Funding Rural | Episode #18 | Season 3: Jordan Lewis, PhD “We Still Take Care of Each Other”
There are many folks who want to age in place but live far away from the care they need, and that can present challenges for their health, happiness and the social fabric of their communities. Dr. Jordan Lewis is the director for the Center on Aging at the University of Hawaii at Manoa with the Thompson School of Social Work and Public Health. He’s Alaska Native on his mother’s side and got his PhD in Community Psychology from the University of Alaska Fairbanks. Over the course of his career, Jordan has been drawn to the study of elder care— especially in rural and American Indian/Alaska Native communities. He wants to study the ways in which people can “age how they wish” and what we can all learn from the elders who are navigating that chapter of life.
“If one wants to age where they grew up, in rural America, which they should be able to, how do we get those resources to them?” —Jordan Lewis, PhD
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About Jordan Lewis, PhD
“There are great clinics in rural America; they’re doing incredible things…but for the access to specialized care… you may have to go to a big city.”—Jordan Lewis, PhD
Discussion Questions
Jordan talked about what he learned from Alaskan elders who are aging in the way that they wish, and there are some possible areas there for funders to consider. From his 6 keys to successful aging (listed below), how could your organization best offer support?
- Family, community engaging
- Spirituality
- Emotionally/mental health wellbeing, staying sober
- Physical health (but less so in Native communities than western elders)
- Engaging in native way of life (harvesting native foods, etc)
- Generativity: the desire to share knowledge to improve future generations
Resources
- Jordan P. Lewis, PhD | WWAMI School of Medical Education | University of Alaska Anchorage
- Alaska Native Successful Aging in Northwest Alaska: Aging in a Good Way Starts with Your Family
- SW 726 SWK Practice with Older Adults_Fall_2025
- Honoring and Preserving Culture Through Indigenous Cultural Generative Acts to Reduce Generative Mismatch and Improve the Health of All Generations (1)
- NSF Arctic Congress Report 2024
- Alaska Native Quality of Life: Culture, Rurality and the Sacred
- Generativity Holds Many Positve Effects for AI_AN Older Adults
“The big difference is in Indigenous communities, there’s still a strong sense of looking out for each other.” —Jordan Lewis, PhD
Transcript: Episode #18 | Season 3: Jordan Lewis, PhD “We Still Take Care of Each Other”
Erin Borla 0:10
You’re listening to Funding Rural I’m Erin Borla, Executive Director and Trustee of the Roundhouse foundation in Sisters, Oregon. Aging and elder care in rural and remote places comes up a lot for us here at Roundhouse because we know there are so many folks who want to age in place but live far away from the care they need. That can present challenges for their health, their happiness and the social fabric of their communities. Dr. Jordan Lewis is the director for the Center on Aging at the University of Hawaii at Manoa with the Thompson School of Social Work and Public Health. He’s Alaska Native on his mother’s side and got his PhD in Community Psychology from the University of Alaska Fairbanks. Since then, he’s had quite the career. He spent time in D.C. learning about the intersection of social work and policy. He was a Fulbright scholar. He did his post doc at the University of Washington School of Medicine and taught in the school of social work there. And over the course of his career, Jordan has been drawn to the study of elder care – especially in rural and American Indian/Alaska Native communities. He says he wants to study the ways in which people can “age how they wish” – and what we can all learn from the elders who are navigating that chapter of life…
Jordan Lewis 1:24
yeah. So, I guess it would, you know, there are some major, some themes across rural America, I’d say just in general, with older adults, you know, the the challenges of access to health care, specifically specialized health care, you know, you can get. There’s great clinics in rural America. They’re doing incredible things. They’re kind of the, you know, everything for everyone, for some places,
Jordan Lewis 1:46
