Growing evidence suggests a low engagement in advance care planning (ACP) among ethnic minorities in the U.S. The purpose of this study was to synthesize findings from prior research about ACP among ethnic minorities. An extensive literature search was conducted using multiple electronic databases. After applying inclusion criteria, 26 studies were included. Four categories of facilitators and barriers to ACP were identified: (1) Socio-demographic factors, (2) health status, literacy and experiences, (3) cultural values, and (4) spirituality. Socio-demographic factors showed inconsistent findings regarding their association with ACP engagement. Worse health status and knowledge about ACP are common facilitators across ethnic minority groups, whereas mistrust toward the health care system was a barrier only for Blacks. Collectivistic cultural values influenced ACP engagement among Latinos and Asian Americans; however, spirituality/religion played an important role among Blacks. The implications for culturally competent approaches to promote ACP and future research directions are discussed.

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Purpose -The purpose of this paper is to increase understanding of elder abuse in Ethiopia by considering the perspectives of abused elders. Design/methodology/approach -A phenomenological study was conducted to investigate the lived experience of 15 elders (six men, nine women) in Ethiopia who experienced domestic abuse. Data were collected using unstructured interviews and were analyzed using interpretive phenomenological analysis. The results described here focus on Ethiopian elders' perceptions of factors contributing to abuse. Findings -Themes identified in elders' statements about the factors contributing to elder abuse included: declining respect for elders, conflicts of interest, poor health, mutual dependency and other economic issues, and loss of support providers. Abject poverty was evident as an underlying influence contributing to abuse. One elder stated, "Life is meaningless without food and without a caregiver. I am ready to welcome death." Research limitations/implications -Documentation of elder abuse is needed to bring recognition to abuse as a problem deserving public attention and response. Practical implications -Given the apparent influence of poverty-related factors on the occurrence of elder abuse among the study's participants, policy initiatives are needed to enhance the economic well-being of older adults in Ethiopia. Originality/value -Since elder abuse is generally not viewed as a societal problem in Ethiopia, there have been very few studies documenting its existence. Research on elder abuse in Ethiopia and other developing nations can help to bring the issue to the attention of communities and authorities.

Elderly men are more likely to commit suicide than any other age group in the United States. Moreover, their rate of suicide steadily increased between 1979 and 1988. National Center for Health Statistics (NCHS) Compressed Mortality data were used to perform an age-specific analysis of linear trends. Males 65 and over were the most likely to use firearms followed by those 55-64. In 1988, nearly 8 out of 10 suicides by males 65 and over were committed with a firearm. Firearm-related suicide rates were much lower for blacks than whites 65 and over; however, suicides among blacks were more likely to involve firearms than among whites in this age group. The authors call for a broad public policy effort directed at reducing the availability of firearms.

As migration, urbanization, and aging accelerate in developing nations, traditional family supports for elders are diminishing. With these trends in mind, hermeneutic phenomenology was used to examine the experiences of 10 rural Ethiopian elders of age 70 and older. Narrative data from in-depth interviews revealed three prominent themes: the “good old days,” drained happiness, worry and pessimism. Elders felt devalued by their children, grandchildren, and youth in general. Compared to how they treated their own parents, elders believed that their children’s sense of filial obligation was weak and unreliable. Interactions were described as undermining, embarrassing, and abusive. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite such challenges, participants viewed aging as a privilege. New cooperative models of community-based care are needed to ensure that elders in developing nations can expect adequate care throughout their lives.