The aim of this qualitative study was to explore rural family carers' experiences of the nursing home placement of an older relative. The study was undertaken in a large Health and Social Care Trust in Northern Ireland using a grounded theory approach. Purposive sampling was used to initiate data collection and thereafter theoretical sampling was employed. Semi-structured interviews were conducted with 29 relatives of nursing home residents and the resultant data were recorded, transcribed and analysed using constant comparisons. The software package, QSR NVivo, was used to facilitate data management and retrieval. Older people had deep attachments to their homes and entry to care was a last resort. Rural family carers had close relationships with health- and social-care practitioners and felt supported in the decision-making process. The choice of home was a foregone conclusion for carers who had a strong sense of familiarity with the nursing homes in their area. This familiarity was influenced by the relatively rural communities in which respondents resided and by an efficient ‘grapevine’, which seemed to thrive in these small communities. This familiarity, in turn, influenced the choice of nursing home, timing of the placement and responses of family carers. The findings indicate that issues such as rurality and familiarity warrant a more detailed exploration in future research on entry to care.

Meaningful engagement in activity is associated with the maintenance of health and wellbeing, but reduced activity participation is common among persons with dementia. Family care-givers play an important role in engaging their relatives with dementia in activities but little is known about their perception of occupational engagement. This study aimed to examine care-givers’ perception of occupational performance of their relatives from three aspects: person, occupation and environment. Adopting a qualitative methodology, semi-structured and in-depth interviews were conducted with 14 family care-givers. Care-givers were also asked to document the activity patterns of their relative, using the Activity Card Sort Hong Kong version (ACS-HK). The ACS-HK findings suggested that high-demand leisure activities were mostly retained (61%) while instrumental activities of daily living were the least retained (37%). Qualitative analysis revealed that care-givers’ perception of activity participation was intertwined with their motives and behaviours to get their relatives engaged in activities. Care-givers acknowledged occupational engagement as a means of maintaining wellness and used various strategies to encourage their relative's activity participation. Apathy and passivity, however, are difficult to deal with. Also, activity decisions appear to depend on the availability of support resources and a balance between safety concern and risk-taking. Clinical practitioners could assist care-givers by suggesting activity strategies and providing support resources for continued engagement of their relative in activities.

The introduction of choice and consumer mechanisms in public services has been identified as a fundamental shift in welfare service provision internationally. Within the United Kingdom (UK), such mechanisms developed and integrated into English services have not been replicated in their entirety in Scotland and Wales. For the first time since the inception of the UK welfare state, there are now formal differences in entitlement for older people as a result of devolution. This paper uses comparative policy analysis to review a range of sources not hitherto brought together in order to explore how these concurrent developments – choice and devolution – impact on people over state retirement age. We also consider the extent to which a more consumerist approach to public services might redress or increase later-life inequalities. Drawing on theoretical research and policy evidence, we argue that for many people over state retirement age, the prospect of becoming a consumer in these varied contexts is difficult and unwelcome. We suggest that although it is too early in the devolutionary process for any significant impact of these divergent policies to materialise, continued policy divergence will lead to different experiences and outcomes for older people in Scotland, Wales and England. We conclude that these divergent social policies offer significant research opportunities, particularly concerning their impact on later-life inequalities.

Although the socio-economic and structural contexts of retirement have been the subject of previous research, few studies state explicitly how societal ageism and structural constraints obstruct retired persons' choices or options available in post-retirement life. This study attempts to contribute to the literature of ageing, retirement, and wellbeing in later life in general, by providing real examples of ageism around the time of retirement as structural constraints of old persons. It also illustrates how they consequently reduce the choices of retired persons, and in turn affect their later life. The study draws on data from interviews with 34 retirees aged in their late fifties and sixties in Korea. Within the socio-economic context of ageism around the time of retirement, four options/strategies appear to be available; namely reconciling, complaining and not knowing what to do, finding roles in other activities, and disengaging. Older persons' decisions to continue to work after retirement are often reconciling ones, that is, taken within a context of limited choice and control. Permanent leavers' decisions not to work are also influenced by the limited quality of work available in the labour market. The study concludes by arguing that policies for older persons should take into consideration their diverse expectations and aspirations for their later life, but, at the same time, should remain aware of their constraints within socio-economic contexts.

