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.

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.

This chapter provides definitions and theoretical perspectives regarding the productive engagement of older adults. It explores the productive engagement of four ethnic minority groups African Americans, Hispanic Americans, Asian Americans, and Native Americans. The chapter discusses programs and policies that will help increase the productive engagement of older adults. It is possible that older adults will be judged by their ability to be productive and expected to be productive. Those older adults who have been disadvantaged across the life course will continue to be disadvantaged in later life when they still face discrimination in access to or support for productive engagement. Both definitions and theoretical perspectives are important to understanding the productive engagement of older racial/ethnic minorities. At the societal level, increasing the productive engagement of older adults, in general, may increase the supply of experienced employees, volunteers, and caregivers.

Improved nutritional status is an important component of efforts to improve the health of older adults, whose ability to consume a healthy diet is affected by comorbidities and behavioral, cognitive, and psychological factors. In addition to genetics and nutrition intake, nutritional status of the elderly could be affected by socioeconomic factors, such as education and income levels, and environmental factors, such as proximity to stores and transportation, that can affect food variety and availability. Nutrition and aging are connected inseparably because eating patterns affect progress of many chronic and degenerative diseases associated with aging. Anthropometric measurements are often used for nutritional assessment of older adults and are reliable across ethnicities. The Mini-Nutritional Assessment (MNA) tool was developed to evaluate the risk of malnutrition among frail older adults. Dietary patterns may better capture the multifaceted effects of diet on body composition than individual nutrients or foods.

This chapter summarizes and discusses the findings of the predictors of nursing home admissions and the issues regarding access among four groups of racial/ethnic minority older adults: blacks/African Americans; Hispanics/Latinos; Asians/Pacific Islanders; and American Indians/Native Americans. It provides a summary of the need for providing culturally competent nursing home care and future directions for alleviating racial/ethnic disparities and segregation in nursing home care. Minority older adults were once disproportionately underrepresented among nursing home residents. With the demographic revolution among racial/ethnic minorities and older adults, the number of racial/ethnic minority nursing home residents will continue to increase. Improvement in the quality of nursing home care for racial/ethnic minorities also requires culturally competent care. In providing culturally competent nursing home care, nursing home administrators and staff should involve community representatives from faith/spiritual communities and from civic and cultural organizations in the facility’s planning, monitoring, and quality-improvement meetings.

Social work is an applied discipline with a long tradition of using the theories and methods of social sciences to enhance practice, policy, and research. In their professional roles, social workers practice work with minority older adults and their families in diverse community-based and institutional settings that encompass social and health services. The conduct of social work practitioners and researchers in working with human populations is guided by the Code of Ethics of the National Association of Social Workers. A more sustained and concerted effort is required to ensure that there is a sufficient supply of gerontologically trained social workers to meet the growing demands of a more aged and diverse society. Social work researchers and practitioners will need to be responsive to the impact of government social spending cuts on the availability and delivery of services to their elderly clients who are most in need.

The family is the most basic social institution throughout the world. Families are studied in many disciplines, including anthropology, demography, economics, family studies, geography, gerontology, psychology, public health, social work, and sociology. This chapter explores what contemporary families look like around the globe, with a special focus on older members. This is a challenge, because one of the major characteristics of families is their diversity. The chapter begins with a brief example of the variability in contemporary definitions of the family. It then examines how population aging and global interconnections (specifically, economic and social factors) have changed the structure of families. Next, the chapter examines the living arrangements of older adults and their families, and looks at relationships within families. Finally, it explores macro- and microlevel factors that influence family functioning, and presents two important emerging roles of older adults in families.

The Older Americans Act (OAA) passed in 1965 provides a foundation for such involvement through its original mandate to serve all older Americans through a plethora of services and supports designed to help maintain the independence, security, and well-being of older adults. In 1958, legislation was introduced that asked for a White House Conference on Aging, which would bring together persons from all parts of the country to make policy recommendations that would focus on the economic security of older persons. Indicators show that it has been helping homebound elderly at risk of nursing home placement to stay at home, and it has continued to build the capacity of state agencies and Area Agencies on Aging (AAAs) to implement comprehensive systems of care. To improve its performance, the Administration on Aging (AOA) is focusing on improving efficiency, improving client outcomes, and further targeting services offered to the vulnerable elderly.

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.