This chapter reviews the grandparent–grandchild relationship when grandparents are healthy, when they contract chronic illness and are in need of care, and when they are in the process of dying. It includes the particular aspects of health because each has the potential to play an important role in the grandparent–grandchild relationship. For example, as some leisure activities require a certain level of physical ability, research on leisure and grandparent–grandchildren time together may reflect grandparents’ health. Finally, the cognitive health of grandparents may play a role in how grandparents and their grandchildren interact. The process of aging is associated with a broad range of unique and often simultaneous declines, including physical, cognitive, and psychological changes. As age-associated illnesses arise and develop there may be instances, although not common, where grandchildren are so involved in their grandparents’ life that they become a caregiver for their ill grandparent.

This concluding chapter discusses grandparenthood and provides a brief description about the book. In this book, authors have presented multiple perspectives bearing on a deeper, multileveled understanding of grandparenthood, including the cultural/historical, developmental, ecological, cultural and cross-cultural dimensions, as well as from a clinical/family systems perspective. It attempts to understand the current and changing nature of grandparenthood, including the impact of changing historical and interpersonal contexts as well as the diverse roles that grandparents perform in families. Indeed, families today are different than before. With the increase in longevity and life expectancy leading to greater expansion of research on aging and the family, coupled with the growth of the grandparenthood literature, it is clear from the chapters in the book. The chapter concludes with future directions.

Much of what has been accomplished in elevating elder rights and abuse prevention internationally has been accomplished by nongovernmental organizations (NGOs) that work in collaboration with the United Nations (UN), are supported by the UN, or that focus on influencing UN policy and programs. The UN also has “specialized agencies”, committees, councils, and commissions that play significant roles in promoting elder justice. UN entities employ a wide range of strategies to address aging issues, which are International Assemblies, Sustainable Development Plans, Treaties and Conventions, Public Awareness Events and Observances, and Special Procedures. American advocates have much to gain from participating in the systematic, deliberative, and inclusive processes that the UN and international NGOs have applied to aging, elder rights, and elder abuse prevention. This includes the UN's tripartite approach to age as a matter of human rights, public health and social development.

There are positive and negative aspects of life at every age throughout the life span, and aging is no exception. This chapter presents a more balanced view of older adults’ mental health and cognitive abilities, one that moves away from the stereotypes. It focuses on mental health and cognitive abilities as people age, with a presentation of the many positive characteristics of older adults’ psychological and emotional well-being as well as difficulties some may face, such as depression and dementia. The chapter also describes how personality changes over the life span and how the creative arts can positively impact the lives of older adults. Finally, it discusses factors that can positively and negatively affect older adults’ mental and cognitive abilities. The Practical Application presented at the end of the chapter focuses on unique challenges faced by individuals currently around 80 and above due to mental health stereotypes and stigmas.

This chapter focuses on older people’s living environments—where and how they live. Their living environments include the communities in which they live, with whom they share their accommodations, and the type of housing in which they live. As with most aspects of older adult life, great diversity is common in all of these areas. The opening scenarios indicate just that, with some older people aging in place, others moving to retirement communities with enticing amenities, and yet others sharing their accommodations with others. This chapter discusses living arrangements, housing options, and age-friendly communities for older adults. It stresses the importance of living environment to older people and outlines the factors that influence their decisions about where to live. The chapter also outlines the advantages and disadvantages of living alone and investigates the issue of homelessness among older adults.

When it comes to aging, medical conditions quickly become one of the most important issues facing people. As people grow older, they are more likely to have medical conditions that require attention and that can hinder their ability to perform the daily tasks of living. Improved medical care and prevention efforts have contributed to dramatic increases in life expectancy in the United States during the past century. They have also produced a major shift in the leading causes of death for all age groups, from acute illnesses and infectious diseases to chronic conditions and degenerative illnesses. This chapter describes medical conditions experienced by older adults and outlines the major features of continuing care retirement communities, assisted living communities, and nursing homes. It also highlights the difficulty many people face in paying for the long-term care they need and discusses the significant financial burden of long-term care.

Improving the lives of older adults is the primary goal of those who work in the field of gerontology, and doing so invariably also improves the quality of life of those who spend time with them, whether they are family members, friends, neighbors, or those who work with and for older adults. This chapter explores the many career opportunities within the field of gerontology and explains how the study of aging can be applied to any position in any field. It outlines educational pathways, professional organizations, credentialing opportunities, and job-seeking resources for those interested in a career in gerontology. The chapter also highlights the importance of entrepreneurship and innovation to help address the unmet needs of older adults. The Practical Application offers concluding remarks about the unlimited opportunity in the field of gerontology.

Boomers, now in their 50s, 60s, and early 70s, are the leading edge in the use of complementary and alternative medicine (CAM). This chapter briefly discusses CAM and aging. The National Institutes of Health defines CAM as that which is not practiced in the medical mainstream. Most medical schools and residency programs in the United States are teaching CAM content or practices in one or more required or elective courses, usually in a department of family practice or internal medicine. Naturopathy emphasizes the healing power of nature, and practitioners attempt to support the body’s own healing capacity with natural therapies. The sales of dietary supplements have been unleashed ever since the Dietary Supplement Health and Education Act stripped away much of the regulations. The three most popular dietary supplements in the United States—multivitamins, vitamin D, and omega-3 fatty acids—are not supported by research unless there are deficiencies.

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.

Even the most enduring public policy and aging-related legislation, such as Social Security—about 85 years old and definitely geriatric—requires constant refinement in order to be responsive to changing needs. Another major piece of legislation, Medicare, is both age-related and aging over more than a half century, and requires constant attention if it is to survive and prosper in the coming years. Related to Medicare is the Affordable Care Act which could be a bold step toward Medicare for all or some other legislation that implements universal access to healthcare and extends both life expectancy and health expectancy. There are many age-related public policies and legislation in need of nurturing, change, or elimination. The two pieces of major legislation, Social Security and Medicare, have improved the lives of millions of Americans and have lasted more than a half century.