Future increases in need of old-age care warrant research on receipt of informal care among older people in different policy and cultural contexts. Separating informal care into help provided by spouse and by children may shed more light on dynamics of informal help, important in alleviating the demands on the formal sector. Using nationally representative data from England and Finland, we performed logistic regression analyses to study receipt of help from spouse and children among community-dwelling persons aged 70+ years with functional limitations. In both countries, women and those with more functional limitations had higher odds of receiving spousal and filial help. In England – but not in Finland – those receiving formal public help had lower odds of receiving spousal help than those with no formal help. Those with low education received more filial help in England, but no association was found between formal and filial help. In Finland, the effect of education was not significant but those receiving formal help had higher odds of also receiving filial help. The results suggest that in a liberal market-led state, the role of children may be to help their parents living alone and with low financial resources. In the context of a generous welfare state, children may function more as active agents bridging the gap between their parents and formal services.

The onset of ill-health and frailty in later life, within the context of the policy of ageing-in-place, is increasingly being responded to through the provision of home care. In the philosophy of ageing-in-place, the home provides for continuity of living environment, maintenance of independence in the community and social inclusion. The provision of assistance to remain at home assumes continuity in the living environment and independence in the organisation of daily life and social contact. This paper explores the changes that occur as a result of becoming a care recipient within the home and concludes that the transition into receiving care is characterised by discontinuity and upheaval which tends to reinforce social exclusion. We draw on the rites of passage framework, which highlights social processes of separation, liminality and reconnection, in analysing this transition to enhance understanding of the experience and gain insights to improve the policy and practice of home care. Separation from independent living leads to a state of liminality. The final stage in the rites of passage framework draws attention to reconnections, but reconnection is not inevitable. Reconnection is, however, an appropriate goal for the care sector when supporting frail or disabled older people through the transition into becoming a home-care recipient.

This paper examines the contributions that generativity in older age may make to the concept of successful ageing. To this end, two perspectives on successful ageing are described: successful ageing as a set of clinical criteria, and successful ageing as the application of adaptive processes aimed at achieving efficient functioning. After showing the limitations of the first perspective, particularly from a developmental point of view, the paper argues that the adaptive version of successful ageing helps to put ageing into a developmental frame, but needs to be complemented by identifying specific content and goals that guide these adaptive processes and establish new feasible gains for older people. Generativity in older age could play that role and provides a conceptual framework that enriches the concept of successful ageing, both by emphasising the social context in which people age and by highlighting a personal growth component.

Ageing in Place policies have transferred responsibility for many frail elderly people and those living with dementia from residential to in-home care. Despite this placing a greater obligation on families, in Australia carers continue to under-use day respite services. This qualitative design study identified issues around the use of day respite care from the perspective of the family carer, focusing on barriers to attendance and strategies to facilitate attendance. Telephone interviews were held in 2007 with Tasmanian carers whose family member refused to attend day respite care (ten carers) and those whose family member attended (17). Carers considering day respite care were often overwhelmed by the quantity of information, confused about the process, and worried about the recipient's safety in an unfamiliar environment. They felt anxious about public acknowledgement of the condition leading to fear of embarrassment. Day respite care users appreciated the break it provided them and the opportunity for their family member to socialise. To facilitate a greater uptake of day respite care, reliable information sources and strategies to help carers deal with the emotions they face on a daily basis, together with a wider social acceptance of dementia, are important. Furthermore, carers need an opportunity to talk with others, enabling them to gain support from those who have successfully introduced a family member to day respite care.

Thailand has been severely affected by AIDS/HIV. The epidemic has undermined the health of the population of working age, placing stress on intergenerational relations and threatening the social fabric. Older people in families affected by the disease, although not the main victims, have experienced major changes in relationships with their adult children and grandchildren. However, the availability of antiretrovirals has transformed HIV infection from a lethal to a chronic disease. Intergenerational relationships are analysed with data from a quantitative survey of HIV-infected adults currently receiving antiretroviral treatment in Northern Thailand. The introduction of antiretroviral treatment has eased the pressure on families. Where HIV-infected adults are more dependent on their older parents, it is because they are single and childless or single parents. While ageing parents remain a source of support for their adult children, the introduction of antiretroviral treatment has radically changed the prospects for HIV-infected adults and their regained health allows them to work, take care of their family and fulfil their filial duties as expected in Thai society. If Thailand's original aim in introducing health policies in this area was to curtail the HIV epidemic, its positive impact on intergenerational relations is an additional benefit.

