Although the demographics of aging vary from country to country and region to region, one thing is constant: the world's aging population is rapidly increasing. Countries around the world are confronting a common need for services for older persons with disabilities. While the needs may be similar, the ways of meeting those needs may be quite different. The cultures of different countries may have different views of aging and the roles of older persons in society. The values of the recipients and providers of care often influence the types of services provided.
This special international issue of Topics in Geriatric Rehabilitation examines rehabilitation and caregiving from a comparative perspective. The issue begins with 2 related articles by Tomita and coauthors. The articles show results from a research study of caregivers in India, Taiwan, and the United States who provide care to older adults with dementia. The first article presents the characteristics and perceived supports of primary caregivers in the 3 countries. The study found that some characteristics of caregivers and caregiving tasks were similar whereas others were quite distinct.
The second article by Tomita and colleagues focuses on the psychological health of the caregivers. It found that the economic development of a nation does not necessarily improve caregivers' psychological health, with India exhibiting the best levels of caregiver psychological health. Taiwan had lowest levels, indicating that "where new lifestyles do not sustain traditions, caregivers especially suffer financially and psychologically to keep their care recipients with dementia at home." The importance of the prevention of loneliness is stressed. The authors conclude that there may be a need for different prediction models for developing and developed countries.
The next article by Iwarsson and colleagues is "Sociocultural Care and I-ADL Dependence Among Very Old European Women." The article reports results from a study of women in 5 European countries. The results indicate that sociocultural care and service context factors and socioeconomic indicators do have an impact "on I-ADL independence/dependence among very old, single-living European women, with marked cross-national differences." The findings point to a need for alternative approaches to assessments that take macro level dynamics into account.
The article by Hasnain and Rana, "Unveiling Muslim Voices: Aging Parents With Disabilities and Their Adult Children and Family Caregivers in the United States," is a literature review that examines the cultural factors that affect Muslim families as they provide care for aging Muslim immigrants with chronic conditions. The article provides recommendations for addressing the caregiving needs of this group.
The article by Mann and Aparecida Ferreira de Mello, "Assistive Technology Use by the Elderly in Brazil and the United States of America," compares patterns of assistive technology availability, use, financing, satisfaction, and effectiveness in the 2 countries. It also analyzes assistive technology by type of disability and notes the need for more attention to assistive technology research in Brazil.
The final article by Justine and colleagues, "A Multicomponent Exercise Program Effects on Health-Related Quality of Life of Institutionalized Elderly," reports on a study conducted in Malaysia. The results confirm research performed in Western countries in concluding that an exercise program can be important in improving the quality of life of older people living in institutions.
As we attempt to better understand disability and rehabilitation issues and solutions in our own countries, it is often instructive to contrast them with approaches in other countries. We hope that this issue of Topics in Geriatric Rehabilitation will be useful in providing some international perspectives as we attempt to strengthen the quality of rehabilitation services for older persons.
-John Stone, PhD
Guest Editor, Director, Center for International, Rehabilitation Research Information & Exchange (CIRRIE), State University of New York at Buffalo