Chronic Illness Self-care and the Family Lives of Older Adults: A Synthetic Review Across Four Ethnic Groups

Abstract

The purpose of this paper is to integrate the literature on family and social ties among older ethnic minority men and women with the literature on chronic illness self-care among elders in these groups, in order to increase understanding of social influences on self-care behavior, raise questions for future research, and inform culturally appropriate interventions to maximize the health-promoting potential of social relationships. The paper presents demographic and chronic illness prevalence information, and then summarizes literature about patterns of chronic illness self-care behaviors for older AfricanAmericans, Latinos, Asian-Americans, and American Indians in the U.S. For each group, the sociological literature about residential, cultural, and socioeconomic patterns, family lives, and other social ties is then reviewed, and the self-care literature that has accounted for these patterns is discussed. Finally, six themes are outlined and related questions are identified to further illuminate the social context of older adults' chronic illness self-care. KeywordsChronic illness; Ethnic minorities; Family; Older adults; Self-care; Social ties Although living with chronic illness is a reality for the majority of older adults in the United States, there are significant disparities in chronic illness prevalence across racial and ethnic groups (NCHS 2006). Furthermore, racial and ethnic minorities experience greater complications and higher death rates from most chronic illnesses (NCHS 2006;Harris 2001). To reduce these disparities in chronic illness outcomes, we need to better understand how members of these groups live with and manage chronic illnesses, in order to design effective intervention strategies that will enhance chronic illness outcomes (Becker and Newsom 2005).Self-care behaviors, defined as "the range of health and illness behaviors undertaken by individuals on behalf of their own health" (Dean 1992), play a crucial role in enhancing quality of life and active life expectancy among older adults (Ory and DeFriese 1998). This is particularly true for chronic illness self-care behaviors, which often involve regimens of

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