Koopman-Boyden and associates (2003) strongly endorse the hiring of older workers by factually destroying the stereotypes that many managers hold to, and show that older workers as generally more productive, not less productive, than younger workers. They also suggest that even higher productivity from older workers will result with flexible working arrangements. They specifically encourage older educators to continue working past the normal retirement age and suggest  changes in mandatory retirement for academics.  

      College students will need the understanding and the tools to work with change and to learn to manage greater variability in workers ages and in a more diverse workforce. Those students who will provide direct services to the elderly, such as in nursing homes, will need to be more prepared to work in a more diverse workplace. Kranz and Lund (1996) suggest a service learning component be a part of student’s preparation and have shown that such learning stays with the students for many years to come. In their research, they discovered that students who had been exposed to the actual homes of diverse populations still held to the truths that they learned more than 20 years later. It had an impact in any career field and opened up the student to a celebration of diversity.

     In every diversity course, there remains the critical task of introducing students to specific diverse groups. Too often, however, the material is not age oriented although it may serve well as a basis for understanding diverse groups. It is in this area that a number of journal articles have been sought to bring aging into race and ethnicity.

      One example is Smerglia and associates’ (1988) article on comparing the differences with family helping and caregiving between black and white families. In measurements of social supports, they found that both groups take care of their elderly, but that black families show more honor and respect to their matriarchs. However, medical decision making is somewhat removed from the elderly black person as it is considered the responsibility of the family in taking care of them.

       Reimann and associates’ (2004) article focused on the Mexican-Americans when they are being treated by physicians and found that the cultural competence of the doctors was very low. Besides the language barrier, customs were not understood (such as having the eldest matriarch pronounce the family member ill before allowing the doctor to do so). Given that Latinos have a high rate of Type II Diabetes, most probably from diet, the normal reluctance of the patient to facilitate care is a problem. The patient is usually quiet and respectful rather than giving the doctor information about their symptoms. They are often fatalistic in belief and that creates a problem in following doctor’s orders.

       Older American Indians were written about by Garroutte and associates (2004). Once again the cultural incompetence of the medical personnel got in the way of treatment. One such aspect is the reluctance for Indians to look the provider in the eye when he is talking to them. It is a sign of respect to the doctor, but it is often mistaken as a sign that the message is not getting through to the patient. When the patient was able to use a Cherokee Nation clinic, for example, patient satisfaction with the treatment greatly improved. It seemed that the technical skills of the medical staff were not a deciding factor, but the cultural understanding was held as very important by the patient.

      Navajo elderly who live in a reservation nursing home were studied by Mercer (1994). This was especially significant due to the very low number of nursing homes available for the older Indian and the low rate of use of most health care among the reservations (often due to lack of availability). She reported that “many Indians referred to the reservation as a Third World country within the United Sates.” Beyond the family, the extended family, and the neighbors, older Indians who are lacking the very basics of life and have distances to travel to get medical care are more likely to give up their way of life for the nursing home, if available and if it is culturally sensitive to their needs.

       Connery and Brekke (1999) looked at ethnicity with relationship to mental health and home based care. Of course, the home is the best place to treat the patient and the study measured how ethically different peoples could be trained to take care of their loved ones. They found that the strongest help among the African American and Latino populations was the extended family relationships that are seen as normal life. Also impacting was the church, spirituality, and work ethic along with the education of the patient and family members. When service providers respect those cultural concepts, the family can be taught to serve the loved one very well.

      McCurdy and associates (2003) also looked at home-based family support with regards to ethnic variations. They found a greater number of Africa-American and Latino families stayed with the programs supporting their loved ones than did the Euro-American families. Their article has a wealth of data and, again, points to the extended family norm among these two diverse groups as the reason they did more than the Euro-American families.

      Culture has even been researched with relationship to homicide by Weaver and associates (2004). They found that the Southern culture in America, which is conservative, and teaches respect for the elderly did not, surprisingly, “insulate the elderly from victimization.” This is a research report that needs to be followed up on to find out whether the findings were reliable and valid, since it goes against common sense.