ELEANOR KRASSEN MAXWELL AND ROBERT J. MAXWELL

INSULTS TO THE BODY CIVIL: MISTREATMENT OF ELDERLY IN TWO PLAINS INDIAN TRIBES *

ABSTRACT. The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone Mountain and Abundant Lands, the abuse or neglect of elderly is construed as a health problem which is a dysfunction of the community as a whole. Both physical abuse and neglect are more common on the Lone Mountain Reservation, occurring in association with other indicators of community disorganization such as unemployment and substance abuse. On the Abundant Lands Reservation physical abuse was categorically denied and what neglect existed appeared to be a function of role strain, geographic dispersal, climate and terrain. We attribute differences in the prevalence of mistreatment of elders to variations in economic opportunities for younger residents. Examining the historical and present contexts of intergenerational relationships on the reservations, we discuss the implications of this study for social exchange theory and policy applications. Key Words: elder abuse and neglect, holistic health, Plains Indians, social exchange

theory, social policy, the body civil The mistreatment o f older people is difficult to treat with precision. Victims are often reluctant to discuss their situations and when they do, their problems are likely to be expressed as a consequence o f individual deviance or family disorganization. There is the additional problem o f variance in the definition o f mistreatment. Members o f the two Plains Indian tribes discussed here tended to construe the mistreatment o f elderly as a dysfunction in community health. In a diachronic context, such mistreatment is associated with perceived powerlessness, which on these reservations seems to be a function o f limited economic resources and enforced acculturation. Adopting the perspective o f these two tribes, we suggest that an investigation o f the antecedents o f elder abuse from a social structural perspective has important policy implications. ELDER ABUSE DEFINED The treatment o f elder abuse as a social problem has received increasing attention mainly over the past ten years, following the "discovery" o f child abuse by radiologists and others. H o w e v e r no clear definition o f elder abuse has been agreed upon. The definition expressed by the Plains Indians with whom we worked is distinctive, based on a h o l i s t i c concept o f health. "Health" becomes an all-embracing term, encompassing behavioral as well as somatic and psychological conditions; not so much a sound mind in a healthy body, as a sound mind and body in a healthy community. That this definition of the situation is held by other Plains Indian tribes is suggested by written testimony offered in the course o f a hearing before the U.S. Senate Special Committee on Aging. Resolution 8 8 - 1 4 o f the National Indian Health Board refers specifically to elder abuse as a Journal of Cross-Cultural Gerontology 7: 3-23, 1992. © 1992 Kluwer Academic Publishers. Printed in the Netherlands.

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health issue and asks that "The Indian Health Service identify and request adequate funding for grants that will have significant impact on Indian elder abuse (U.S. Senate Hearing 100-981, 1988:169)." As far as the two present cases are concerned, it became clear that mistreatment o f the elderly was as much a threat to the body civil as a spear was to the body physical. Physical abuse and deprivation o f the elderly were equally threatening in so far as each was a symptom o f community ills. O f course physical wounds were seen as requiring medical treatment, but "healing" in its general sense needed to address the entire community. One elderly informant, interviewed at a youth-elder camp-out, said for example that he saw the gathering as "an opportunity to heal [his] community." Definitions o f elder mistreatment vary considerably across cultures. The ways in which human beings collectively interpret their social circumstances vary with the purposes o f people as well as with time and with space. A n d here, in the realm o f ethnography, the variance can be truly impressive. Carlton Coon cites a report describing some o f the ways in which the infirm elderly were treated by the "Mission Indians" of California a century ago. It is to be feared that some of those who are seized with illness far from the mission, and not carried thither are buried alive, especially old people, and such as have few relations, for they are in the habit of digging the grave two or three days before the patient breathes his last. It seems tedious to them to spend much time near an old, dying person that was long ago a burden to them and looked upon with indifference .... On their way to the mission, some natives broke the neck of a blind, sick, old woman in order to be spared the trouble of carrying her a few miles further. Another patient, being much annoyed by gnats, which no one felt inclined to keep off from him, was covered up in such a manner that he died of suffocation (quoted in Coon 1948:76--77). The ethnographer seems to be troubled by the killing more than the Indians themselves, who view the act rather casually. At or near the opposite end of the continuum must rest the case o f the traditional Han Chinese, whose veneration o f their elderly has become legendary, and who interpreted a m a n ' s murder o f his own father as the most heinous crime and punished him not only by subjecting the abuser himself to a long and lingering death but by tattooing his mother's face with four ideographs indicating her son's crime, while others o f his family would forfeit land, the bones o f his forefathers be dug up and scattered to the winds, and the schoolmaster who instructed him in his youth would be decapitated (Gray 1878). These examples serve to illustrate the diversity o f constructions placed upon the mistreatment of the elderly when the process is viewed pan-globally. That reality is socially constructed is an idea that has a history o f some depth, both in philosophy, from Zeno o f Citium and Epictetus through Kant, and in social science (eg., Berger and Luckmann 1967; Schneider 1985), and it has been shown to have important consequences in health studies since the pioneering work of Zborowski (1952). l As a statement attributed to Gregory Bateson put it,

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"The human individual is endlessly simplifying and generalizing his own view of his environment; he constantly imposes on this environment his own constructions and meanings; these constructions and meanings are characteristic of one culture as opposed to another (quoted in Kluckhohn 1949:356)." Treating ill health and elder abuse as taxonomically similar preserves the integrity of the Plains Indians' Weltanschauung. To them, the two have traditionally been indistinguishable: behavioral deviance is the equivalent of psychophysiological deviance, and both are a reflection of the fact that something is wrong with the mechanics of the system of which they are a part. In contrast, the construction placed by some non-Indian professionals upon behavior described as "abusive" construes it as a particular kind of social problem, a form of individual deviance, requiring sanction. Some nonprofessionals may challenge some labels of abusive behavior, considering that the behavior so defined is unfortunate, but not self-evidently severe enough to warrant the intrusion of outside agencies into matters of family authority, Still, the majority of states have adopted mandatory-reporting laws covering adult abuse or have passed an adult-protective service law, although there is a good deal of variation between states in terms of definitions of what is abusive and therefore much variation exists in policy as well. PROBLEMS OF MEASUREMENT As with the definition of other social problems, once we acknowledge that the problem of "elder abuse" is socially constructed, we are faced with the problem of whether or not any objective comparisons are possible across societies. Thus we might ask, "Is there any behavior that is universally judged to be 'abusive'?," in order that we may "measure" it. If such "objectivity," is impossible, how can we interpret one's group's social construction for another whose definition differs? In order to discuss elder abuse among the tribes we will call Lone Mountain and Abundant Lands and contribute to the growing body of sociological literature on elder abuse, we attempted to place the behaviors identified as abusive by the tribes into a framework that "objective sociologists" might follow. Of course we understand that some information is lost in the process. We assume for purposes of this paper that mistreatment of elders exists, because tribal leaders were considering how they might remedy this problem at public meetings of the tribal councils. The exact frequency of the behavior in question is beyond the scope of this paper, but it should be understood that the behavior was "real enough" that different people, representing different institutions, reported either having witnessed or having been involved in the same incidents. Certainly some of the consequences of their concern were "real". In 1990 the identification of elder abuse led the Lone Mountain Tribe to consult with professionals to investigate the problem at an "Elder Abuse Awareness Forum" at which multiple instances were described. Although not part of the Plains Indian social construction of "elder abuse," the authors recognize three cutting points in a continuum of what might be

