Older adults and their families are highly heterogeneous. This chapter addresses diversity both within and among older adult populations and considers ways to improve service provision through flexibility and awareness. The concepts of cultural competence and cultural humility are introduced, and strategies for increasing one’s level of cultural competence are explored. It is important to note that diversity is not only about race and ethnicity but also includes age, ability, gender, geographic location, religion, sexual orientation, socioeconomic status, and so forth. Similarly, different perspectives and backgrounds are found among professionals working throughout the field of aging. Activities in this chapter promote recognizing that diversity is not the sole domain or concern of marginalized groups, that everyone has a culture and a social lens through which they view the world, and that this lens influences not only their perspective but also the way they interact with those around them.

At one time, we used “old age” as a diagnosis for a resident passing. However, this is far from the truth. The body is made to operate for a long time and can do so, barring any disease or pathological processes. The problems associated with these diseases and pathological processes can accelerate death. The two groups that study aging individuals are physicians and gerontologists. This section describes the ten body systems. It discusses the phenomena that can be applied to the aging population such as changes in collagen; reduced reserve; gradual changes in the immune system; temperature response changes; postural imbalances; decalcification of the bones; decreased bone and muscle mass; urinary system; decreases in bowel function control; frequent anorexia; hearing and vision; skin; and memory. The section provides a brief description on the differing theories of aging, and the effects of exercising on aging persons.

Age is relative, as the saying goes, so how do we know when we are “old”? Some of us may turn 40 and start to proclaim, “I feel so old! I’m falling apart.” Others may celebrate their 80th birthday and ask, “I wonder what is next? I’m so excited about what I am still learning and experiencing.” As we have discussed in this textbook, the age ranges that represent different stages of development have shifted over time. Since as recently as 100 years ago in the United States, the average lifespan was 47 years old and so today our perceptions of “old age” have certainly changed. Today, people in Western societies are living longer and longer. Within gerontological research, it is typical to distinguish among the “young-old“ (50–64 years), the “old“ (65–74 years) and the, and the “old-old“ (75+ years; Cronin & King, 2010). Our previous chapters discussed middle adulthood reaching into the lower to mid 60s; we now focus our discussions on this phase of life to include the ”old” and the ”old-old.” In this chapter, we explore the cultural and contextual factors that impact this final stage of lifespan development. As individuals move into their later phases of life, how do they experience the developmental process? How do beliefs around old age, physical and mental health, death and dying, and the role of “elder” in families and cultures impact the experiences of the old and very old? We will focus on the case of Rose, a recent widow of a partner of 40 years who is beginning to experience dementia.

In the previous chapter, we examined some of the cultural and contextual factors impacting development in late adulthood. This stage of life is typically characterized as starting in the mid 60s and continuing into the 80s, 90s, or until the end of the natural lifespan. In this chapter, we look at developmental theories, models, and research about older adults, and strive to understand how to apply these theories to work with adults in late adulthood. As it is important to always view developmental theories with a critical eye, we include both critiques of the theories presented, and recent and relevant research and writings about how these theories inform our understanding of older adults. Using the case of Rose, our fictional client introduced in the previous chapter, we will present psychosocial development theory (Erikson), human potential stages (Cohen), bioecological theory (Bronfenbrenner), and the ecological theory of aging (Lawton). We include additional cultural and contextual factors of aging impacting development, and conclude with thoughts from two experts from the field, Dr. William Barkley and Dr. Nina Nabors.

As the field of human sexuality continues to expand and interface more positively with mental health, physical health, and our culture at large, increasing numbers of helpful resources are becoming available for sex educators, lay folks, and anyone seeking updated and positive information. This final chapter provides lists (with some synopses) of essential sexual health-related websites, TED Talks, podcasts, books, and educational resources for eye movement desensitization and reprocessing (EMDR) therapists and clients. National and regional sexual health training organizations are also listed for further learning. Additionally, although directly addressing children’s sexual health was out of the scope of this book, educational resources for children and teens regarding sexual health are included in this chapter. Please keep in mind that as the field and agents of sexual health continue to expand, these resources may quickly become outdated or replaced by more current versions. Try to locate the most current websites and/or editions of the listed resources to learn about updates or revisions.

This chapter covers the organizational management domain of practice and discusses three main areas that are essential to the knowledge-base of the assisted living administrator: The Assisted Living Industry: Context, History, and Overview; Policy, Licensing, and Regulations; and Organizational Overview. Area 1 focuses on the basic concepts of assisted living, including historical background, nomenclature, definitions, and a description of the industry. Assisted living administrators need to be familiar with these fundamental concepts as a basis for understanding their role and responsibilities. Area 2 focuses on laws and regulations regarding assisted living and the similarities and differences across states. Area 3 provides an overview of the organizational patterns and models. Understanding the concept of "aging in place" in the context of assisted living is essential. This area highlights the need for today's assisted living administrators to be well-informed and remain attuned to the evolving needs, practices, and models in the industry.

This chapter covers five main areas that are essential to the knowledge-base of the assisted living administrator: Accessibility, Fire Safety, and Disaster Preparedness; Models of Care; Universal Design and Aging in Place; Home and Community-Based Service Alternatives to Assisted Living; and Information and Communication Technology. Area 1 provides the assisted living administrator with a brief review of selected federal regulations, laws, and statutes related to disaster preparedness and accessibility as well as information about National Fire Protection Associations. Area 2 provides information on methods of service delivery in assisted living communities. Area 3 is focused on universal design and aging in place. Area 4 is designed to provide assisted living administrators with information about home and community-based services as components of long-term care and assisted living services. Area 5 includes an introduction and descriptions of information and communication technology.

The growth of the aging population in the United States is expanding, but our knowledge of sexuality among older adults is not keeping pace, allowing the ongoing perpetuation of myths about sexuality and aging. Aging couples may benefit when they understand that they may not be able to restore the sexual health they remember from their teens, 20s, or 30s but can expect to determine realistic, attainable goals that may include a variety of changes in routine, expansion of their sexual repertoire, and the incorporation of medications. This chapter briefs on the social context of aging, myths about sexuality in older adults, and challenges to sexual activity as people age. It then describes biological, psychological, and relationship changes and aging; and sexual behavior in residential healthcare. Older adults need to be counseled about practicing safer sex as 12% to 22% of all new AIDS diagnoses occur in this population.

As human beings grow up and older, there are some predictable changes over time. This chapter introduces distinct facets of aging, from physical to psychological, social, and societal, as well as the notion of “successful aging”. All facets are powerfully affected by the social world. Because aging is a lifelong process, a life course perspective is necessary to understand aging. The chapter introduces the key principles and building blocks of a life course perspective, which will be important to the book’s chapters. It discusses how the “sociological imagination” can help reveal how social forces matter in shaping aging experiences and in creating diversity and inequality in aging experiences. It also describes the growth of gerontology as a field of study and practice, and closes with an invitation to readers to apply knowledge of aging in their personal, professional, and civic lives.

Many people can easily conceptualize aging when they think about individual people–they simply imagine the physical and social changes they have observed in others as they have grown older. This chapter explores the future of aging and the life course. It highlights the fact that the future of aging is already here and can be understood by studying younger cohorts and examining cohort differences. The chapter shows how aging is being reconfigured by changes in the life course and families. It emphasizes how aging processes and outcomes are both diverse and unequal. The chapter identifies several important initiatives to improve life span, health span, and the vitality of older people. Finally, it offers parting thoughts to readers about the significance of aging for their lives, underscoring the need to understand personal aging by looking beyond the person and to see how it is powerfully shaped by social forces.