The active management of the experience of living with dementia appears to improve quality of life despite the lack of disease modification. However, research to date has been largely of modest scale and explanatory factors for improvements have been under-conceptualised. Thus, although promulgated through national strategies, the evidence base is relatively weak. This paper reports on a nation-wide study of the influence of the National Dementia Strategy for England in relation to Dementia Adviser and Peer Support Network services in 40 demonstration sites. The research aimed to identify ways in which the services contribute to the wellbeing and resilience of people with dementia and care partners. A mixed-methods research design collected data through: activity and outcome monitoring; organisational surveys; in-depth case studies, including qualitative interviews with people with dementia (N = 47) and care partners (N = 54), wellbeing and quality of life measures, and interviews with staff and other stakeholders (N = 82). Three themes are explored: addressing individual and community needs; promoting independence, control and choice; and getting a life back. Services promoted independence, control and choice, and consequently enabled people to re-narrate their lives as purposeful within their communities. Ways in which these are achieved resemble the public health model of lay health advisor and this research adds to the imperative to approach dementia as a key public health concern.

Sub-Saharan Africa's older population is projected to nearly double in size by 2030. At the same time, demographic changes have caused major shifts in the units primarily responsible for the care of older adults: the family and household. The purpose of this paper is to examine the relationship between household composition and health at older ages in rural Malawi. We use data from the Malawi Longitudinal Study of Families and Health, which contains detailed information on household and family structure, along with measures of mental and physical health (from the Short Form-12). We focus on several measures of living arrangements that are expected to be associated with health: overall household size, sex composition and kin structure (based on co-residence with offspring and grandchildren). Results show that: (a) older women who co-reside with offspring have better mental and physical health compared to those living only with grandchildren; (b) older men who live in larger households or in households with a higher proportion of females have better physical health.

Institutional exit pathways shape individual trajectories from work to retirement. In the Netherlands, early retirement schemes as well as disability and unemployment benefits structure the timing and complexity of transitions within such trajectories. Simultaneously, access to these exit pathways depends on the individuals’ entitlements to various social security programmes as well as their freedom to decide on the timing and path of exit. In this study, sequence analysis was applied to register data of primary sources of income with the aim of identifying the main trajectories from work to retirement between the ages of 56 and 66 for a sample of Dutch men and women born between 1943 and 1945 (N = 2,277). Seven distinct trajectories were found: ‘early retirement’, ‘premature retirement’, ‘late retirement’, ‘disability’, ‘unemployment’, ‘inactivity’ and ‘drop-out’. Multinomial logistic regression analysis was applied to investigate the relations of these trajectories with a set of individual and socio-economic characteristics, as well as factors at a firm level. Especially women, non-natives, the lower educated and the self-employed were found to have a greater risk of ending up in the ‘involuntary’ trajectories of late retirement, disability, unemployment and inactivity. Public-sector employees, farmers and craftsmen, and skilled blue-collar workers were less likely to differentiate from the norm of entering into premature retirement between the ages of 60 and 64.

There is a need to understand the underlying mechanisms at work within health promotion and occupational therapy interventions. The aim of this article was, therefore, to explore and describe how the participants of a group-based occupational therapy intervention with positive health outcomes created meaning of and around their experiences of the intervention. The studied intervention was part of the evaluation of a single-blinded, exploratory randomised controlled trial of three different interventions. A total of 19 participants between 77 and 82 years of age with experiences from the group-based intervention were interviewed, and the transcribed interviews were analysed from a constructivist approach. The results showed five different perspectives of meaning, including enjoyment, usefulness, togetherness, respect for individuality and self-reflection. Based on our findings, we argue that the possibility of getting information, sharing with others and having fun, and the ability to adjust the activities in the intervention so that they met the individual's needs, created meaning for the participants. Moreover, meeting with others supported the participants’ perspectives of themselves. The results are discussed in relation to the pervasive discourse of successful ageing, including how it was present but also challenged within the participants’ accounts of the intervention.

This study examined how financial strain, worry about having no care-giver and social engagement modify the association between widowhood and depressive symptoms among older adults in China. Using national representative data from older adults in China in 2006, we ran structural equation models and ordinary least square regressions to investigate the mediating and moderating effects of financial strain, worry about having no care-giver and social engagement on the association between widowhood and depressive symptoms. All three variables significantly mediated the association between widowhood and depressive symptoms. Compared to their married counterparts, widowed older adults showed more worry about having no care-giver, increased financial strain and lower social engagement, which were significantly associated with depressive symptoms. Higher level of worry about having no care-giver and lower social engagement significantly exacerbated the adverse effects of widowhood on depressive symptoms in the moderation analyses. Our finding of mediating effects suggests that widowhood is negatively related to psychological wellbeing via financial strain, social engagement and care resources. The results regarding moderating effects suggest that alleviating worry about having no care-giver and increasing social engagement may buffer the deleterious effect of widowhood on psychological wellbeing in later life.