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termed intergenerational mistreatment of older people. Mistreatment of older people is defined as behavior in which a younger person violates longstanding culturally specific norms for intergenerational relationships and the violation is remarkable to others in the community. It might thus be said that mistreatment occurs whenever one acts contrary to "role expectations" and his or her behavior is noticed. The three cutting points on the continuum are reflective of the degree of variation from role expectations. In this manner "physical elder abuse" is assumed to occur when one violates prescriptive norms governing physical relationships between generations such that the behavior of the younger party is defined as "inflicting personal harm" on a member of the older generation. "Primary neglect" is assumed to occur when one neglects age-specific tasks which are expected on the part of a younger person given a status complementary to that of an elder. Primary neglect is said to be purposeful in that it represents the rejection o f one's role expectations rather than being a consequence o f role strain, role conflict, or circumstances beyond one's control. "Secondary neglect" occurs when one neglects age-specific tasks and it is assumed that neglect of one's responsibilities is the consequence of role strain or role conflict. To draw an example from one of our communities, if it were normative for one's son to participate with his parents in peyote meetings and the son did not do so, this would constitute neglect. If the son announced that it was unreasonable to expect him to attend peyote meetings, because he didn't believe in the old Indian ways, his neglect would be "primary". If on the other hand, the son was employed in a "socially accepted occupation," whose responsibilities prevented him from attending the peyote meeting, his neglect would be defined as "secondary." The continuum might then be treated as a three-point scale. (1) Physical abuse, like battering. (2) Primary neglect, like taking an elder's money or leaving a sick elder alone at home in order to go fishing or drinking for an extended period, subsequent to having agreed to care for the elder. (3) Secondary neglect, in which significant difficulties impose themselves between the elder and his usual providers which may or may not be the younger person's fault. 2 The cutting points along the continuum would distinguish between physically and emotionally abusive behaviors, although we recognize that the categories shade into one another. Physical battering shades into rough handling and verbal abuse. And deliberately deserting an old person shades into not being able to visit him: how much snow has to fall before you believe it is impossible to visit your ailing parents? At any rate our informants were not concerned with these distinctions. As their view of well-being is holistic, they did not initially distinguish between the physical and civil bodies. 3 Let it be emphasized that the predominant tenor of intergenerational relationships on both reservations is cooperative and often warm. A recent book supposed to deal with elder abuse was commented on by a reviewer in this way: "Most [of the contributors] conclude that families generally function to assist rather than abuse their elders during times of need. Were one to read these

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chapters without the benefit of the book's title, the reader would be likely to infer that the contributions came from a volume on family solidarity or family relations rather than elder abuse" (Kahana 1989:403). The same general observation should be kept in mind with regard to the cases treated here. CONTEXTS OF ACCULTURATION At the time of their earliest contact with whites, both the Lone Mountain and Abundant Lands people had mostly family-owned chattel like weapons, and individually owned personal effects; both had tribally owned land as well as tribally owned ritual objects. Private property was generously shared. There was a well developed system of tribal allegiances and enmities that was expressed in small and irregular revenge raids and horse-stealing parties. Following this early contact, their subsistence came to be based on horses and buffalo and involved a semi-nomadic way of life. This well-integrated system lasted from about 1840 until about 1865. With the coming of Euroamericans, along with their weapons and diseases, and the extermination of the buffalo, dismal consequences ensued. After fighting a series of battles against the United States Cavalry the economy of the tribes was abruptly and painfully shifted to one of dependence on a federally introduced symbolic medium of exchange, namely currency, and a reservation life style. Methods of coping with the newly imposed alien pattern of restricted travel and resource management needed to be devised. Perhaps later contacts with white people can be said to have followed axes of acculturation that resemble those of the Grassy Narrows Ojibwa described by Kai Erikson (1985:xiii-xiv). (1) The Ojibwa were decimated by influenza in 1919. The Lone Mountain people have been subject to recurring illnesses introduced by Europeans, and the Abundant Lands people lost most of their population during the 1840s to a wave of smallpox. (2) Ojibwa children were removed from their reservations and educated elsewhere as a matter of policy, and thus stripped of their native language, skills, and Indian identity. Some of the Abundant Lands people were subject to such forced removal during the 1930s. The Lone Mountain people were not forcibly reeducated, but were subject to rather rapid acculturation, particularly the younger men who were liable to the draft. The impact of World War II is difficult to overestimate. The Secretary of War referred to it as the greatest exodus of Indians from reservations that has ever taken place. (3) Missionaries converted the Ojibwa, undermining the traditional religious practices of the elders. Both the Lone Mountain and Abundant Lands tribes have been under similar pressure over the last century and a half. (4) The Ojibwa community as a whole was moved to a new reserve in the mid-1960s. The Abundant Lands people were permitted to stay in their homeland, although its boundaries were circumscribed, reduced to about one twentieth the extent allowed in an 1855 treaty. The Lone Mountain people were forcibly removed in the last century to the Southern Plains. Half the population -