but the access for specialized care, you know, as older adults. So you’d be you may need orthopedics, or, you know, specific things as you get older that you may have to go to a big city for. And so that’s a challenge we’re seeing, is if you want to age in where you grew up in rural America, which they should be able to how do we get those resources to them? You know, the other big challenge we’re seeing is out migration of younger generations. We also see out migration of older adults too, where it’s not not just young people anymore, but that leaves a challenge, you know, does the older adults follow their family to an urban setting, to stay near their grandkids, to have that support system, or do they stay back where they are in their rural area and try to make it as long as they can? Some can. It’s not to say that everyone can’t, but that’s a challenge we hear elders talk about all the time, like, sometimes it’s cost, like some rural areas, it’s really costly to live there. So can you afford to live there on your own if you don’t have family supports. You know, the I, you know, climate change is a huge hot topic. Maybe, you know, this administration, maybe it’s not the topic to talk about, but we’re seeing, you know, climate preparedness? Are people ready for disaster preparedness? Climate change, whether it’s in Alaska, whether it’s these more tornadoes and flooding and things happening that as an older adult, you can’t react as quickly, or maybe you don’t have a way to get your house or the care facility of what happens there. And I just don’t think you know it’s we’re having conversations here and with my colleagues, there’s a growing more as more older adults in the world now than younger people, and so the workforce development issues of how are we going to care for this population? You know, yes, they’re living longer. Some are living healthier, but also living longer and not healthy. And with that comes a need for people who are trained to work with older adults in different capacities. You know, we have policymakers and tribal leaders in Alaska and cross Indian country who say, Well, eventually we’re all gonna be able to age in place in your own home. That would be ideal, but maybe not possible. I don’t think it is. I think some people, regardless of their situation, wishes to be at home. Specialized care is what you need, right?
Erin Borla 3:51
Well, in a lot of your research is around tribal and indigenous communities. Alaska Native communities specifically. What does that look like? How does that differ from Western culture when we talk about aging and aging support services? Yeah, I
Jordan Lewis 4:05
think the big difference is in indigenous communities, I think there’s still a strong sense of looking out for each other. There’s that natural support network people hopefully know who’s in the community. I’d say most communities do, they stay connected with people. They have, they follow up. There’s really a lot of them have really strong elder support programs. So there’s a lot of programs and services, whether it’s providing meals at the school every day for them, elder centered programs and services. There’s elder, probably an elder center that’s more focused on social engagement activities that or just gatherings. There’s, you know, there, there’s a strong sense within families that we take care of our own, regardless of the disease they may have, whether it’s dementia cancer, that we still take care of each other, which I think not. I would say this is not across all Western cultures, but that’s much more individualized. You know, we don’t. Right? We have families who live very far apart. Maybe, you know, the first reaction for some families is, you know, as older adults get older care facilities is the first thought that comes to mind, whereas in a native community like you know, we’ve heard families that retrofit their home so their loved one can stay and be comfortable, so they’ll change their environment, their situation, to accommodate for people who need more advanced or specialized care. Not to say that doesn’t happen in families who are non native, but I think it’s more common that that’s and we are also hearing, I think, along the same lines, right? We have here elders say, I don’t want to be a burden, so I’m not going to stay with my daughter. I’m not going to stay with my son. And so there’s and that’s even happening more native communities is as this generation of people who are growing older now grow older where and are more accustomed to maybe they went to college, or they are more acculturated. I guess they also have this mentality of, well, I’m just going to put myself in a care facility. My daughter has two kids. She has a job. I don’t want to be a burden to her. So even that mindset is shifting a little bit, which I’d say is good and bad, and I think, you know, we’re have families that fight that, but I think that’s the big difference. Is indigenous communities support each other. They look out for each other, and they’ll make changes in their environment to support people and then more individualistic. Western focuses, you know you’re on your own or, you know we’re doing our own thing, yeah. Well,
Erin Borla 6:29
and on the counter side of that, what does success mean in the aging process?