One of the strongest and most consistent predictors of self-regulated driving is gender, with women more likely than men to limit their driving in situations like bad weather or at night. However, studies have focused more on documenting these gender patterns than on explaining the processes underlying them, which may vary in their implications for transportation, health and ageing policy. Our study addresses this issue by examining two potential explanations for women's greater likelihood of self-regulated driving: their greater health limitations and use of driving alternatives. Using a nationally representative sample of older Americans (2011 National Health and Aging Trends Study, N = 4,842), we conducted logistic regressions predicting driving under four limitations: alone, at night, in rain or other bad weather and on highways. Our results provide stronger support for the driving alternatives explanation, especially women's greater reliance on rides from family and friends. Health limitations do contribute to explaining one of the self-regulated driving behaviours – avoiding driving alone. Our findings suggest that willingness to use driving alternatives is part of transitioning from driving. However, the relatively low use of all the alternatives we examined points to the importance of better understanding older adults’ transportation needs and preferences, including their gendered dimensions.

Little is known about the perspectives of health-care workers when it comes to prolonging their working lives. This exploratory paper focuses on physiotherapists and aims to offer new insights into the underlying processes that may influence perceptions of ageing and how they impact on motivation to work longer. Data gathering took the form of focus groups with 43 National Health Service physiotherapists. A thematic analysis was used to characterise and articulate key concepts and meanings. The analysis applied interpretive techniques. The six headline themes to emerge were: worry over physical capability and ability to cope; the need to maintain a professional image; work, retirement and exit norms; beliefs about ageing; extrinsic job demands; organisational support – line management; and organisational support – career progression. The key findings suggest that the current unchanging context of high job demands is very salient, consequently resulting in negative and pessimistic feelings about capabilities when it comes to being an older worker and having an extended working life.

The combination of population ageing and climate change is creating a new threat for many Australian coastal hamlets vulnerable to the impact of tropical cyclones. Increasingly, elderly people are facing future tropical cyclones alone, without support from family and friends, relying instead on already stretched government and authority resources, despite Emergency Management Australia's (EMA) policy expectation that all citizens must be self-reliant. This research explored the future self-reliance and disaster resilience of coastal hamlets through the lens of the Social Cognitive Theory by outlining the findings from focus groups, personal interviews and questionnaires involving participants over 65 years of age, residing in townships previously impacted by Cyclone Larry (in 2006) and Cyclone Yasi (in 2011). Participants recalled a lack of social support following the cyclones, a fear of evacuating their homes, as well as the trauma of recovering from such intense destruction. Respondents were also concerned about the physical, cognitive and financial impacts of ageing on their ability to prepare and recover from future cyclones, frightened that experiences from the past might be repeated in the future, contributing to feelings of isolation, frustration and the loss of community, and a rethinking of ageing in the place of their choice. These considerations impact on the dependence EMA has that all citizens will remain self-reliant when faced with a natural hazard and should be considered when making future policy decisions in relation to more isolated coastal townships.

Gender penalties in pension outcomes are widely acknowledged and have been documented for majority populations in various settings. A recurring finding is that the gendered impact of family formation on work–care trajectories adversely affects women's accumulation of pension rights over the lifecourse relative to men. Although maternal employment is particularly low in migrant populations, few papers have explicitly addressed pension protection of migrant women. Using longitudinal microdata from the Belgian Social Security Registers, we analyse whether entry into parenthood differentially affected the build-up of first pillar pension rights of working-age migrant women compared to natives between 1998 and 2010, further distinguishing by origin group and migrant generation. The results show that native women are most likely to build up pension rights through full-time employment both before and after parenthood. In contrast, first-generation women and women of Turkish and Moroccan origin are more likely to build up pension rights though assimilated periods or rely on derived pension rights after parenthood, even when controlling for type of pension build-up before parenthood. We conclude that policies reinforcing individualisation of pension rights based on employment or decreasing the importance of derived rights may erode pension protection of groups having limited access to the labour market, and require co-ordination with employment and family policies that support the combination of work and care responsibilities.

In the United Kingdom (UK), an ageing population met with the reduction of social care funding has led to reduced support for older people marked with an increased demand on family care-givers. Assistive telecare (AT) devices are viewed as an innovative and effective way to support older people. However, there is limited research which has explored adoption of AT from the perspectives of family care-givers. In-depth, semi-structured interviews were conducted with 14 family care-givers of patients who used the Assistive Telehealth and Telecare service in Cambridgeshire, UK. Family care-givers were either the spouse (N = 8) or child of the patient (N = 6). The patients' age ranged from 75 to 98, and either received a telecare standalone device or connected service. Framework analysis was used to analyse the transcripts. This study revealed that family care-givers play a crucial role in supporting the patient's decision to adopt and engage with AT devices. Knowledge and awareness, perceived responsibility, usefulness and usability, alongside functionality of the equipment, were influential factors in the decision-making process. AT devices were viewed positively, considered easy to use, useful and functional, with reassurance of the patient's safety being a core reason for adoption. Efforts to increase adoption and engagement should adapt recruitment strategies and service pathways to support both the patient and their care-giver.