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men, women, and children - found their new habitat uncongenial and left one night for their original territory, pursued by the United States Army. An internal disagreement led to another split, and more than one hundred o f the illegal migrants turned themselves over to a military facility in a midwestem state. Poorly clothed and fed, they attempted an escape and suffered many casualties. The remaining Lone Mountain people reached their northern homeland and finally, in 1900, the present reservation was created. The tribe currently remains split between its northern and southern groups. Cornell describes United States Indian social policy from 1960-1984 in terms of efforts by the United States government to encourage economic development on reservations in order to gain access to tribal resources, especially those resources connected with sources of energy. Earlier policies encouraged the social control of Indians and ultimately their assimilation by white institutions, establishing similar tribal representative governments on all reservations, for example, despite the fact that some Indian groups do not believe in representative government. Comell notes that it is ironic that these policies strengthened tribal governments and supra-tribal organizations. He stated that although some tribes are more concerned than others about avoiding practices which subject them to white institutions, many Indian tribes "have been attempting to overcome a position of relative powerlessness by either bypassing or directly attacking the political/administrative structure of Indian-white relations (Cornell 1984:48)." The Lone Mountain Tribal Council exemplifies those who wish to avoid white institutions as it actively opposed economic development policies linked to energy resources. Members viewed these policies as examples of white interference in Indian life and in 1977, the Tribal Council passed a resolution to cease oil exploration and coal mining in order to preserve their sacred lands and to protect the environment in general. In contrast, the Abundant Lands Tribal Council bypassed the Bureau of Indian Affairs in 1988 in negotiating directly with the Smithsonian Institute for retum of ancestral remains. RESEARCH METHODS During the summer of 1988 the authors were post-doctoral fellows of the Gerontological Society of America. Funding for the fellowships was provided by an area office of the Indian Health Service (IHS) and the Fred Meyer Charitable Trust. We visited the Lone Mountain Reservation again in 1990. This paper reports information on only a minor area of investigation. The chief focus of the study was the health delivery system to elderly on reservations in a western state. We examined relevant archives at the IHS area office detailing clinic and hospital use rates on the reservations, then used traditional methods of naturalistic observation at the field sites. We entered Lone Mountain Reservation first and interviewed elders, their families, political and religious community leaders, and health providers about the Indian Health Service delivery system. And we repeatedly encountered spontaneous comments from our

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informants about what they called "elder abuse" as a problem. In other words, when we asked about health, they responded by talking about what we might think o f as an aspect o f social disorganization. It became clear during our first days on the site that interviews would prove more useful for our purposes than medical archives that were categorized in terms o f patient visits for diagnosis and treatment without detailing incidents o f health problems as defined by our Indian informants. W e attempted an archival study o f tribal police data on elder abuse incidents after the problem was identified for us, but these data supplied us with unreliable comparisons between reservations, as the two tribal police departments employed unique systems o f record keeping. W e were informed by the Tribal Prosecutor in Lone Mountain that although she knew o f several cases o f physical abuse, her files contained only one instance in which an elder had agreed to file a formal complaint against family members. W e attempted to define health the way our informants treated it and thus began to consider the mistreatment o f the elderly as an aspect o f health-related behavior. W e concentrated not so much upon the frequency and other quantitative features o f "abuse" nor upon the technical meanings o f the term, but upon the significance o f any kind o f mistreatment o f elderly and the definition o f this mistreatment as a health problem, rather than simply a "social" or "behavioral" or "moral" problem. Just the same, when an informant told us about elder abuse, we interviewed tribal police, social workers, and staff at the IHS clinic to see whether there was any official record o f the behavior having occurred, checking our sources and confirming statements much the same way journalists do. On Lone Mountain Reservation we lived in housing provided by the IHS in Big Elk. On Abundant Lands Reservation we rented a motel room in South Park. W e attended Pow W o w s , camp-outs, and sweat baths and were invited to a peyote ceremony o f the Native American Church. Our entr6e into both communities m a y have been eased by the presence o f our six-year-old son, an adopted Korean who was readily perceived as Indian. W e spent roughly one month at the offices o f the IHS and one month at each of the reservations. The data we will refer to here are qualitative. Informants' names have been deleted from the quotes and most place names altered.

LONE MOUNTAIN

General Circumstances Lone Mountain Reservation is centered around its principal community o f Big Elk in the central part o f the state. The reservation is relatively small and not located on a main traffic route, so it receives few casual visitors. Big Elk is built around a crossroads through which whiz cars and an occasional fast truck. There are only two stop signs on the reservation and no traffic lights at all. The scenery is attractive, high plains interspersed with ranges o f small timbered hills, but not

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enough to be a tourist draw in itself. Tourists wishing to visit local Indians usually bypass Lone Mountain Reservation and stop at an adjacent reservation which is conveniently located on the Interstate Highway and where signs appear encouraging tourists to visit a nearby national monument. On Lone Mountain Reservation there is a small shop selling locally made artifacts such as beaded moccasins to tourists, but it is out of the way, and no signs direct the casual visitor to its location. There is an annual 4th of July Pow Wow which attracts few non-Indian visitors. The Community College in Big Elk is closed in the summers. In general, contact with non-Indians is minimal on the reservation except for those persons who work for federal- or state-funded service programs. The reservation is legally "dry," but alcohol is readily available if one drives ten minutes north of Big Elk to an off-reservation saloon. There are somewhat fewer than three hundred persons over the age of sixty on the reservation, most of whom live in and around Big Elk in housing that is for the most part structurally sound and comfortable but old and poorly maintained, and with unreliable heaters. None has air conditioning. A handful of elders live near the town of Axeville, the site of the Catholic mission, thirty miles east of Big Elk. The road between Axeville and Big Elk has been described as treacherous during winter months due to frequent ice and snow storms. Still, Indians from the Axeville area must travel to Big Elk for medical treatment.

Socioeconomic Conditions There is virtually no industry on Lone Mountain Reservation. There had been some logging in previous years, but it was minimal and in 1988 a fire wiped out the forested area. Most of the employed work for government or tribal sponsored service programs. In other words, almost the entire workforce is in the "service sector." There are few in the "productive labor force." Little income is generated from tourism. Most of the income that does come from tourism is earned from activities sponsored by the Catholic Mission in Axeville and funds so generated are used to support the mission museum and school activities. The mission employs a small number of its graduates. The Tribal Council has on occasion hired "economic development experts" who have made suggestions for improving the economy of the tribe. The Council then experienced political battles concerning which of these suggestions was most worthy. Oil exploration and coal mining were finally rejected, for example, when traditionalists argued that development would eventually destroy land which has been sacred to the tribe for generations. (One elder guarded two sacred hills on his property with a rifle in his hand.) When the Council has agreed on an economic development program, they have rarely been able to get sufficient capital to implement it. Many expressed pessimism concerning the tribe's future economic situation. The young on Lone Mountain believe that in order to succeed they must leave the reservation. Consequently, many are educated elsewhere and few return. Many attend the boarding school at the Catholic Mission. Some are excellent students. One was awarded a scholarship to Stanford Medical School.

