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"Everyone is the age of their heart."

—Guatemalan Proverb


By the end of this chapter, readers will be able to:

  1. Describe cultural factors relevant to older adults and aging.

  2. Discuss how cultural beliefs affect activities of older adults.

  3. Identify key ethical issues relevant to the experience of growing old.

  4. Describe how culture and attitudes about aging affect understanding of these ethical issues.

  5. Define elder abuse.

  6. Describe factors that contribute to elder abuse.

  7. Discuss the responsibilities of care providers in addressing elder abuse.

  8. Discuss the relationships among attitudes about aging, cultural factors, and ethical challenges in working with older adults.

Clinical Vignette

Caleb Johnson is an 87-year-old widowed former postal worker who lives in a small cottage in an inner city in the Bay Area of California. His four grown children and 18 grandchildren all live in California, but most have moved away and see Mr. Johnson only at Thanksgiving and Christmas. Until recently, Mr. Johnson participated actively at his church, but increasing mobility limitations related to long-standing diabetes and mild cognitive impairment have reduced his current involvement. His children hired a neighbor to spend a few hours a day with Mr. Johnson to make sure he gets his meals and that he has companionship. During a visit home, Mr. Johnson's son notices that the sink is piled high with dirty dishes, the refrigerator is empty, and Mr. Johnson's treasured collection of silver dollars is missing.

  1. What are some possible explanations for what the son discovered?

  2. What steps can and should the son take?

  3. If an OT or PT were to be involved in providing care for Mr. Johnson, what are some strategies they might recommend?

As described in Chapter 1, individuals grow old in a complex social, physical, and cultural environment. That environment colors perceptions about later life, framing attitudes of society, social networks, and elders themselves. It also affects care providers' attitudes toward aging and the ways in which they approach the inevitable ethical challenges they face in providing the best possible care.

This chapter explores cultural and ethical considerations in working with older adults, including ways in which the experience of aging is culturally mediated, the ways in which culture affects care strategies, and the ethical dilemmas that emerge in the context of specific cultural environments. The chapter also examines the phenomenon of elder abuse, which is a legal, moral, and ethical concern.

Culture and Aging

Individuals experience the world in the context of culture. Culture can be thought of as "shared symbols and meanings that people create in the process of social interaction," which orient "people in their ways of feeling, thinking, and being in the world" (Jenkins & Barrett, 2004, p. 29).

Cultural values can help elders make sense of life, develop personal goals, and ...

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