The demand for residential care by older people is increasing in Beijing as a result of dramatic demographic and socio-economic transformations. Little is known about the way older people access residential care in the context of Beijing. In this research, qualitative data collected from 46 in-depth semi-structured interviews with residential care facility (RCF) managers, older residents, and their family members in six RCFs in Beijing were transcribed and analysed using the constant comparative method. The findings included the following themes: access to residential care as geographical access, information access, economic access, socio-cultural access, and the socio-managerial environment. Geographical access is influenced by location, distance, and the micro-physical environment and amenities of RCFs. Information access refers to the capability to acquire related information on available resources. Economic access is the financial affordability for the resources. Socio-cultural access is affected by individual attitudes and aggregative cultural values on ageing and care of older people. Additionally, the social-managerial environment such as reputations of RCFs, quality of services, and management mechanisms are also important to the decision-making process. All these factors influence older people and their family members’ decision-making process of which RCF to choose. The research provides a multi-perspective analysis of access to residential care and suggestions on improving the accessibility of residential care for older people in Beijing.

Governments around the developed world are seeking to meet the challenges of the ageing population through strategies which promote a holistic approach to ageing, captured in catch-phrases such as ‘successful’, ‘active’, ‘positive’ and ‘healthy’ ageing. These strategies are supported by a growing body of research, with a particular emphasis on the prerequisites for health and quality of life. Drawing on that research, and using a methodology developed by the London School of Hygiene and Tropical Medicine, the ‘Minimum Income for Healthy Living (MIHL): Older New Zealanders’ study used a health lens to investigate the retirement income needs of older New Zealanders living independently in the community. The MIHL was estimated for people living alone, couples, renters and debt-free home owners. In each case, the MIHL estimates were appreciably higher than the universal state pension paid to older New Zealanders. People living alone and those renting their homes were shown to be worse off than couples and debt-free home owners, respectively. The results highlight that many older New Zealanders are living on an income which may not be enough to support a healthy life. This has important implications for the demand for health, residential and social services and brings life to the question of what level of income might be needed in retirement.

This paper discusses findings from a qualitative study which explored older adults' experiences of becoming regular exercisers in a gym triggered by health problems and their interactions with their younger gym instructors. A key question which the study sought to address was whether becoming embedded in the sub-field of exercise challenged traditional discourses of ageing (age habitus). While these older gym users reported significant benefits (greater health capital, expanded social networks and a return to active life after illness), they nevertheless were engaged in a complex and ambiguous negotiation of attitudes to bodily ageing and meanings of fitness and competence. In contrast, the instructors subscribed to a model of physical activity oriented towards physical capital as greater fitness. The paper suggests that these positions manifest competing understandings about what constitutes appropriate and desirable physical capital in later life. Budgetary constraints, beliefs about physical ability, professional expectations and the persistence of the discourse of decline prevent this gap from being easily bridged and allow alternative notions of ageing physicality to colonise the sub-field of exercise. The paper concludes that there is a need to develop ways of breaking down barriers in communication to overcome divergent understandings of what constitutes legitimate physical capital as we get older.

The aim of this paper is to ascertain the existence of differences in self-perceived health and depression between immigrants and native-born populations aged 50 years and older living in Western and Northern European countries. We examine the effect of country of origin, length of time in the host country and citizenship on the health of adults, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). As the logistic regressions reveal, some immigrant groups are more likely to perceive worse self-rated health and to suffer from depression than native-born groups, even when demographic and socio-economic variables are taken into account. In particular, people born in Eastern Europe living in Germany, France and Sweden have the highest odds ratio of poor health with respect to natives. Nativity status, duration and citizenship clearly contribute towards explaining health differences which are shown to vary significantly across countries. Furthermore, the perception of poor health rises as the length of stay increases, although a non-linear pattern was found. Results indicate that greater efforts by policy makers are needed in order to improve the health of specific middle-aged and older groups of immigrants in Europe.