Jordan Lewis 6:35
Yeah, so our in our research successful aging, there’s six things that elders across Alaska say are are important to have in their lives if they want to age well, family and community engagement is really important. Spiritual presence, which could be more traditional spirituality to Western religion, emotional or mental health or mental well being is another one. So that’s, you know, not taking something that alters the mind, remembering that words have power. So thinking through what you’re going to say to someone else. Physical health is also important, but they you know, unlike more Western notions of successful aging or physical health, is the most important thing in your life, elders in Alaska say, as long as I have these other things in my life, my physical health isn’t the priority I could you know, we had elders who were had advanced stages of cancer, amputations, they were homebound. But because they had these other five elements in their life, because even though they had poor health conditions, they still saw themselves as aging well, the other one was being able to engage in your native way of life. So whether that’s just having someone bring you native foods, or being able to go out and harvest your own native foods participate in native activities are important to you. And then the last one is this idea of generativity. And generativity is Eric Erickson’s idea that as we grow older, we have this desire to share the knowledge we’ve learned over our lifetime with the goal of improving future generations. So those six things elders say are important to have in their lives, and that’s what enables them to age well,
Erin Borla 8:18
I think that’s such an interesting and important. We talk about intergenerational work a lot in our work here at the Foundation, and I think that’s a really important piece of like, what is it that we get to give back as we get older? It’s such an interesting component that that is one of the six signs of successfully aging, is that you do get to give back?
Jordan Lewis 8:39
Yeah, I think. And as we’ve analyzed our data more, and as we’ve continued and had more research team members kind of look at our data from different perspectives, we’re coming to the conclusion, I think generativity is the, probably the of those six, the most important, if you if we don’t provide outlets for elders to share their knowledge, even other research has shown that it has shown that it has a negative impact on your physical and mental health. And you know, I think there’s a difference between growing older and becoming an elder, and this idea of the capital E elder is something that’s bestowed upon you by your community, your family, and it’s not something that’s given to you. And I think it’s because they embody these six things that they say are important. So when we talk to them about, you know, what is successful aging mean to you? Or is now we change it to aging in a good way, because our elders, you know, they’re like, well, successful aging compared to what so aging in a good way is kind of like, you’re more like a it’s like a process, right? Or something you do every day. You consciously think about, you know, your emotional well being, your physical well being, all these things that are so important. But I think, you know, they step into this role, and they’re seen, and they’re revered as an elder, because they they share their knowledge. And I think that’s, you know, there’s an interesting podcast that I just heard a few weeks ago. That we can be intelligent as older adults, but also we become wise when that intelligence and knowledge is shared without expectations for something back. And so I think that’s that our elders also have wisdom. I think that’s that’s what other people see in them, that they give them that title or recognition.
Erin Borla 10:18
No, I think that that’s really great, and I love that that’s one of the most important factors in some of your research. You’ve talked about aging and sobriety, talk about about that work that you’re looking at and studying, particularly, I know across native communities, we can sometimes see higher rates of substance use. How does that impact the aging population. Yeah.
Jordan Lewis 10:44
So when I was developing this idea of indigenous cultural genetivity Several years ago with a mentor, we wanted we had our successfully in data set. But then there’s also the people awakening data, which came out of UAF back in the early 2000s which is a large statewide study on reasons for sobriety, so a more strength based perspective. And then I did some work with homeless older adults in Seattle, again, seeing up these ideas of successful aging applied also to other populations. So I wasn’t just looking at healthy elders in Alaska, but within the recovery data, get we saw very similar things. And when we when older adults were talking about their journey in recovery, they start off with this the you know, whether it’s stopping naturally, so not going to treatment program. A lot of, I would say, most of the older adults in that data set, and then people we’ve talked to since then about alcohol related research, unlike western literature, I think we’re mostly, you know, it’s more common for people to stop drinking for negative things, whether it’s a DUI, hitting something, crashing your car. For the native population, we worked with you, they stopped drinking either because they realize they need to, because they’re not going to be able to fulfill this role of being an elder. They’re not gonna be able to be a grandparent. They won’t be on tribal council. Or there’s something positive in their life that they want to be sober for, for example, having the birth of a grandchild, or they’re getting offered a new job, or they get to do something that they really wanted to do, and to do that, you have to be sober. So their current lifestyle. It doesn’t align with the cultural values of what they want to do, and it’s best explained to me as, you know, before they get to that stage that they talk about. You know, I need to, I need to regain what alcohol took away, whether that’s, you know, being able to do beating or go to a Potlatch or participate in your native games, or, you know, eat your native foods, or do things are important in your native community, you you aren’t asked to do those things if you’re actively using so being it if you can stop. So how they usually stop? If they don’t stop naturally, then they start off with, they could go to AA on their own. They do their own studying. But then over time, they start realizing that, yeah, that was a good start. It gave them the tools they need to stop. But then they start replacing aa with these cultural activities that were so important to them, and over time, those activities then start replacing the drinking behavior to the point where then they just that becomes common again, and they regain and are able to step back into the role of what they wanted and to them that’s much more powerful and meaningful to them than when the drinking was. And so thinking about that, you know, generativity, it’s more referred to in the alcohol research, as redemptive narratives. And so within redemptive narratives, what your elders share these stories of, you know, when I was drinking, this happened, and you know, negative things have happened, or things that they are which didn’t happen, happen, but over time, those experiences was most likely negative turn into lessons for them. And they’ll say, you know, this happened to me over time, I processed it and I learned this is what came out of that experience. I’m sharing that with you, whether it’s a young person, someone else in the same age cohort with the goal of really hoping to help them not have the same experience. So they’re being generative in their recovery, or using these redemptive narratives to help other people have maybe not have a more as difficult experience as they have, and having that outlet is so important to them.
