The novel coronavirus (COVID-19) outbreak has affected living standards around the world, and pandemic anxiety has changed social habits. In this context, this paper investigates the relationship between fear of COVID-19 and quality of life, and assesses the mediating effect of loneliness on this relationship among a sample of older adults in Turkey. The study considers data from approximately 400 people, all of whom completed the CASP-19 Quality of Life Scale in Older People, the Loneliness Scale for the Elderly and the Fear of COVID-19 Scale. Confirmatory factor analyses were performed to confirm a one-factor structure for each instrument. Subsequently, mediation analysis, correcting for age as a continuous covariate, was performed to assess the nature of the relationship between fear and quality of life, and the extent to which that relationship is mediated by loneliness. Our study showed that there is a negative and direct relationship between loneliness and quality of life. Another important finding of our research is that fear of COVID-19 has a significant effect on loneliness. Finally, loneliness mediates the relation between fear of COVID-19 and quality of life. This finding strongly suggests that fear of COVID-19 influences quality of life via loneliness. This result is noteworthy, as we could not find any similar finding in the literature.

Little is known about the effects of informal care-giving on employees' absenteeism due to illness. This paper therefore provides a longitudinal analysis of the consequences of taking on informal care-giving for men's and women's working hours and workplace absenteeism due to illness. Data were taken from the Dutch Labour Supply Panel (waves 2004–2018); 495 of the 6,452 male observations in this panel and 696 of the 5,961 female observations had taken on informal care-giving. It was tested whether respondents who became (intensive) informal carers were more likely than respondents who remained non-care-givers to reduce their work hours or stop working between waves t and t1, or to be absent from work due to illness in wave t1. (Multinomial) logistic regression analyses showed that taking on informal care reduced women's working hours when the care they provided was intensive, but not men's. The predicted probability of women reducing their work hours was 12 per cent if they had remained non-care-givers between waves t and t1, 15 per cent if they had started giving non-intensive care and 19 per cent if they had begun providing intensive help. In addition, starting to provide (non-intensive) informal care increased the risk of workplace absenteeism among both women and men. The study highlights the need for workplace policies that prevent female carers from reducing their work hours, and enable male and female carers to continue working in a healthy way.

More people are working into older age, raising questions about how many hours they can work before their health becomes compromised. This paper models work-hour tipping points for mental health and vitality among older Australian workers aged 50–70 years. We use longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, 2005–2016 (about 44,900 observations), and bootstrapping Three Stage Least Squares (3SLS) estimation techniques to adjust for reverse and reciprocal relationships between wages, work hours and health. Our approach corrects for heteroscedasticity in the system equation error terms, and we estimate models on the relatively healthy older adults who have remained employed into older age. Among these older workers we observe weekly thresholds of 39–40 hours beyond which mental health and vitality decline. This average, however, hides variability in work-hour limits linked to overall health and occupation. Thus, weekly tipping points for blue- and pink-collar jobs are 7–9 hours lower compared to white-collar jobs, and even wider gaps (11 hours) are apparent for workers with poorer physical functioning, which becomes common as people age. Our modelling reveals that age is not the biggest limiting factor for how many hours older adults can work, rather their health and the types of jobs are critical, and likely widen the gap in who ages successfully or not.

Involuntary retirement is associated with diminished mental health. However, little is known about the mechanism that connects involuntary retirees' coping resources to their loneliness. Gender patterns in the mechanism of involuntary retirement are also unclear. This study examines gender differences in the link between involuntary retirement and loneliness through secondary stressors (material and physical vulnerability) and coping resources (social support and self-efficacy). Two-step structural equation modelling was used to examine the effects of several mediators. For both men and women, involuntary retirement was associated with increased loneliness in terms of physical vulnerability and social efficacy. We found the female involuntary retirees are facing loneliness with multiple mediating factors. The layers of experiencing loneliness among female retirees are (a) directly from involuntary retirement; (b) indirectly from involuntary retirement and secondary stressors (material vulnerability and physical vulnerability); and (c) indirectly from involuntary retirement, secondary stressors (material vulnerability and physical vulnerability) and coping resources. The specific gender differences in the complex mechanism leading to later-year loneliness among the retirees may inform the interventions and policies that mitigate the disadvantages among involuntarily retired older adults in the United States of America.