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On Lone Mountain Reservation we were told that in order to provide for basic family needs, some o f the population depends on income from firefighting. There is no other source o f income unless one has land, which can either be grazed or leased to off-reservation concerns for agricultural purposes. Lone Mountain territory is small per capita and much o f the land is not suitable for grazing. What little there is tends to be owned by the oldest generation who occupy an economic position superior to that o f their offspring. Elders have a guaranteed income from government pensions (Social Security or Supplemental Security Income). Those elders with land have additional money. The younger people with families have little opportunity for employment and no reliable source o f income. Some families received welfare, but this is insufficient for providing anything more than necessities. Income was generally derived from leasing the land. W e were told that more income could be had from leases than from working o n e ' s own land and the risk o f loss was smaller. (One earns income from leased land even when a crop is small due to drought, as occurred in 1988.) The situation we encountered on Lone Mountain Reservation may be c o m m o n among Plains Indians. In describing conditions among the Oglala Sioux in Pine Ridge, South Dakota, the Director o f the Community Health Representative Program explained that the elderly must provide economically for their families. The reason they are the sole providers is that the Grandmas or Grandpas are usually the landowners on which homes are build [sic] or they are the ones paying the rent out of their meager S.S.I. income. They usually take care of their children or grandchildren who live with them. In the winter time it's sad to see the elderly suffer needlessly when their S.S.I. payments are stopped because they get their lease checks. They survive all year on S.S.I. and look forward to this lease check so they can get a washing machine or fix their car if they have one or buy something they really need (Janis 1988:19, U.S. Senate Hearing 100-981).

Mistreatment o f Elders on Lone Mountain Our informants and guides included a number o f Community Health Representatives or CHRs, ordinary community members whose responsibilities resembled those o f outreach workers, paid by IHS to help others access health care systems. One had worked with old people for four years and she guessed that the exploitation and abuse o f elders by family members is "close to one hundred percent." In her opinion, the only way the young have o f getting money or land is to survive their elders; until then, some younger people steal from their elders or "con" them, often to support drug or alcohol habits. The Director o f the CHR program in Lone Mountain said about elder mistreatment: "Our way o f life is threatened. W e have elder abuse here .... It's directed towards old men and old women." Mostly, he claimed, it involved the neglect o f elders by younger relations who take the checks and use the money for alcohol, leaving

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the old people alone and in a bad situation. " I t ' s hard to stop abuse. Sons have been known to steal heating stoves from their parents, sell their pickups," and so on. " W e d o n ' t know where this came from. Indians never treated elders this way," he said. The residential Senior Citizen's Complex organized an elder abuse program in the past after instances o f physical and sexual abuse had been reported. A staff m e m b e r said that "the elders needed advocates." But when she acted as the elders' ombudsman and reported to the local prosecutor, the prosecutor published the names of those who had complained. Everyone concerned was embarrassed and the program was soon cancelled. In another instance we were told about two adults who had beaten up old people and stolen their jackets. In 1990, several people told us about related incidents which they referred to collectively as "elder abuse." W e were told the incidents represented a spiritual message sent to the Lone Mountain people to return to traditional ways. Informants explained that an elder had allowed outsiders to attend a Sun Dance. Subsequently, one of the elder's grandsons shot and killed another grandson. A short time later, the old m a n ' s daughter died in an automobile accident. The elder and his wife were beaten when they wouldn't give younger relatives money for alcohol. The old m a n ' s wife died o f a "broken heart" and he himself is now in a nursing home. Several people felt that the elder abuse would stop if the Lone Mountain people would return to their Indian ways, and as an attempted remedy an all-night prayer meeting was held at which Indian "medicine" was shared by participants occupying two teepees. The physical abuse, sickness, and injuries mentioned in these incidents were confirmed by Indian Health Service staff. There were also credible instances of primary neglect such as when the Director of the CHR program, for example, found an old lady at home, too sick to get out o f bed. He chopped wood for her, cleaned her up, and got her into the hospital. Her two sons had carelessly gone off somewhere, having left her alone. In another case we were directed by one informant to an older man who was physically handicapped and had a personal care worker taking care o f him. Earlier, his two sons had lived with him but d i d n ' t bother to care for him. The CHRs moved him to a well-heated place o f his own. But then his brother moved in with him, which was illegal! The brother later died at the hospital, and the disabled old man was finally moved into a room at the Senior Citizens' Complex in Big Elk. A few old people have been abandoned on the doorstep o f the clinic. There were also a few instances o f secondary neglect on Lone Mountain Reservation. The Medical Director stated that lapses in the traditional respect for e l d e d y could partly be attributed to the impact o f geography. Children put off visiting them until health problems become severe.

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THE ABUNDANT LANDS RESERVATION General Circumstances

The Abundant Lands Reservation is centered around Cool Springs in the western part of the state. It is large, about one and a half million acres, most of it in range land. The topography is much more varied than in Lone Mountain. The gentle hills of the plains change abruptly into the eastern face of imposing mountains in the west. Visitors entering the nearby national park from the east cannot avoid passing through the Abundant Lands Reservation so tourism is an important element of the economy. A lodge managed by the U.S. National Park Service in South Park is located on the reservation about twelve miles from Cool Springs and has regularly scheduled programs describing Indian culture. The lodge also employs several Indians in housekeeping positions. Cool Springs itself, the headquarters of the Abundant Lands Reservation, is sprawling. The driver who intends to simply pass through town must stop at at least two red lights. The reservation also includes about a dozen other settlements, all with only limited facilities, many of which are closed in winter. Residents plan provisional requirements carefully because they often must travel to Cool Springs for groceries. A shop featuring local Indian craft is located prominently in one of the hamlets. In order to reach any of these small communities from Cool Springs during winter months one must travel over roads covered with ice and snow, portions of which are mountainous and poorly graded. A museum dealing with Plains Indian culture, noted in most tour guides, is located in Cool Springs, as is Abundant Lands Community College, which offers its facilities to the public during the summers. The College is run by the tribal cultural leader, who has organized a guided tour of the reservation for tourists. He is a busy activist who recently negotiated the return of some skeletal remains from the Smithsonian Institute, an important enough achievement to be covered in a feature article in the New York Times. During the summer months, the IGA Market downtown is continually crowded as residents and tourists depend on the store for food, camping provisions, banking needs and the exchange of information. The market sells beer, but no liquor with spirits. The age distribution of the Abundant Lands labor force appears to be similar to that of other rural communities in western states. Although scattered throughout the reservation, most of the approximately 560 people sixty and older lived in or near Cool Springs. The housing of older people on the reservation varied in structural quality, but many homes showed evidence of recent renovation as part of the Housing Improvement Program. The farther removed one was from Cool Springs, the more delapidated the housing of elders appeared. Several of the eiders who lived in the small outlying settlements mentioned that they were considering a move to Cool Springs because it was easier for the elderly in the city. There were no air conditioners in the homes of elderly on the reservation, but there were also no complaints about heaters breaking down and being left unrepaired.

