Margaret Moss
An
Educator and Researcher with a JD
Margaret
Moss, The Three Affiliated Tribes of North Dakota,
DSN, RN, JD, is Associate Professor in the School of
Nursing at the University of Minnesota. She is Chair
of the Leadership, Systems, Informatics and Policy
Co-operative at the school as well as Director of
Inclusivity and Diversity.
Concern
about the elderly
When Moss was a
floor nurse at the Santa Fe Indian Hospital for five years
in the 1990s, she was concerned about the very sick Elders
who often traveled long distances to get to the hospital.
“Some of the Elders with problems, such as diabetes, didn’t
come to the hospital until they needed something drastic,
like a leg amputation. When we did discharge planning and
suggested that they go into long-term care at a nursing
home or assisted living in the city, they refused. They
would literally rather die than accept care off the
reservation or care provided by others who were not their
own people. I asked myself, ‘Why is this happening?’”
Moss began exploring this issue by doing a geriatric
leadership fellowship at the University of North
Dakota National Resource Center on Native American
Aging. Next she
earned her master’s degree in nursing at the University
of Phoenix in Albuquerque. Soon she began work on her
DSN at the University of Texas Health Sciences Center in
Houston. As part of her doctoral work, Moss needed a
research focus. “I had noticed that the Elders who were
most likely to refuse care were traditional people, I
decided to study Zuni Elders because they are one of the
most traditional pueblo tribes. It took me about 800
hours to gain entry into the pueblo to do the study.
Then I spent about 1800 hours over the course of a year
in the pueblo.
“While working with the Zuni elders, I got my answer, and I
discovered what was needed.” Moss became more acutely aware
that Elders could not practice their ceremonies in a
mainstream long-term care facility. For example, she
realized that if Elders living in a long-term facility go
outside early in the morning to practice a ceremony, alarm
bells might go off. Also, staff are not likely to
understand the Elders’ need for fasting at certain times.
Moss was also aware that some Elders refuse long-term care
because of their understandable distrust of the non-Indian
agencies and institutions, particularly given their
generations’ painful experiences related to the federal
government’s attempt to assimilate them into the dominant
culture.
“These experiences taught me that Zuni Elders need to have
24-hour long-term care facilities on their reservations. I
realized that many Elders around the country also needed
long-term care on their reservations.
Upon completion of her DSN, Moss accepted a position as
assistant professor at the University of Minnesota School
of Nursing. While teaching nursing students, Moss pursued
her interest in indigenous Elders by undertaking a
two-year, post-doctorate fellowship at the University of
Colorado Native Elder Research
Center.
Meanwhile, Moss explored the possibility of long-term care
facilities on reservations. “I discovered that only 12
reservations have nursing homes,” she said. “But I ran into
a problem. It’s very hard to build nursing homes on
reservations. Thirty-two states, including Minnesota, have
moratoriums on building new nursing homes. I sit on the
Minnesota State Board on Aging. I know the intent is good.
The trend is to move funds from nursing homes to home care.
For the majority population that already has lots of
nursing homes, that is good. But for Indian people who are
often hit with chronic diseases in their 40s, this is not
good. Indian communities can build their own nursing homes,
but they need to use their own money. And they aren’t
likely to get a state license, if they build it themselves,
so their funding streams will be limited.
“All of these obstacles led me to my latest project, which
was going to law school,” she said. “In nursing school, you
hear about obstacles to care, such as poverty, lack of
education, geography and culture, but you don’t hear about
legal barriers. I decided I wanted a legal background so I
could use legal words and concepts.”
Last year after attending weekend courses at Hamline
University School of Law in St. Paul, Minnesota for 4
years, Moss earned her juris doctor( JD). In the same year
she also received tenure at the University of Minnesota.
While attending law school, Moss continued to teach. She is
still teaching two undergraduate nursing courses: one on
research and theory, the other on transcultural nursing and
global health. In addition, she teaches health policy and
research dissemination to doctoral students. Moss sits on
the doctoral committees of 3 students and is primary
advisory to several masters students.
Moss is director of diversity for the School of Nursing.
She also directs Native Nurses Career Opportunity
Program (NNCOP).
Funded through the Indian Health Service, NNCOP provides
a scholarship program for American Indian nurses (RNs)
to earn their masters in nursing degree.
Moss has earned the respect of her peers. In 2005, she
represented the National Congress of American
Indians as Delegate
to the White House Conference on Aging. The
National Alaska Native American Indian Nurses
Associations honored her
with the Nurse Competence in Aging award.
In the future Moss hopes to lobby for tribes around the
issues of health, aging, and education. She feels that
someone needs to monitor state and federal actions to make
sure that the rights and needs of indigenous people are
honored.
Moss is the mother of four children, ages 12, 13, 14, and
17. She describes her husband, who is a school social
worker, as a “saint”. “I couldn’t have done any of this
without him,” she declares.
This
article was originally published in the Summer 2007 issue
of
Winds of Change. (The cover
artist is Bunky Echo-Hawk, Yakama/Pawnee.)
Update
2010
For up-to-date information on Dr. Moss, see her faculty
page at the University of
Minnesota. Among her
recent accomplishments, Moss completed the
2008-2009 Robert Wood Johnson Health Policy
Fellowship. Her
fellowship assignment was to the Senate Special
Committee on Aging. She was also elected secretary to
the National Interfaith Council on Aging, an interest
group of the National Council on
Aging.
To hear Dr. Moss giving a presentation about the complex
issues surrounding the health and care of American Indian
elders, go to Faculty Learning About
Geriatrics.