The medical model in psychiatry assumes medical intervention is the treatment of choice for the constellations of diagnosed symptoms that comprise various mental disorders. These treatments may include pharmacotherapy, electroconvulsive treatment, brain stimulation, and psychosurgery. Therefore, psychopharmacology for older adults can be considered palliative rather than a cure for a brain disease causing psychopathology. Older adults experience many psychopathological problems, including anorexia tardive, anxiety disorders, delusional disorders, mood disorders, personality disorders, schizophrenia, and co-occurring disorders with substance abuse/dependence disorders. Therefore, it is critical for the social worker to understand the various manifestations of psychological problems in older adults from the perspective of an older adult, rather than extrapolating information commonly taught in social work programs that neglect to focus on older adults and restrict teaching to psycho-pathological problems in younger and middle-aged adults.

For older adults, the phenomenon of death is accepted and does not induce the fear experienced by younger adults. Older adults who do not engage in end-of-life planning may receive unwanted, unnecessary, costly, and painful medical interventions or withdrawal of desired treatment. Many older people feel that the goal of palliative care is to make the best possible dying experience for the older adult and his/her family. In addition to palliative care, an older adult will most likely find himself or herself in an intensive care unit as part of his or her terminal care. Euthanasia, or hastened death, is seen by some as an alternative to palliative care. A psychological aspect of death that an older adult is concerned with, in addition to place of death, is whether he or she will die in his or her sleep or die suddenly, making the death experience an individual phenomenon.

This concluding chapter summarizes the major points regarding elder abuse (EA) presented in the preceding chapters. It concludes the chapter by taking one last opportunity to encourage exploration and initiation of system-level efforts to solve a major public health problem. The socioecological framework for violence prevention utilized within domestic and global public health work is applicable and extendable to EA. Throughout this book, the authors have argued that EA is a public health problem and that EA may well be among the most under-recognized and under-resourced population health problems of the early 21st century. Public health has frameworks, tools, approaches, relationships, structures, systems, and a variety of agents and organizations poised to address the problem of EA. The imprimatur of the growing population of older adults and the character of demographic transitions occurring globally provide the perfect rationale for action—now.

This chapter focuses on the following topics: demography, gender, age at diagnosis/onset of cardiovascular disease (CVD), Medicare usage, work and retirement, social support, social context and neighborhoods, ethnography of families, qualitative research, and social policy. These topics constitute some of the key areas that should be the focus of future research on the sociology of minority aging. The chapter provides a rich description of trends in the ethnic and racial composition of older cohorts to illustrate the dramatic changes that have taken place in the United States in the past century. The rising costs of health care and the increasing older minority population, additional reform will be needed to maintain the sus-tainability of the program. Additional work examining within-race group differences is key to understanding minority aging issues given the large amount of cultural diversity in the United States.

This chapter focuses on informal caregiving among minority groups. It also focuses on context of caregiving and discuss the various specific challenges caregivers of minority older adults face. The chapter examines some of the specific caregiving interventions tailored for families of color and discuss the implications for practice, policy, and research. Medical advances and greater longevity point to healthier and longer lives for many, but both formal and informal caregiving remain a concern as individuals age and develop conditions that require care. Caregivers are often able to realize the positive aspects of caregiving when they are not struggling with financial or social support challenges. Despite the vast literature on caregiving in general, research pertaining to the needs and experiences of racial/ethnic minority older adults and their caregivers is limited, particularly for American Indians, Pacific Islanders, specific Asian American and Latino subgroups, and religious minorities groups such as Muslim Americans.

This chapter discusses current thinking in the field of social support and social relationships, and physical and mental health among older racial and ethnic minorities. Social relationships are an important predictor of health and psychological well-being across the life course. Many minority older adults will face the continued challenges of declining functional status due to physical and mental health conditions over the course of their lives. Most empirical studies on social support among older racial and ethnic minority adults explore the association between social support and both physical and mental health. The wealth of studies on social support among minority older adults has much to offer with respect to understanding the correlates of emotional support and patterns of assistance. The biological mechanisms explaining the link between social support and physical health outcomes have been largely unexplored among older racial and ethnic minority groups.

Neurorehabilitation has become more of a global phenomenon and is not necessarily limited to industrialized or Westernized societies. Culture often connotes concepts of race and ethnicity when discussed in the context of health care disparities. Socioeconomic and other demographic variables make up the majority of the balance on discussion regarding culture in health care. Multicultural neurorehabilitation must emphasis “multiple”, and do so in a dynamic manner. In other words, at any given time, multiple cultures operate in each interaction and in each therapy delivered in the neurorehabilitation setting. Recently, there has been increased interest and research into the newly developing field of cultural neuroscience. Several models are available to conceptualize the influence of culture in human functioning. The most persuasive model is one that mirrors a dynamic, ecological system.

This chapter focuses on aging and health issues in all of America’s major minority populations including African Americans, Hispanics/Latinos, Asian Americans, as well as Native Americans. It addresses the issues of health inequality and health advantage/disadvantage. The chapter introduces relatively new areas of inquiry including long-term care, genetics, nutrition, health interventions, and health policy issues. In addition to possible genetic factors, the literature has emphasized the influence of poverty and socioeconomic status as well as stressors associated with minority group status. The system of long-term care services will need to be restructured to take into account issues affecting minority populations such as health care coverage, housing and income supports, as well as cultural issues as filial piety and trust. The field of minorities, aging, and health has been dominated by a health inequality perspective that has been illustrated by the application of cumulative disadvantage/cumulative inequality theory.

This chapter provides a selective review of research on social support among older African American, Hispanic, Asian American, and Native American adults. It focuses on social support as a dependent variable in relation to different sources and types of aid provided to older African American, Hispanic, Asian American, and Native American adults. The chapter highlights the findings in three specific areas: marriage and romantic relationships, extended family and non-kin as sources of informal social support, and black-white differences in informal social support. Informal social support networks are critical for individuals of all ages but especially for older adults who are dealing with difficult life circumstances. Older African Americans depend on informal social support networks of family and friends for assistance in emergency situations, as well as for help with various tasks of daily life. Elderly Asians often utilize kin and social support networks for a variety of reasons.

To truly understand how important and central memory is to us, it is important to understand what life is like for people who experience memory loss, or amnesia. This chapter examines the amnestic syndrome, which has been widely studied and the knowledge of which has significantly influenced theories of memory. The abilities and nonabilities of those with amnestic syndrome demonstrate that there are multiple independent systems of memory. The chapter also examines two controversial diagnoses, the main feature of which is memory loss dissociative identity disorder (DID) and psychogenic or dissociative amnesia. It discusses a form of memory loss that does not fit the technical definition of amnesia because it eventually affects not just memory but all cognition: Alzheimer’s disease (AD). AD is common among older adults and demonstrates how a worsening loss of memory and cognition can lead to a complete disruption of everyday life.