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Socioeconomic Conditions Agriculture is an important source o f income for residents o f the Abundant Lands Reservation, but unlike Lone Mountain, it is not the only source o f tribal income. There seems to be much more "workable" land to go around on the Abundant Lands Reservation and less economic dependence on elders. Younger members o f the Abundant Lands Tribe spoke spontaneously about the variety o f jobs available on the reservation. The Abundant Lands Reservation, especially the community o f Cool Springs, appears to be more modernized and resembles other small towns in the state. There are thus many commercial establishments on the reservation, ranging from restaurants to hardware stores, a bank, service stations, clothing stores, and the like. Members o f the tribe either own or are employed at each of these businesses. There are several stores on the main road in Cool Springs which sell Indian crafts. St. Theresa's, a small town located near an entrance to the national park, has more tourist attractions than elsewhere on the reservation. Tourists can pet a caged bear at one establishment and then cross the road to another which sells "authentic" tribal crafts, which are primarily the work o f elderly Indians. The reservation as a whole owns and manages a factory which produces office supplies and markets it wares off the reservation. They have been successful in winning the K-Mart contract for pencils and crayon markers. There is also a productive lumbering industry and many residents earn income from tourism, as described. As on Lone Mountain Reservation, some income is derived from firefighting and the Abundant Lands firefighters are proud o f the awards they have won. There are good schools on the Abundant Lands Reservation. Six-year-olds play computer games under the tutelage of committed and knowledgeable teachers. Some youths in outlying settlements attend public high schools in communities off the reservation as a matter o f convenience. Generally, Abundant Lands youth are more likely than are Lone Mountain youth to have social and economic relationships beyond the reservation. As has been said, the Abundant Lands people, especially those living in Cool Springs, resemble other residents of their state to a large extent. This is not to say that change has destroyed the native traditions o f Abundant Lands, but rather that there is a greater variance in the orientation o f tribal members, some of whom are highly "Americanized" and others not. Actually some o f the younger members are more "Indian" in orientation than might be expected. Elders see these younger people as rediscovering their culture in a manner reminiscent o f many third-generation ethnic immigrants in other parts of the United States. O f course this results in the sort o f dual orientation that is not always conflict free (McFee 1972). Mistreatment of Eiders on Abundant Lands W e found only secondary neglect in Abundant Lands and instances of neglect

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tended to be more vague and voiced with uncertainty. None of our informants brought up the subject spontaneously. And none claimed to have been personally involved as a participant or witness. Some had however heard through other parties of cases in which older people were found in need of provisions or medical care, especially during winter in the more isolated settlements, when travel is so difficult. One informant, for example, first indicated that elder mistreatment was not a serious problem but later admitted that the problem existed in Abundant Lands as it did in so many other places. He said that the children and grandchildren of elders do take their checks and sometimes use the funds for alcohol but that they usually also see to it that the elders get enough to eat and to take care of themselves. Physical abuse was categorically denied. ELDER MISTREATMENT COMPARED As mentioned earlier, we found that published reports of physical abuse in official records were exceedingly diificult to identify on both reservations. However, each Tribal Council identified elder abuse as a serious problem. Our data suggest that less abuse accurs on Abundant Lands Reservation than on Lone Mountain Reservation because there is greater income potential on that reservation from private sources and younger people are less dependent on their elders. On the other hand, there is a greater potential for neglect of elders in remote Abundant Lands communities, given the distances that one must travel to visit these elders. We found a few instances of neglect; even here, however, emotional relationships with elders seemed positive. On Lone Mountain Reservation the agricultural land is insufficient to support the entire population and ownership is largely in the hands of older people, a situation which sometimes incites exploitation. To some extent the differential geographic distribution of valuable resources has resulted in different styles of coping, with the Abundant Lands people in a sense able to cash in on their spectacular landscape and strategic location, so that their socioeconomic ties with neighboring and superordinate political entities became relatively strong and useful, while the people of Lone Mountain, fewer in number and limited in natural wealth, found themselves internally marginal. To state the current situation simply, we see the greater contact of the Abundant Lands Reservation with the outside world as leading to the integration of younger people into community life. Employment opportunities are available on the reservation, in the pencil factory, for example, or in the innumerable bureaucracies associated with servicing a large reservation. Authorities in Lone Mountain, on the other hand, are not willing to use resources which outsiders perceive as useful; thus the tribe remains relatively isolated. Employment opportunities are sufficiently limited that many of the more ambitious young people move elsewhere, leaving the less adaptable behind.

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Applicability of Exchange Theory In their study o f dependency and physical abuse o f the elderly, Karl Pillemer and his colleagues (Pillemer 1985; Pillemer and W o l f 1986) reviewed the literature concerning what exchange theory might predict about the nature of the relationships between elders and those who mistreat them. As Phillips (1986) describes social exchange theory, it is based on the idea that social interaction involves the exchange o f rewards and punishments between at least two people and that all individuals seek to maximize rewards and minimize punishments in their interaction with others. Rewards are derived from the exchange o f positive sentiments, instrumental services, and personal resources. Punishments include the exchange o f negative sentiments, the withholding of resources and services and the exchange o f punishing behaviors. O f course, exchanges are not necessarily equal because some people have more resources than others - more money, more prestige, or a greater capacity for doing personal favors. Such an imbalance in an exchange is called power. Summarizing what was known then and what Pillemer's own study added theoretically, we could expect the following to hold true: 1. Power is intrinsic to exchanges. If a person is less dependent on the outcome of an exchange made with another, then the first person has a power advantage over the other (Dowd 1975:587). 2. When people have a power advantage over others they do not use physical force to control others, because such force is not necessary (Goode [ 1974] cited in Pillemer 1985:148). 3. Abuse occurs in response to a perception of powerlessness. This perception of powerlessness is as important in predicting abusive relationships as whether the abused actually is more powerful than the abuser (Finkelhor [1983] cited in Pillemer (1985:148).5 4. Caretakers of dependent elderly may experience stress and a sense of powerlessness to alter their situations which sometimes leads to abusive relationships (Steinmetz 1983) cited in Pillemer (1985:147). 5. In the majority of cases of physical abuse, the abuser is excessively dependent on the elder. Abuse arises when the abuser is powerless. When his or her personal resources are low, violence may result (Pillemer 1985). Pillemer presented data on elder abuse within families by comparing 42 abusive relationships between relatives to the same number o f relationships in non-abusive families. Two dependency hypotheses were tested. Hypothesis one, suggested by the work o f Steinmetz ([1983], cited in Pillemer [1985:147]), examined the extent to which physical abuse o f dependent elders is linked to caregiver stress. Hypothesis two examined the extent to which dependency on elderly by other family members leads to mistreatment o f the elderly. While Pillemer found examples o f each kind of dependency contributing to abusive relationships, there was much stronger evidence to support hypothesis two. Our