Although the literature on informal care-giving for older parents shows that daughters have a higher tendency to provide care compared with sons, only a few studies have focused on the gender composition of all children or parents’ entire range of care options. Our study examines the effect of children's gender composition on informal and formal care types, as well as the informal care network. Using data from the 2015 Survey of Health, Ageing and Retirement in Europe (N = 40,312), we found that parents with daughters tended to use less formal care because daughters take on additional informal care-giving responsibilities. Daughters were the main care-givers among parents’ informal care networks. Further analysis indicated that daughters-in-law play an important role in the care-giving process when parents have only sons. We concluded that the presence of a daughter among the children reduces the use of formal care. The results indicated that children's gender composition is an important factor in explaining the allocation of informal care to parents.

Participation in social activities might increase older adults’ chances to interact with other people and has been found to be important in reducing the likelihood of depression. A picture of older adults’ attitudes towards ageing and their self-esteem constructed through the lens of how they interact with other people might cast light on the sources of older adults’ depression. This study explored the influences of social participation and attitudes towards ageing on depression of Chinese older adults. Using two waves data from the China Longitudinal Ageing Social Survey (CLASS) in 2014 and 2016 (6,908 participants in 2014 and 3,477 participants in both 2014 and 2016), we found that social participation in 2014 could prevent the risk of depression in both the 2014 and 2016 cohorts. In addition, both psychosocial loss and psychosocial growth in 2014 were negatively associated with depression in both 2014 and 2016. However, there was no evidence that social participation moderated the relationship between attitudes towards ageing and depression in either cohort. Social policies need to encourage older adults’ conversion from ‘passive participation’ to ‘active participation’. This could help older adults understand the process of ageing and their value to society, as well as have positive effects on older adults’ mental health.

To create environments conducive to the wellbeing of workers, especially older workers, it is important to gain insight into ageism among young workers as a distinct segment in the workplace. However, this ageism remains unclear. This study explored the psychosocial predictors of discrimination against older Japanese workers by their younger male counterparts. Four models – Intergroup Contact Theory (ICT), Knowledge–Attitude–Behaviour Model (KABM), Terror Management Theory (TMT) and Frustration–Aggression Theory (FAT) – formed the basis of the study. All the models included positive and negative dimensions of stereotypes as mediators between predictors and discrimination. Data from 874 participants were obtained through a voluntary web survey for employees aged 25–39 years who lived in the Tokyo metropolitan area. A scale describing interactions with older workers (supportive, uncomfortable and avoidance), Facts on Ageing quiz, fears of being an older worker and a job dissatisfaction survey were employed to examine the hypotheses based on the above theories. The results supported the hypotheses based on ICT and FAT but not KABM. Higher supportive contacts were significantly related to lower discrimination mediated by a higher positive and lower negative dimension of stereotypes. Contacts characterised by higher discomfort were significantly related to higher discrimination mediated by a lower positive and higher negative dimension of stereotypes. Higher job dissatisfaction was related to higher discrimination mediated by lower positive stereotypes. Interestingly, higher fear of being an older worker was significantly related to lower discrimination mediated by higher positive stereotypes, contrary to the TMT-based hypotheses. Thus, ICT and FAT regarding ageism can explain young male workers’ discrimination against older workers in Japan, which differs culturally from Western countries. Furthermore, the results of the study suggest that boosting the quality of interactions as well as reducing bad interactions with older workers contribute to lower discrimination.

Previous research has found varied effects of informal care provision on the carer's health status. Few studies have, however, examined this relationship dynamically. This paper is the first to analyse trajectories of care among men and women in mid-life and their impact on health outcomes using a nationally representative prospective cohort study. Data from three waves of the United Kingdom (UK) National Child Development Study (N = 7,465), when the respondents were aged 46, 50 and 55, are used to derive care trajectories capturing the dynamics of care provision and its intensity. Logistic regression investigates the impact of caring between the ages of 46 and 55 on the carers' report of depression and poor health at age 55. At age 46, 9 per cent of men and 16 per cent of women provided some level of informal care; rising to 60 per cent for both genders at ages 50 and 55. Just 7 per cent of women and 4 per cent of men provided care at all observation points, with the most common trajectory being ‘starting to care’ at ages 50 or 55. New carers experienced a lower risk of depression at age 55, reflecting that they may not have experienced the caring role long enough to have an adverse impact on their wellbeing. The findings highlight that the majority of individuals with surviving parents experience caring at some point during mid-life, underlining the need for further longitudinal research to better understand the complex relationships between care-giving and health for different groups of cares.