Older employees face a severe employability problem, partly because of dominant stereotypes about them. This study investigates stereotypes of older employees in corporate and news media. Drawing on the Stereotype Content Model, we content analysed newspaper coverage and corporate media of 50 large-scale Dutch organisations, published between 2006 and 2013. The data revealed that stereotypical portrayals of older employees are more common in news media than in corporate media and mixed in terms of valence. Specifically, older employees were positively portrayed with regard to warmth stereotypes, such as trustworthiness, but negatively with regard to competence stereotypes, such as technological competence and adaptability. Additionally, stereotypical portrayals that do not clearly belong to warmth or competence dimensions are found, such as the mentoring role stereotype and the costly stereotype. Because competence stereotypes weigh more heavily in employers’ productivity perceptions, these media portrayals might contribute to the employability problem of older employees. We suggest that older employees could benefit from a more realistic media debate about their skills and capacities.

At the intersection of increasing social support needs due to population ageing and the promotion of older age as a time of contribution and social connection, volunteering is an important focus with advantages for older people. One service that addresses both these imperatives is home visiting services. Home visiting services connect home visitors with isolated older people. To examine how older people navigate volunteering for a home visiting service, six visitors were interviewed and the interviews were analysed using discourse analysis. A professionalism discourse was used to construct home visiting as a structured social support service that improved the lives of isolated older people. A personal relationship discourse constructed home visiting as an opportunity to forge long-term relationships that benefit both parties. At times these two discourses created tension for home visitors. Examining how the home visiting service is described by the service organisation online explains these tensions. The online materials construct active older volunteers as providing professional services while those they visit are constructed as receiving friendship. These discourses provide different ageing identities for visitors from those they visit, which contributes to the difficulties in navigating home visiting services. Addressing these tensions will enable service co-ordinators to better meet the needs of both visitors and clients in the context of increasing need for such services.

This study examines the retirement income of women in Europe, focusing on the effect of motherhood. Due to their more interrupted working careers compared to non-mothers and fathers, mothers are likely to accumulate fewer pension entitlements, and consequently, to receive lower incomes in later life. However, pension systems in Europe vary widely in the degree to which they compensate for care-related career interruptions by means of redistributive elements or pension care entitlements. Therefore, care interruptions may matter for the retirement income of women in some countries, but may be rather irrelevant in others. On the basis of life history data from the Survey of Health, Ageing and Retirement in Europe (SHARELIFE) for women aged between 60 and 75 years in 13 European countries, the interplay of individual lifecourse characteristics with institutional and structural factors is examined. The results show that the lower retirement income of mothers is mainly a result of fewer years in employment and lower-status jobs throughout the lifecourse. The analysis of institutional factors reveals that pension care entitlements are not able to provide a compensation for care-related cutbacks in working life. A generally redistributive design of the pension system including basic or targeted pension schemes, in contrast, appears as an effective measure to balance differences in employment participation over the lifecourse.

Older care home residents are excluded from the sexual imaginary. Based on a consultative study involving interviews with three residents, three female spouses of residents and two focus groups of care home staff (N = 16), making an overall sample of 22 study participants, we address the neglected subject of older residents' sexuality and intimacy needs. Using thematic analysis, we highlight how residents’ and spouses’ accounts of sexuality and intimacy can reflect an ageist erotophobia occurring within conditions of panoptical control that help construct residents as post-sexual. However, not all accounts contributed to making older residents’ sexuality appear invisible or pathological. Some stories indicated recuperation of identities and the normalisation of relationships with radically changed individuals, e.g. because of a dementia. We also examine care home staff accounts of the discursive obstacles that frustrate meeting residents’ needs connected with sexuality and intimacy. Simultaneously, we explore staffs’ creative responses to dilemmas which indicate approaches to sexuality driven more by observed needs than erotophobic anxiety and governance, as well as panoptical surveillance.

European welfare states used to be based on the principle of the family. Since the 1990s, however, ‘individual responsibility’ has been promoted, which fundamentally alters the traditional welfare-institutional framing of the family and the corresponding construction of the social citizen. One policy field that has been heavily influenced by this development is old-age security. The literature assumes a convergence towards institutional individualisation. We show this however to be incorrect. We empirically analyse and classify welfare-institutional change in old-age security with regard to individualisation. An innovative methodological approach for institutional analysis allows a nuanced identification of the welfare-institutional trends towards individualisation of the social citizen above pension age both within and between welfare states. We conclude that there has been no general and no partial convergence towards individualisation. Instead, on average, family elements in old-age security have either increased or persisted. Also, our analysis suggests that welfare-institutional change with regard to family is far from being a linear process and in part even displays contradictions.

