A Systematic Meta-Review of Mindfulness-Based and Mindfulness-Integrated Programs with Parents and Families: Evidence from Over 25 Years of Research.

Rising longevity, coupled with declining fertility rates, has led to population aging in the United States (US). In 2022, approximately 1 in 6 Americans—about 58 million people—were aged 65 or older. By 2050, this number is projected to rise to 82 million, representing a 47% increase (). These demographic trends bring to fore the rising demand for old-age care – be it informal or formal. And as the US population rapidly ages, so would its sexual minority members. One study estimates that 2.4% or approximately 2.7 million of older adults aged 50+ in the US identify as lesbian, gay, bisexual, and transgender (LGBT). Among them, around 1.1 million were 65 and older (). Despite their smaller numbers, sexual minority older adults are a crucial population to study, as many have faced a lifetime of stigma and discrimination – resulting in distinct disadvantages in health, healthcare access, family formation, and social support. In this study, I investigate the disparities in anticipatory support based on sexual identity. Anticipatory or perceived support refers to the belief that someone will be available to provide help when the need arises (; ). This form of support has been shown to promote well-being, particularly mental health as it functions as a social safety net that fosters a sense of security, belonging, and purpose. While anticipatory support is highly predictive of actual support received, it differs in important ways: unlike received support, it does not risk undermining personal autonomy and may instead promote a sense of mastery and encourage problem-solving from the vantage point of the recipient (; ; ). In this study, I focus specifically on anticipatory support in the context of potential future limitations in activities of daily living (ADLs). These limitations affect about half of adults aged 65 and older and can significantly hinder their ability to age in place – especially when adequate support is unavailable (; ). Individuals who are minoritized due to their sexuality are at greater risk for functional limitations and chronic conditions, largely due to the cumulative effects of stigma and discrimination (; ; ). At the same time, they have historically faced barriers to family formation – particularly because same-sex marriage was only nationally legalized in 2015 – despite family often being the primary source of informal care (; ). As a result, sexual minority individuals are aging with a shrinking safety net – just as the cracks in that net are widening under the weight it is expected to bear. They face elevated health risks while also having fewer available support resources. This raises an important policy concern, as informal care may serve as either a substitute for or a complement to formal care systems that are increasingly overburdened by rapid population aging (). Understanding disparities in anticipatory support for future ADL limitations by sexual identity is therefore essential to identifying care gaps and promoting equity in later life.