This chapter focuses on more integrated approach or process for developing a health intervention for ethnic minority groups that incorporates accepted principles of medicine and scientific methodology. The changing demographic has led to complex challenges in the U.S. health care system. The delivery of effective health care services hinges on health care professionals’ ability to recognize varied understandings of and approaches to health care across cultures. Health care providers may employ different strategies to increase participation of service users by bridging barriers to communication and understanding that stem from these racial, ethnic, cultural, and linguistic differences. In the context of health or health care improvement, little debate exists concerning the recognized need to help ethnic minority patients maintain and restore health. There are two general approaches for developing culturally appropriate health interventions. The first approach is from science to practice and the second approach is from practice to science.

In older adults, sexual activity declines as a result of multiple causes like medical illness, disability, psychological problems, and social constructs that exist in institutional settings. Another phenomenon of older adult sexuality is that many older adults are aging without major health problems that would limit their sexual functioning. Older men often reveal their problem with erectile dysfunction to a health care provider or social worker. There are multiple approaches to treating erectile dysfunction in older men. The first and primary intervention is referral to an urologist. Functional problems contributing to the decline in sexual activity of older women include co-occurring anxiety or depression, urinary incontinence, thyroid conditions. Many older adults suffering from various forms of dementia become sexually disinhibited and show increasing hypersexuality as their cognitive deficits increase. Social workers have an opportunity to provide psychoeducation to families and caregivers in managing hypersexuality exhibited by patients suffering from dementia.

This chapter describes the current status of caregiving in the United States. Who are caregivers and what tasks they routinely do are discussed. The diversity of caregiving is also considered. Physical, psychological, social, and financial ramifications of caregiving are described along with benefits reported. The chapter concludes with recommendations on how healthcare professionals can support caregivers.

The field of health promotion has come a long way since it was initially defined as exercise, nutrition, and smoking cessation. Moreover, older adults were typically excluded from early writings on health promotion and disease prevention. They were old after all, perhaps resistant to change and without much of a future. Health promotion and aging now covers dozens of topics. Health professionals need to be careful about defining good health among older adults. Health promotion is a more proactive approach than primary prevention, which tends to imply a reaction to the prospect of disease. Directing a client’s anger or frustration into political advocacy work is a proactive, health-promoting enterprise that benefits both the individual and society. Medicare, Medicaid, and Social Security have had a tremendous impact on health. It is important, therefore, to review these legislative acts, as many people do not even understand the difference between Medicare and Medicaid.

Health educators constitute an important profession that is necessary for promoting health, but is not sufficient. They must learn how—and be allowed—to collaborate with health providers who may not recognize their worth, and with patients/clients who may resist their guidance. Health professionals and older adults need to be informed about a great many health education topics. This chapter explores a few of these topics: smoking, alcohol, medication usage, injury prevention (fall prevention and motor vehicle/pedestrian safety), sexuality and intimacy, and sleep. Older adults can share intimate support in many ways. Practical health research findings are reported on in academic journals or popular media almost every day of the year and it is a challenge for health educators, providers, and patients/clients to stay current. A collaboration among the three groups is essential. Perhaps the most successful outcome of health education had to do with smoking cessation.

The rights to health and health care in the event of illness, disability, or old age are detailed in Article 25 of the Universal Declaration of Human Rights (UNDHR). These rights are fundamental to the well-being of older adults as their needs for medical care increase with age. As episodes of acute illness decline, chronic conditions increase with age, impacting both individuals and society. Chronic conditions such as arthritis and heart disease permeate many areas of a person’s life, often increasing demands for an array of support. Medicare was developed in the 1960s to address the needs of the aging population with regard to health care. Medicaid, Title XIX, under the Social Security Act was passed in 1965 to provide health care for those below the poverty line. Consumer-directed care programs have the older person responsible for hiring the care provider and determining the services he or she wants.

Empowerment for an older person means having the opportunity to learn, discuss, decide, and act on decisions. From the perspective of the health professional or health educator, empowerment of older patients in the clinic setting or clients at a community site means not only to provide service to them, but also to collaborate with them, to encourage their participation. Certain personality characteristics, such as patience, tolerance, and a positive attitude, enhance the health educator’s chances for collaborating successfully on a health goal. There are health-promoting strategies that may help. For those who are behavior management-oriented and like recordkeeping, the health contract might be helpful. There are support groups to help with chronic diseases, caregiving, coping with loss, and alcohol or other addiction problems. Empowerment, with its rewards and risks, is fast becoming a requirement in the era of chronic healthcare conditions that must be managed, sometimes for decades.