Erin Borla 14:20
Yeah, so this show is a lot about philanthropy. We focus on how we can get private funds to whether it’s research institutions like yours studying some of these issues, or it’s folks on the ground actually applying this work. What are some of the things? Are there specific funding areas that you think folks should know about aging adults or elders, particularly in rural and native
Jordan Lewis 14:44
communities. I don’t know if it’s tied for first, but I would say first, you know, intergenerational connections, social engagement, is pretty high up there. I’d say that’s, you know, we were looking at, you know, trying to think about, you know, there’s different foundations focused on social isolation. There. Trying to figure out, what are some solutions to bring generations together, whether it’s across the same age cohort or, you know, older adults and younger people. But tied with that, though, I think, as you know, just creating programs and funding to send to communities to create, like, a very basic awareness of Alzheimer’s and dementia, I think that’s a growing concern across I don’t think it has a geographic low, you know, fixed area. It’s everywhere. Whether you’re extremely wealthy, extremely poor, live in the middle of rural America, middle of Iceland, wherever. I mean, think it’s, it’s there. And so, you know, if we could put funding towards just, you know, I think the other aspect of that is funding towards resources and training for the family or informal caregivers, I think is a big gap that we don’t have addressed. Either there’s families who are already doing it, but as more and more people are living longer, having dementia for 510, 15 years, there’s a lack of understanding and awareness of that disease progression and what can be done or can’t be done, or some tools and tips to help not only just know how to manage the person with dementia, you know could be that the unmet needs, the challenging behaviors, but also caregiver self care. And how do you protect yourself and learn how to ask for help so you have respite? So I think that’s without that. I think if we don’t have supports for our caregivers, we’re going to be an even a bigger problem probably down the road. I hope you know, because there’s studies that are showing that without adequate supports, caregivers are used most likely pass on before the people with dementia due to health conditions and the stress of the caregiving duties. So that’s mean, that’s a huge concern, especially if you’re primary caregiver in your rural area, or because then, you know, where does your loved one go? Or do they go to a different family member? I would say those are the top two. I think you know, the other big one, of course, is like, how do we keep people the rural America has its own unique, special gifts about it. How do we keep communities from disappearing? I think that’s a that’s a bigger issue, right? There’s so many variables that go into play into how you would do that, but
Erin Borla 17:06
talk more about that. Like, help me understand. Like, are you thinking of the certain population in a community, or communities in general?
Jordan Lewis 17:13
I think communities in general. Like, we, you know, we, every once while you hear about, oh, rural America, like in Alaska, for example, oh the villa, no one lives in the village anymore. That do we take out the map? Do people just go there in the summer? Is it just now? Is it just a fish camp because they’re out migrating? Or, you know, there’s, you know, we have villages in Alaska where it’s only people who are 70 and older, and there’s like 20 of them. Is that still a village? Like, what’s happening to these rural areas? You know, I’m not, not as familiar with the lower 48 or contiguous the United States and rural areas there, but I can imagine rural communities might be changing or shifting in their population and what’s happening. But you know, there’s, you know, there’s for the generations who were like the baby boomers now, who are growing older, if they came from a rural area, there’s that there’s something special about people who want to go back. You know, we hear a lot of elders say, I went back to my village in Alaska, and it’s just not the same. So I can’t live there anymore. It’s not what I remember it when I was living there. And so how, what was that? And how do we bring that back? Is it because there’s no young people there? There’s no sense of engagement, social connection, social, social it, you know, programs and services. No, even the village I grew up in, nacnic, I go back and it’s like, yeah, there’s people there. I don’t people I grew up with there don’t live there anymore. So it’s like, yeah, it doesn’t have the same feel for me anymore. So how, what is that feel? You know, is that, does that mean in 2030, years, when the baby boomers have passed on that rural America is going to have a America is going to have a different feel. If it even exists anymore, I’m sure it will.