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study contributes to an understanding of the dynamics of abusive relationships by assessing support for each hypothesis with comparative data from two American Indian communities. The works of Dowd (1975), Goode (1974) and Steinmetz (1983) suggest an explanation for the fact that physical abuse reports are less common than reports of neglect on Abundant Lands Reservation where it is the elders who are somewhat dependent on their busy and distantly located adult children for help with shopping, transportation, and housekeeping. Physical abuse may be rare because younger kinsmen are not financially dependent on the elders who thus lose their power advantage over their caretakers. While physical abuse can occur when the situations of caregivers are very stressful, it may be that neglect is the most common consequence of relationships in which the caretaker has the power advantage. The caretaker may elect at times to avoid contact with the elder to avoid an unpleasant situation and this avoidance may constitute neglect in the eyes of observers. The work of Brody (1981) on the kind of role overload experienced by "women in middle" who are the caretakers of their dependent parents also suggests that this might be the case. Finkelhor's work (1983) helps to explain how intergenerational family relationships differ between Abundant Lands and Lone Mountain. In Lone Mountain, the Medical Director of the IHS Clinic indicated that there were several cases of physical abuse in addition to reports of neglect. In comparison to Abundant Lands, Lone Mountain appears to be resource bankrupt. The Lone Mountain Tribal Council has, at least for the time being, decided not to exploit its coal deposits, which many inside and outside the Reservation define as a potentially marketable economic resource. On the Lone Mountain Reservation, there were many more families than in Abundant Lands which included adult members who were financially dependent on their elders. And, in many of these families, the elders' resources were barely sufficient. These dependents on the Lone Mountain Reservation can be divided into two distinct groups in relation to their political views on coal as a potential resource. One group would vote to mine the coal if they were in the majority and this group resents the power of their elders, whom they hold responsible for their economic plight. The other somewhat larger group of dependent adults shares the older generation's respect for traditional Indian institutions, including its spiritual values, and are thus opposed to developing energy resources. Members of the second group may perceive themselves to be more powerless than the first group in that they lack even a vision of economic development. At any rate, both those who would develop the coal and those who would not currently perceive themselves as powerless in that the coal is not currently an available resource. In Lone Mountain the elders commonly give their dependents what they believe they can afford to share, yet their dependents often remain economically deprived, frustrated, and "powerless" to alter their situations. Pillemer offers explanations of why non-dependent elders allow abusive relationships to go on when they are the ones with the power advantage (1985:154). At first glance the explanations he offers are remarkably similar to

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explanations of abusive relationships which we heard in Lone Mountain. People in Lone Mountain reported that they cannot turn their relatives in and cannot charge them with elder abuse. They said that their children were powerless. "Jim has no place else to go." "Where else will my son eat? .... What else can we do?" As bad as the personal situations of the elders were, their reasons for protecting their offspring appear to be due to their unwillingness to relinquish control of their everyday affairs to outside institutions such as the State Department of Social Services or the Police Department. This seems consistent with their statements that "no elder abuse existed before the white men came" and their rejection of other assimilationist institutional practices. 6 Although exchange theory is very useful in illuminating the dynamics of relationships between the elderly and others in some Native American communities such as the Tlingit of coastal Alaska (Author) and although it has been used extensively in an attempt to explain why abusive relationships develop, the theory probably has the greatest predictive value when it is used to explain exchanges in societies which have sufficient resources to survive; i.e., societies in which the body civil is not threatened. In such instances it makes sense to discuss how the party who is more dependent in an exchange experiences a power disadvantage in relation to the other party. The predictive value of exchanges in Lone Mountain and to a lesser extent in Abundant Lands is complicated by the fact that all parties to exchanges are often dependent on resources controlled by outsiders. When a society is in fact dependent on the resources of another community in order that its own population may survive, then a meaningful analysis of exchanges depends on recognizing the balance of power between the dependent community and its so-called benefactor. The point is that there is something troublesome in drawing conclusions about exchanges between abusing family members and abused elderly in Lone Mountain, when the entire community has been "abused" by assimilationist policies without regard to the indigenous culture to which those policies were applied. In this limited sense the families of Lone Mountain and the society as a whole are isomorphic systems. The connection we are proposing between dependence on others, feelings of powerlessness, and deviance is of course not very new. Examples can be found in case studies. An extreme instance, mentioned earlier, provides a dramatic illustration. In Anastasia Shkilnyk's book, A Poison Stronger Than Love (1985), the poison is a lethal blend of alcohol, methyl mercury, and ultimately enforced acculturation. The Canadian Ojibwa reserve she studied, Grassy Narrows, is described as "destroyed," characterized by extremely high rates of alcoholism, suicide, drug abuse, child abuse, incest, rape, illnesses, vandalism, unemployment, and murder. The Grassy Narrows Ojibwa were removed from their familiar reserve to a strange new one because mercury from a paper processing plant had polluted the rivers and lakes from which they drew sustenance, their social life disrupted, destroying territorial norms, and lessening chances for gainful occupation. The overall result has been a sense of lost autonomy, feelings of powerlessness, and

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what amounts to an ongoing collective suicide. Shkilnyk dates the beginning of the distintegration from the mid-1960s, the time of the relocation. Prior to that, from 1959-1963, 91 percent of all deaths were due to natural causes. But by the mid-1970s, only 23 percent of deaths could be so categorized. Kai Erikson in his forward describes Grassy Narrows as "a place of rape and murder and incest and thoughtless vandalism..a place of tremendous rage and frustration" (1985:xv). One of his informants called it "a diseased place to live." The change took only fifteen years. Erikson likens life in Grassy Narrows to life in a community that has experienced a disaster. He states that such "disasters sometimes have the potential for destroying the sense of communality that holds people together, for killing the spirit of neighborliness and kinship that is so important a part of their world ..." (Erikson 1985:xvi). The cultural dynamics Erikson and Shkilnyk outline in describing Grassy Narrows are clearly related to those we have described for Lone Mountain although of course much more destructive in their effects.