Long-term care facilities are increasingly important places for palliative and end-of-life care provision in Japan. While the importance of culture has been noted for palliative and end-of-life care, an exploration of its influence on care provision in long-term care settings has received little direct attention in Japan. Exploring staff views and beliefs in palliative and end-of-life care in these settings can potentially enhance our understanding of culturally oriented care and facilitate the development of tailored and more effective support practices. This study aimed to explore the cultural views and beliefs regarding palliative and end-of-life care among the staff in Japanese long-term care facilities. A qualitative exploratory study was conducted using focus groups with facility staff (N = 71) and semi-structured interviews with facility managers (N = 10) in the Kanto region of Japan. Thematic analysis was conducted according to Braun and Clarke's approach. The findings are presented in five key themes: ‘Changes in society's and family's end-of-life perspectives’, ‘Values and beliefs regarding death and dying’, ‘Anxiety and regret’, ‘Tensions in doing the right thing’ and ‘Ways of alleviating pressure’. The findings indicate that the provision of palliative and end-of-life care is underpinned by cultural nuances that influence care providers' approach and delivery. Recognising and understanding the cultural beliefs of staff around death, dying and end-of-life care are important in meeting the needs of residents. Palliative care education for staff in these settings should include cultural considerations that reflect changing societal views on death and dying.

Long-term care for older people is increasingly turning to consumer-directed approaches. As a case in point, the Hong Kong Government recently implemented a new voucher programme for community-based aged care based on a consumer-directed approach: the Community Care Service Voucher for the Elderly (CCSV). The objectives of this study were to explore the lived experience of professional workers vis-à-vis the new programme and to identify barriers to effective voucher use by older people in Hong Kong. In-depth individual interviews were conducted with 16 professionals who had primary responsibility for the voucher programme for community-based aged care. The interview guide covered five main areas: (a) professional's perception and experience on the voucher programme; (b) the decision-making process around the voucher programme; (c) personal capacities of older people; (d) family support and social networks; and (e) institutional support. Findings indicate several barriers to effective use of the CCSV including: lack of self-awareness of service needs, lower education level, poor health condition, lack of financial resources, lack of family support, inadequate family involvement in decision-making, lack of peer and professional support, lack of available services and poor service accessibility. Suggestions for strengthening the voucher programme include institution of a case management model and public education. Different factors or elements are required to facilitate older people to make sound and informed choices, and a case manager can assist in combining different resources and forms of support towards effective use of the CCSV.

Being dependent on homecare potentially threatens a person's integrity and autonomy, particularly when people are dependent on help to manage basic bodily functions that involve intimacy and nudity, making the person vulnerable despite being in his or her own home. As the population continues to age and live longer, more people are expected to be dependent on homecare. The aim of this study was to investigate the phenomenon of dependence on homecare among people ageing at home. Individual in-depth interviews were used to explore 15 Danish and Norwegian homecare receivers’ experiences of dependence on homecare. Interview records were transcribed and analysed in a hermeneutical phenomenological process described by van Manen. First and foremost, the experience of dependence on homecare is a question of adaption. The older people in this study struggled to get used to their deteriorating body and at the same time they continuously had to negotiate to get care in accordance with their values. Being dependent on care could be experienced as being reduced to a task or a problem to be solved though the participants had a significant need for undivided mental attention. The presence of homecare staff in the participants’ homes could entail a change where the participants experienced that they lost control over the surroundings. According to the voices of the older people in this study, future homecare should be accommodated in an organisational set-up that gives priority to stability and continuity in the relation between the homecare receiver and the homecare staff. Also it is significant that homecare staff do not have a task-oriented approach to their job and are sensitive to the values of the homecare receivers.

Independent mobility is an important component of healthy ageing. Public transit may be an affordable way to achieve independent mobility, and yet little is known about older adults’ transition to public transit. This paper addresses this research gap by providing an exploration of older adults’ experiences transitioning to public transit use, and by comparing these experiences to those of older people who have always travelled using transit. Twenty-four older adults (65+) living in Hamilton, Canada, who use public transit completed semi-structured interviews during which they discussed their experiences when they first began to use transit. These experiences are framed herein with the concept self-efficacy, i.e. how one's belief in their ability to complete a task shapes their ability to complete said task. Results indicate that most older adults acquire skills to transition to public transit, such as trip planning, boarding, knowing where to sit and exiting the bus. These skills are developed through practice. As one gains experience, one becomes more confident in their ability to meet their daily travel needs using transit. Therefore, the transition to public transit as an older adult can be more challenging for those with little experience using public transit. This paper highlights the danger of assuming all older adults will effortlessly take up transit and stresses the importance of older adults gaining experience using public transit.

