Retired Arizona Nurse Is Working to Address Needs of Elderly Native Americans

Residents of the Tohono O'odham Nation had to leave the reservation if they needed skilled nursing care until Frances Stout helped establish the first skilled-care facility for aging Native Americans on the Tohono O'odham Reservation.

After 33 years working as a nurse, Frances Stout retired and then immediately went back to work to help the elders of the Tohono O'odham Nation, a federally recognized Indian tribe. While Stout is an enrolled member of the Tohono O'odham Nation, she did not grow up on the Tohono O'odham Reservation, nor does she speak the native language. But as Stout noted, "There is more than one language in caring for people."

Without a skilled facility on the reservation, elders had no other choice but to leave to find such care. Stout stays, it was a painful experience for them because the food was different, nobody spoke to them in their native language and they couldn't take part in traditional ceremonies. "They wanted to come home, and we began the process of bringing our elders home by building our own facility," said Stout.

With the benefit of experience acquired in her 33-year nursing career, Stout was an active participant in the creation of a 60-bed skilled nursing facility, the first of its kind on the Tohono O'odham Nation. She also worked to find and train staff. "We don't currently have any Native American registered nurses at our facility. We do have Native American certified nursing assistants and licensed practical nurses in addition to non-Indians providing nursing care. We continue to search for physical and occupational therapists who would be willing to travel or relocate to our remote location," Stout said. Undeterred, Stout is working with the local community college to launch a nursing program.

"Healthy aging is an important issue," Stout says. Many of our people have diseases that could be prevented. We must invest more in preventive health and education, including the incorporation of traditional Native American medicine. Western medicine does not have all the answers," she says. "Our elders suffer from a number of chronic diseases, such as diabetes and hypertension." In addition, transportation, housing and safety are also major issues for the aging Native American population. "We live very far apart, and many of the elderly live alone. How are they supposed to get to the grocery store or to the clinic when there is no transportation? It is very difficult," said Stout. "We have to literally create all of our own services." She has been instrumental in creating an elder care consortium which includes the Indian Health Service, the tribe's Health and Human Services Department, the Tohono O'odham Community College and others, to work together to address the varied challenges.

One of the biggest challenges, Stout says, is her age. She is 74. In this second career, she must drive two and a half hours each way to frequent board meetings at the skilled nursing facility. Fortunately, she says the scenery is beautiful and calming. "I was raised with the idea that as long as you are physically and mentally able, you serve," said Stout.

Despite her years, Stout says she believes in the importance of living and planning for the future. "There are some tribes that believe in planning for seven generations ahead, but mine is not one of them," says Stout. "We always honor the people who came before us, our ancestors, but we need to think about children and those who are coming after us."