Policy Implications Across the country many treatment programs have been created to deal with elder abuse, child abuse, and substance abuse. What many of these treatment programs have in common is that they are attempts to treat individuals who are "guilty" of troubling others. Treatment paradigms are typically organized on one or the other of two assumptions. Either individual psychopathology is assumed to be the consequence of an illness, or, alternatively, an individual's weak will is believed to be the cause of his or her immoral behavior. Depending on the assumption and available funding, individuals whose behavior is troublesome are treated with imprisonment, counseling, or some combination of the two, but the goal is always to alter the individual's behavior so that he or she no longer troubles others. Such treatment programs were present on both the Lone Mountain and Abundant Lands Reservations. On Lone Mountain Reservation, substance abuse, spousal abuse, and elder abuse were regarded as problems by the Tribal Council. These concems were also discussed by the Elder Council of Advisors on the Abundant Lands Reservation. Support for treatment programs waxed and waned on both reservations as the Councils recognized that the same individuals were recycled through those treatment programs. Lone Mountain Tribal Council had an additional dilemma in that the council and a few households were dependent on the income generated from the programs regardless of their effectiveness. But as in most non-Indian communities, policy makers were unaware that one reason individual treatment programs were failing is that they were able to do little if anything to eliminate the structural conditions which lead to incidents of abuse. It is obvious that policies should consider those conditions, but when they so often fail to do so, the suggestion must be explicit. Estes writes that throughout

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the nation an "aging enterprise" of service providers has not been able to improve the quality of life for the elderly because policy makers have ignored the structural problems associated with poverty, sexism, and racism (Estes 1979, 1986). With regard to Grassy Narrows, the Ojibwa Reserve described earlier, Erikson makes a similar point in discussing the two kinds of injury that follow a cultural disaster. The first is individual trauma, the physical and psychological wounds suffered by individuals and leading to shock and withdrawal. The second is collective trauma, leading to injuries that damage collective bonds, which happens so slowly that we usually don't notice it. He asserts that the United States and Canadian governments are more aware of individual than collective trauma and thus better prepared to treat it. The reason we slight trauma suffered by the community as a whole is that "we do not generally think of that loss as an injury requiring treatment" (Erikson 1985:xvii). Policy makers rarely focus on structural antecedents to social problems, because individual treatment programs are favored by our individualistic culture. And an individual is of course much easier to identify as the locus of deviance. The police do not arrest "conditions", they arrest someone naive or unlucky enough to have drawn attention to himself or herself by doing something disapproved of. Because we are less familiar with community-level approaches to aberrant behavior, addressing structural conditions makes the problems appear insurmountable. Such approaches do in fact require more sophisticated, hypothetical reasoning. (Indeed, the underlying hypothesis may be wrong). In addition, administrators fear that effecting structural change will require some inconvenient redistribution of wealth or power, encouraging reluctance in the privileged. When the privileged are politically engaged they may wish for quick solutions such as the removal or public identification of offenders, which if nothing else, will enhance the likelihood of their retaining office. The examples provided by these two cases indicate that such an approach is ill-advised, even from the point of view of those who might appear to be threatened by the adoption of corrective social measures. On the reservations we studied, none of the treatment programs addressed the structural antecedents of the social problems being treated. The long-term effectiveness of individual treatment programs has been demonstrably low. The recidivism rate of abuse is high for individuals on Lone Mountain Reservation; few if any non-reservation communities have lowered their rates of substance abuse or mistreatment of others through individual treatment programs alone. An alternate approach would highlight the fact that the limited economic opportunities within Lone Mountain Reservation are antecedent to the high rates of abuse within the community. In order to combat the mistreatment of elders among Lone Mountain Tribe, one must address the need for community-wide economic development of the sort that would not violate traditional tribal values. Minimally, one must coordinate the various individually oriented abuse prevention programs which currently exist on the reservation in recognition of the fact that one sort of abuse leads to another.

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In order to reduce secondary neglect on the Abundant Lands Reservation, one should consider offering the most distant elders an opportunity to temporarily relocate each winter, so that services are more accessible to them and so they are more accessible to their families when help is needed. Such a communityfocused treatment plan would take history into account. Plains Indians traditionally followed the seasons in their patterns of movement. They sat out the winters in settlements constituted of several families, subsisting chiefly on dried foods, came together in larger communities during the spring and summer months for communal hunts, then scattered again to follow the buffalo on their rounds. It is ironic that the Lone Mountain Tribe, whose problems with abuse and primary neglect are greater than that of the Abundant Lands Tribe, has already dealt with this risk factor for secondary neglect by creating the opportunity for this kind o f migration. The director of the Senior Citizens Complex states that the census increased regularly during the winter and decreased each spring when better weather allows the elders to return to their own land (Author). None of these statements, of course, should be construed as an argument that community-level approaches to the problem of the mistreatment of elders are always superior to individual-level ones. We wish rather to urge that policy makers adopt a more holistic perspective, one that looks beyond the punishment or counseling of the abuser, one that manages the mistreatment o f the elderly in the manner in which the Plains Indians themselves understand it, as an expression of ill health, an insult to the society, and therefore subject, like many other health problems, to primary intervention. Similar considerations apply to nonIndian communities. And naturally it needs to be kept in mind that whatever changes are introduced into either community should be concordant with existing value sets. A sudden inundation of Lone Mountain Reservation with tourists, for instance, with all that implies in the way of parking lots, motels, saloons, traffic congestion and the general disruption of everyday life, would probably yield something more than the expected economic advantages. The mistreatment of elders might be lessened but some intangibles would surely be lost. Pillemer's research on the dangers o f dependency concluded with a statement concerning how previous research on elder abuse focused on demands of victims and blamed them for their problems. His research focuses instead on the perpetrator (Pillemer 1985:155). Our research suggests that attention should be paid to the fact that relationships between abusers and the abused operate in a systemic context which itself may be more or less conducive to abuse or neglect. As far as treatment models are concerned it may be as counterproductive to wholly blame individual perpetrators as it is to blame individual victims. NOTES * This research was supported by the Gerontological Society of America Applied Fellowship Program in Gerontology. Funds were provided by the Fred C. Meyer Charitable Trust and the U.S. Indian Health Service. The opinions expressed herein are