The Sociocultural Stress and Coping Model focuses on the role of cultural values in shaping the stress and coping process for family care-givers of frail older adults. The literature suggested ethnic group-specific values as influences. The current study explored care-givers’ perceptions of values influencing caring to identify values not addressed in quantitative studies of cross-cultural care-giving. Seventeen family care-givers from Australian Aboriginal, Romanian-Australian, Pacific Island and white non-immigrant Australian backgrounds participated in semi-structured interviews about their care-giving experience and the role that values played in caring for a frail older adult. Thematic analysis of the interview transcripts led to identification of themes of cultural values of familism and care for frail older adults, religious values of filial piety and religious coping, love, reciprocity and responsibility/obligation. While cultural values influenced family care versus institutional care, religion was a more clearly identified source of values. Care-givers mostly shared values of love, reciprocity and responsibility/obligation rather than endorsing culture-specific values, with potential variations in expression between individualist and collectivist cultures. These findings suggest that the focus on cross-cultural differences may have missed core values shared across cultural groups and underestimated the influence of religion on care-giving values. Future research could focus on these perceptions of care-givers themselves rather than external perceptions of researchers and service providers.

Only a few studies have been conducted so far on the long-term impact of war. We investigated whether a life-long impact of the war experiences could be detected in advanced-agers who have successfully overcome all life's challenges. The participants in this study were oldest-old (80+ years) residents of retirement homes in Zagreb (Croatia), who were divided into two groups – ‘war-exposed’ and ‘not-exposed’ – according to their direct war experience (First World War, Second World War, Croatian Homeland War). Within this 1906–1928 birth cohort, a higher percentage of participants with war experiences reached extreme longevity (95+ years). We found no significant difference (p < 0.01) between the two groups concerning demographic and socio-economic characteristics, their life satisfaction, their self-rated current health and functional ability status. Despite numerous similarities, several traits related to life-history, current quality of life, attitudes and reflections distinguish the group of participants with direct war experience. The kind of war involvement – active military service, imprisonment in concentration camps or prisons, forced migration due to war and war-related death of close family members – stretched through various aspects of the life-history features, quality of life and attitudes. It differed for men and women, so it is no wonder that the significance pattern in the two genders mostly seems mutually exclusive. Socio-economic situations strongly differed by gender and according to the kind of war exposure, amplifying the differences within the ‘war-exposed’ group in terms of the life-long impact of wars on their lives. Therefore, we could claim that the war experiences were not the same for everybody, and that they had lasting consequences on the lifecourse of persons who directly faced war-related events. The results also point to the high resilience capacity as a common feature among persons who survived direct exposure to at least two wars and yet survived to exceptionally old age.

The general discourse in health and social care policy purports digital technology as necessary to meet growing demands for long-term care and health care as a result of an ageing population. This needs critical investigation since public policy influences people's health and wellbeing. This study aims to interrogate critically what we call the ‘digital technology solution’ discourse in local Swedish health and social care policies. The main concern of our analysis is the discursive constructions of older people and their informal carers and how the concept of health is constructed. A discourse analysis was conducted of 61 local policy documents using the ‘What's the Problem Represented to Be’ method. Our analysis revealed that so-called ‘e-health strategies’ were rarely concerned with health. Health was often referred to as an activity and seen as a means to achieve independence among older people. The norm advocated independence, with the responsibility placed upon the older person, supported by digital technology. Informal carers were constructed as a resource within an older person's environment and largely taken for granted. We argue that the digital solution discourse ignores older people's agency and capacities as contributors to society, not least with regards to being providers of informal care.

Anecdotal evidence suggests that non-communicable diseases (NCDs) contribute substantially to mortality, morbidity and disability in Ghana. Nonetheless, no data are presently available on Ghanaians with disability from major NCDs, such as hypertension, diabetes and stroke. Using data from the 2007/2008 Ghana World Health Organization Study on Global Ageing and Adult Health (SAGE) and applying ordinary least squares techniques, the prevalence of and associations between activity limitations and participation restrictions in Ghanaians with NCDs are examined in the present study. The results show stroke is the major contributor to activity limitations and participation restrictions among the Ghanaian population with NCDs. The study results further revealed that respondents with higher education reported high levels of disability compared to those with no education. The results suggest that functioning can be restored by providing assistive technologies, such as wheelchairs, prosthetic limbs, walking aids, etc., that can enhance participation of persons with disability in society.

