||This project focused on the demographics and the service needs of American Indian elders, and their families. Specifically, this project reviewed the literature regarding the following issues: (1) "why" elders and their families do not utilise services which arc available to them; (2) is the lack of utilisation due to the lack of needed services, if so "why"; (3) to gain a better understanding of the targeted group (American Indian elder) and how their geographic location, culture, perceptions, and historical context affect their use, or lack of use, of needed services and programs; and (4) investigations and procedures by which studies and research are done have their limitation. This project described successful aging for die American Indian elder in the 1900s, and examined die traditions, customs, and roles of die American Indian elder, and how history, poverty, diversity, and accessibility and utilization of needed services has either enhanced or jeopardized die American Indian elders role in his/her culture. This project also provided a profile of die American Indian elder on a national, regional and state level; examined die American Indian elder's continuum of care or lack of those services in maintaining the elders independence and dignity; and described the health status of the American Indian elder, and needed interventions in either preventing or reducing the risk in the severity of the disease; and offers knowledge of the Navajo Nation and the Adopt* A Native Klder Program., and the perceived needs of the American Indian elder at; a local site- San Juan County, Utah. Based on die review of literature the following recommendations were suggested: (1) Instead of an age-based criteria for funding, services, and programs, the criteria should be grounded on needs-based criteria; (2) An elder or an advocate should serve on aging councils, in all discussions of Medicare, Medicaid, and health reform, and be involved in making recommendations and developing programs. This would vii include coordination and improved communications among administrative units in a cooperative effort to address unmet needs; (3) Utilization of integrated case management and referral. Integration would involve changing the structure of the service system by bundling together various tasks so they are not duplicated; (4) Development of Certification and Internship programs. This training module and internship would include native language speakers, to provide sensitivity and unbiased perception of those being served; (5) More friendly user applications, and appropriations to provide needed services; and (6) Expansion of community based preventive, supportive, rehabilitative, social and medical services and home health services. This also would include expansion of nursing home facilities, specifically on reservations and with ceremonial considerations. One solution to this problem is in the appropriation and added responsibility of Title VI programs in the creation of comprehensive community based supportive and institutional services; and (6) More applied research in die areas of specific diseases, nutrition, housing, utilization of services, and transportation.