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solely those of the authors, and no official endorsement by the U.S. Indian Health Service should be inferred. We would like to thank Pertti J. Pelto, and Steven P. Wallace for comments on earlier drafts. i A vein of what might be called applied constructionism can be found running through the individual psychology of Alfred Adler and the rational-emotive therapy of Albert Ellis. 2 Collecting data required for frequency measures of physical abuse involves witnessing the behavior or relying on written reports submitted to controlling agencies. It is generally acknowledged that we do not know the "true frequency" of physical elder abuse although we assume for reasons already given that published reports are underestimates and therefore somewhat unreliable. "Neglect" data are likely to be even less reliable since measurement of neglect requires measuring the absence of a behavior, which of course cannot be observed. 3 By 1990, having asked professionals in state government for help with the problem, the Lone Mountain Tribe had begun to make such distinctions when they realized funds for elder abuse treatment programs were dependent on the adoption of such alien definitions. 4 As we suggested at the outset, Plains Indians seem loathe to make their complaints public. In testimony concerning the Indian elderly in South Dakota, a Lakota social worker indicated that "elderlies who suffer physical abuse may be too embarrassed to share that information with service providers who could help" (West 1988:96, U.S. Senate Hearing 100-981). 5 Whether one feels powerless or able to control his own situation is akin to what some psychologists have called "locus of personal control" (Rotter 1971). 6 In other discussions of problems on the Lone Mountain Reservation informants were quick to blame the whites and not their own people for their troubles. "There was no alcoholism before white men came .... " "Our people were happy before the white men came .... " " W e didn't have all these suicides before the white men came .... " " W e didn't have diabetes before the white men came ...". These and other statements often prefaced explanations of why people were reluctant to use what they saw as troublesome white institutions such as the Indian Health Services Clinic. REFERENCES CITED Berger, P. and T. Luckman 1967 The Social Construction of Reality. New York: Doubleday Anchor. Brody, E.M. 1981 Women in the Middle and Family Help to Older People. The Gerontologist 21 (5):47--480. Coon, C.S. 1948 A Reader in General Anthropology. New York: H. Holt. Cornell, S. 1984 Crisis and Response in Indian-white Relations: 1960-1984. Social Problems 32(1):44-59. Dowd, J. 1975 Aging as Exchange: A Preface to Theory. Journal of Gerontology 30:584. Erikson, K. 1985 Forward. In A Poison Stronger than Love. A.M. Shkilnyk, ed. Pp. xiii-xviii. New Haven: Yale University Press. Estes, C. 1979 The Aging Enterprise. San Francisco: Jossey-Bass. Estes, C. 1986 The Aging Enterprise: in Whose Interests? International Journal of Health Services 16:243-251. Finkelhor, D. 1983 Common Features of Family Abuse. In The Dark Side of Families: Current Family Violence Research. D. Finkelhor, R.J. Gelles, G. Hotaling and M. Straus, eds. Pp. 17-26. Beverly Hills, CA: Sage. Goode, W.J. 1974 Force and Violence in the Family. In Violence in the Family. S.K. Steinmetz and M.A. Strauss, eds. Pp. 25--43. New York: Dodd Mead. Gray, J.H. 1878 China: A History of the Laws, Manners, and Customs of the People. London: I. Macmillan.

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Janis, G. 1988 Testimony of Geraldine Janis, Director of Community Health Representative Program. The American Indian Elderly: The Forgotten Population, Hearing before the Special Committee on Aging, United States Senate, 100-981, Pine Ridge, South Dakota, July 21. Serial No. 100-25. Kahana, E. 1989 Review of Elder Abuse: Conflict in the Family. K.A. Pillemer and R.S. Wolf eds. Dover, MA: Auburn House. 1986. Contemporary Sociology 18:403--405. Kluckhohn, C. 1949 The Philosophy of the Navaho Indians. In Ideological Differences and World Order. F.S.C. Northrop, ed. Pp. 118-132. New Haven: Yale University Press. Maxwell, R.J. and E.K. Maxwell 1983 Cooperative Independence Among Tlingit Elderly. Human Organization 42:178-180. Maxwell, E.K. and R.J. Maxwell 1990 Housing for Plains Indian elderly: A Pattern of Seasonal Use. Paper presented at the meetings of the Southern Sociological Society, Louisville, Kentucky. March 1990. McFee, M. 1972 Modern Blackfeet: Montanans on a Reservation. New York: Holt, Rinehart and Winston. Phillips, L.R. 1986 Theoretical Explanations of Elder Abuse: Competing Hypotheses and Unresolved Issues. In Elder Abuse: Conflict in the Family. K. Pillemer and R. Wolf, eds. Pp. 197-217. Dover, MA: Auburn House. Pillemer, K.A. 1985 The Dangers of Dependency: New Findings on Domestic Violence Against the Elderly. Social Problems 33(2):146--158. Pillemer, K.A. and R.S. Wolf, eds. 1986 Elder Abuse: Conflict in the Family. Dover, MA: Auburn House. Rotter, J. 1971 External Control and Internal Control. Psychology Today 5(1):37--42. Schneider, J.W. 1985 Social Problems Theory: the Constructionist View. In Annual Review of Sociology. R.H. Turner and J.F. Short, eds. Palo Alto: Annual Reviews. Shkilnyk, A.M. 1985 A Poison Stronger than Love. New Haven: Yale University Press. Steinmetz, S.K. 1983 Dependence, Stress, and Violence Between Middle-aged Caregivers and Their Elderly Parents. In Abuse and Maltreatment of the Elderly. J.L. Kosberg, ed. Littleton, MA: John Wright - PSG, Inc. United States Senate Hearing 100-981 1988 Elder Abuse. The American Indian Elderly: The Forgotten Population. Hearing before the Special Committee on Aging, United States Senate, 100-98, Pine Ridge, South Dakota, July 21. Serial No. 100-25. West, J. 1988 The Indian Elderly. The American Indian Elderly: The Forgotten Population. Hearing before the Special Committee on Aging, United States Senate, 100-98, Pine Ridge, South Dakota, July 21. Serial No. 100-25. Zborowski, M. 1952 Cultural Components in Responses to Pain. Journal of Social Issues 8:16--30.

Department of Sociology and Anthropology University of North Carolina at Wilmington 601 South College Road Wilmington, NC 28403-3297, U.S.A.

Insults to the body civil: Mistreatment of elderly in two Plains Indian tribes.

The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone M...
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