Erin Borla 18:47
But, yeah, no, understood, yeah, I think that’s a really interesting point of like, what, what do you come back to? Right? And it comes back to that point of community and really finding ways to support elders and intergenerational work. So folks do have that place to come back to, where they feel included well, and I know it’s a ways off, but how do you hope that you age? What have you learned through your research that you want to apply to your own life?
Jordan Lewis 19:11
Yeah, I mean, that’s a great question. I think I’ve only been asked that question twice. I think of the second person to ask that, and I’ve never, I still haven’t really thought about what I guess, living long enough to be able to share my experiences of you know, I think, I think every generation says this, right where this I’m in this unique generation, where we grew up before computers and video games and cell phones, but we’ve lived long enough to see what’s going to happen after, whereas a generation now, you know, my sister has always, she’s born In 1990 so she’s always had computers in her life. But, you know, the two sons we adopted, they’ve always, they’re always going to have cell phones and everything, it’s fancy things in her life. So I think I look forward to talking about, and hopefully I’m asked about what life was like back then, you know, it’s we laugh now, like, oh yeah, we grew up before we, you know, had had computers. Had to write everything and typewriters. Um. Um, also, you know, the the native part of growing up in Alaska, of like, what it was like to pick berries and be on the land and know how to read the weather and, like, those are things I learned from my elders, making sure I pass that on. And it’s something I think about now I saw there’s, I guess, that having learned what I’ve learned from my research, there are certain things now I find myself writing down or telling my sons now so I don’t forget, because I have this fear that I’m not going to remember. And I also, you know, doing some work, doing work or reminiscence therapy, I listen to music like yacht rock and 80s music, and it brings me back to these memories. And now I put myself as an older adult. How do I make sure yacht Rock’s still available in 40 years from now, 30 years, like, because it brings back such positive memories for me, for some reason. And so it’s like, I think about those things. The other aspect of my research, like, my parents asked these questions, like, how do I age? Like, what should I be doing? Like, have you not read anything I’ve published? Like, the funny part of it, like, oh, you should read what I’ve written. Or, you know, there’s things that we have learned that you can apply to your own life. But yeah, I think it’s just making sure that the things I want my kids to remember, I want other generations remember I document now, because I’m seeing in the generations and older adults now they didn’t have that opportunity to, whether they’re because of dementia or they passed on to document stuff they thought was important.
Erin Borla 21:16
Yeah, well, it’s been so great to learn about your work, and I really appreciate your research that you’re doing, particularly with American Indian Alaska Native communities. So thank you for doing the work, and thanks for sharing today.
Jordan Lewis 21:29
Of course, yeah, thank you. Appreciate the opportunity. You
Erin Borla 21:47
aging and becoming an elder with a capital E is such a privilege and a time in life that should be celebrated, and there’s such an opportunity for foundations and funders to play a role in that identifying different opportunities within community that would be super helpful for folks to be able to be connected, to learn more. There’s some great national research out there around Alzheimer’s and dementia. How do we ensure that those get applied in these communities? Working with organizations like dementia friendly organizations on the ground, or providing access to education opportunities for first responders or other folks that are working in those spaces. Those are all great ways to ensure that this information and research gets applied in these communities that are further away from where it’s actually happening. I love the list of things that help folks age successfully, especially the generativity, the desire to be able to share knowledge and improve future generations. Head over to funding rural.com to read more of Jordan Lewis’s research, see videos and more. Thanks for listening. You.
Transcribed by https://otter.ai