Based on previous community research, we prioritise the need to understand better how experiences and feelings of invisibility could be shaped by relational dynamics, interfacing with service provision, and social forces, with the overarching view of understanding better the experiences of participants living with Parkinson's disease. A photovoice methodology was employed. A discussion of one case study of Bindy and Volta leads to a better understanding of how strong spousal support can significantly alter how one individual experiences and defines living with Parkinson's.

Older job applicants are vulnerable to stereotype-related bias in the recruitment process. In the current study, we examined how managers’ job interview invitation decisions regarding older job applicants are influenced by applicants’ human capital-related characteristics, general economic conditions and managers’ perceptions of changes in organisational job demands. Data were collected in two waves of a vignette experiment, three years apart, among a sample of 211 Dutch managers from various organisations. Multi-level analysis showed that managers were more likely to invite older job applicants who had matching qualifications, were employed at the time of application and came with recommendations. In addition, managers’ propensity to invite older job applicants was higher in better economic conditions. The effects of recommendations were moderated by the general economic conditions and changes in organisational job demands, such that a recommendation from another employer was especially influential in bad economic conditions, while a recommendation from an internal employee was especially influential when job demands had increased. The results emphasise the importance of considering the organisational and economic context in understanding the recruitment of older workers. The findings also suggest that older workers, employers and policy makers should invest in older workers’ human capital to protect their employability.

Risk factors associated with admission of people with dementia to long-term care institutions need to be identified to support health-care professionals in dementia care at home. An explorative study, combining quantitative and qualitative data collection methods, was performed in people with dementia in Spain. The sample, consisting of people with dementia receiving formal care from health-care professionals but at risk of institutionalisation, and their informal care-givers; and people with dementia recently admitted to a long-term care institution, and their informal care-givers, was interviewed between November 2010 and April 2012. Perceived reasons for admission were determined through an open-ended question put to both groups. Presumed risk factors were collected with validated questionnaires and analysed using bivariate analysis. A total of 287 people with dementia and informal care-givers were studied. Reasons given by the institutionalised group were mostly related to the level of dependency of the person with dementia. People recently admitted to a long-term care institution had more cognitive impairment, a greater degree of dependency and poorer quality of life than those still living at home. Home-care services in Spain need to develop or improve interventions based on the risk factors identified in this study: informal care-giver profile, high cognitive impairment, high level of dependency and the poor quality of life of the person with dementia.

Care-home residents with dementia can experience behavioural and psychological symptoms such as aggression, agitation, anxiety, wandering, calling out and sexual disinhibition. Care-home staff have a duty to keep residents safe. However, residents with dementia can pose particular challenges in this area. In this paper, we draw on a study which explored how care-home staff manage dementia-related behaviours. In-depth ethnographic case studies at four separate care homes were conducted in England. These involved interviews with 40 care-home staff and 384 hours of participant observation. Our analysis showed that some residents with dementia experience behaviours which can either create risks for, or negatively impact on, themselves and/or other residents or staff members. It emerged that the consequences of the behaviours, rather than the behaviours themselves, created difficulties for staff. To cope with the risk and impact of behaviours, staff employed multiple strategies such as surveillance, resident placement, restrictions and forced care. Using the data, we explore how actions taken by staff to manage the risk and impact of behaviours in these communal settings relate to residents’ human rights. Our findings have particular relevance for care-home staff who need support and guidance in this area, for service development worldwide and for the global ageing population whose valued human rights may become under threat, if they require long-term care.

Promoting life satisfaction in later life has long been both a policy and practice challenge. This study examined the association between older adults' self-image and life satisfaction, and that between their intergenerational relationships and life satisfaction. Given that sources of wellbeing for older men and women may vary due to socially constructed realities in early life, gender differences were also investigated in the correlates of life satisfaction. A face-to-face questionnaire survey was conducted in 2014 with a sample of 1,099 older adults aged 60 years and over from four cities in China. Findings of this study showed that older adults’ self-image and intergenerational relationships were significantly associated with their life satisfaction after controlling for certain socio-demographic characteristics, and health and self-care ability. The correlates of life satisfaction were shown to differ between older men and women. Programmes and Services should be developed for older adults to explore and identify positive aspects of themselves, to improve their relationships with their adult children, and to foster a more positive image of ageing in wider society. In addition, service providers should take gender differences in correlates of life satisfaction into account in service and intervention programme development.