Dementia, a global health priority, poses a disproportionately high risk to lesbian, gay, bisexual and trans plus (LGBT+)/gender and sexuality diverse people. Despite this, little research has explored the lived experience of LGBT+ people with dementia or their care partners. This scoping review aims to understand what the literature reveals about their experiences, the ways in which their lives have been investigated, to inform future research, policy and practice. Using an established scoping review methodology, we identified seven papers that reported empirical research on the lived experience of LGBT+ people with dementia and their care partners. Only a single study reported on in two of the papers included people who were trans. This in itself reveals how rarely LGBT+ people are asked to speak about how dementia has shaped their lives in academic research. Our reflexive thematic analysis indicates that LGBT+ people with dementia and their care partners endure overlapping forms of disadvantage. This results in heightened experiences of fear and discrimination, lack of services and compounded social isolation. Importantly, while dementia was embodied as interference and loss by LGBT+ people, it was their gender and sexuality differences that provided solace, even in the face of disadvantage. Importantly, people's relationships with LGBT+ identities were framed as fundamental for safety, resilience and wellbeing, rather than a complicating or confounding factor in living with dementia.

Although the older adult population faces a higher risk of poverty compared to others, there is no clear picture of their poverty in Iran. The aim of this study was to measure multidimensional poverty and its related factors among Iranian older adults. This cross-sectional study was conducted from July to November 2019 and collected data by interviewing 1,280 participants in Tehran, Iran. To compute multidimensional poverty, four dimensions were used: health (disabilities), education, housing and standard of living. Single and multidimensional poverty and the joint distribution of deprivation were calculated. Multilevel logistic regression models were used to determine the relationship between predictor variables and outcome (multidimensional poverty). Multidimensional poverty among Tehran's older people was 59.0 per cent. The prevalence of health, housing, education and standard of living deprivations were 15.4, 25.3, 29.5 and 29.9 per cent, respectively. Furthermore, multivariate analysis shows that living with a spouse, being employed, and having health and social insurance coverage were protective factors, while being female was a risk factor for multidimensional poverty. Approximately 21 per cent of multidimensional poverty variance was attributed to the district level and the remaining was assigned to individual-level factors. This study showed that the older adults living in different areas of Tehran experience different aspects of poverty. So paying attention to the dimensions of multidimensional poverty can play an important role in customising the policies of each district. Also, the findings of this study on risk and protective factors of multidimensional poverty can be effective in designing and implementing interventions to mitigate poverty among the older adults.

During the past decades, childless old age has attracted a considerable amount of scholarly interest. However, few studies address this phenomenon in Southern European familistic welfare states, where there is a pervading expectation that family members, especially spouses and children, care for their older relatives. The present cross-sectional study aims to analyse the relationship between childlessness, social networks and wellbeing in a sample of 612 Portuguese individuals aged 65 and over, comprising two sub-samples: parents (N = 540) and childless (N = 72). Data were collected through a research protocol that included a sociodemographic questionnaire, a personal social network assessment inventory, and several validated psychometric measures of psychological wellbeing focusing on mental health, loneliness, depression and satisfaction with life. Childless older adults' social networks are smaller but more diverse, including a more significant proportion of friends and neighbours. No differences were found in perceived support from significant others, but network reciprocity was lower among non-parents. The childless subsample also reported more feelings of loneliness and less life satisfaction, but regression analysis showed that parenthood status, per se, is not significantly related to any outcome measures. Besides the central role of sociodemographic characteristics and personal functioning measures in explaining psychological wellbeing variance, several network factors were also identified as influential predictors. Implications for micro-level network intervention and macro-level social policy making are discussed.

For older persons, age discrimination can undermine equal participation in modern service and consumer societies. One way to tackle age discrimination is to implement anti-discrimination policy and legislation. However, age discrimination is an ambiguous concept that can be interpreted in different ways and differences in the interpretation can impact the scope and application of related policy and legislation. Hence, to understand how policy, legislation and their central constructs operate within society, it is necessary to look beyond the letter of the law or policy text and explore the interpretations of age discrimination employed by actors in the field. We interviewed experts from Austria and Ireland, who by virtue of their professional or representative position co-structure the conditions for people to claim they have experienced age discrimination. Based on 12 expert interviews and two focus groups, each involving six representatives of the major national advocacy and interest organisations on ageing, we reconstructed four interpretation patterns of age discrimination: age discrimination as the ‘denial of dignity’, as the ‘denial of recognition of contribution’, as the ‘denial of participation’ and as the ‘lack of consideration of need’. The findings are discussed with reference to the concepts of recognition and representation, and considerations are provided on possible legal and political implications of this research.