promising practices with UIOs, Tribes, and Tribal Organizations through the Urban Indian Health Institute (UIHI), the research and evaluation division of SIHB. As a Public Health Authority and 1 of 12 Tribal Epidemiology Centers (TEC), UIHI has a national scope and serves the research, evaluation, and data needs of Urban AI/AN people located across 28 states. We anticipate some of the tools and materials we will develop will include: (1) featured stories about our Indigenous Knowledge Informed System of Care in relation to dementia care; (2) intergenerational approaches to dementia awareness and recognition; (3) leveraging culture as public health, featuring the role of the Elders Council and how Elder’s Program activities can integrate dementia awareness, recognition, and prevention.