This paper examined the relationships between family relations and life satisfaction between the two groups of older people with different hukous in Putian, Fujian, China. Five factors related to family relations: family support network, satisfaction with family support, family harmony, filial support and filial discrepancy, were included in the study. A total of 532 valid questionnaires, 263 and 269 being filled in by older people with agricultural and non-agricultural hukous, respectively, were obtained. Bivariate analyses indicated that five factors were correlated significantly with life satisfaction for both groups of older people. The results of hierarchical regression analyses showed that when controlling for socio-demographic variables, filial support was associated with life satisfaction for both groups of older people; satisfaction with family support and filial discrepancy was only associated with life satisfaction among older people with agricultural hukous; family harmony only contributed to explaining life satisfaction among older people with non-agricultural hukous. The present study confirmed some previous empirical findings, which indicated the importance of family relations to older people's lives, and extended our understanding about the correlates of life satisfaction for the two groups of older people with different hukous in China. Limitations and direction of future studies were also addressed. Meanwhile, the policy and practice implications of the study were discussed in the context of China's social and economic changes.

This article aims to examine patterns of innovation in older adults' tourism, and to explore whether innovation is associated with the benefits gained from the overall tourism experience. The study was based on a national mail survey of 298 retirees, who travelled abroad at least once in the year prior to the survey. Results indicated that participants' involvement in new experiences during their last travel abroad was quite high. Factor analysis of new experiences data identified two factors: ‘external innovation’, which included experiences that were associated with the external environment visited; and ‘internal innovation’, which consisted of experiences that were associated with some intrapersonal processes. Cluster analysis conducted on the new experiences' factors identified three groups of older tourists: non-innovators, external innovators and absolute innovators. These groups were differentiated in terms of travel patterns and destination activities. In addition, the absolute innovators reported a significantly higher level of agreement with various benefits statements than the other groups. Examining the findings through the lenses of the Innovation Theory of Successful Ageing helps to explain older adults' tourism experiences. Moreover, since the findings imply that experiencing ‘internal innovation’, rather than ‘external innovation’, amplified their overall tourism experience, this article suggests a new principle to the theory, which should be tested in future research.

The purpose of this paper was to examine the association of modernisation and filial piety among adult children care-givers of elderly Arab parents in Israel, and to identify factors that mediate the association. Cross-sectional data were collected in 2006–07 through structured interviews with 250 randomly sampled Arab-Israeli adult children care-givers. Hierarchical regression was then applied to the study variables in the respondents’ scores on a culturally relevant filial piety scale. The results revealed a negative correlation between modernisation, as measured by individualistic lifestyle and level of urbanisation, and filial piety scores. The association between individualistic lifestyle and filial piety was partially mediated by perceived care-giver burden. Given the observed trends, programme and policy planners should establish more services that are uniquely suited to the needs of a changing Arab society, in order to provide culturally relevant long-term support for the family network in a period of accelerated modernisation.

Healthy ageing concepts have been extensively studied in Western societies but few studies have explored the perceptions of older people from other cultural backgrounds. The aim of the study was to explore the conceptualisations of healthy ageing and perceived influences on ageing well amongst relatively healthy older Malays, a major ethnic group in Malaysia. Eight focus groups were conducted, with 38 participants recruited via community groups and leaders. Six themes were identified: spirituality, physical health and function, peace of mind, financial independence, family, and living environment. In this paper, we focus on the role of spirituality in healthy ageing which was a core resource in participants' lives. Participants reported that good physical health was an important resource that facilitated commitment to their spiritual activities. Furthermore, deteriorating functional ability appeared to provide an opportunity to optimise their spirituality, rather than hinder it. Participants wished for a ‘peaceful life’ and experienced this by enhancing their spirituality. Other ingredients for a peaceful life were financial independence, living in a place they love and having family members who live in harmony. In this community where religious affiliation is a tradition, spirituality can be fundamental for healthy ageing and its inclusion in aged care policy is imperative. However, further exploration on the diversity of individual expression of spirituality is important.

This paper examines the relationship between attitudes of filial responsibility and five different types of care-giving behaviours to parents among three cultural groups. It does so within an assessment of the relative importance of cultural versus structural factors for care-giving behaviours. Face-to-face interviews were conducted with 100 Caucasian-Canadians, 90 Chinese-Canadians and 125 Hong Kong-Chinese. Multiple regression analyses assessed the association of cultural and structural factors with behaviours among the total sample and each of the three cultural groups. Limited support was found for an association between care-giving attitudes and care-giving behaviours. Attitudes are related to emotional support only among the two Chinese groups as well as to financial support among Chinese-Canadian respondents and to companionship among Hong Kong-Chinese respondents. Attitudes are not the strongest predictors and are unrelated to assistance with basic and instrumental activities of daily living. However, cultural group per se is a strong predictor of care-giving behaviours as are: parental ill health, living arrangements, and relationship quality. This study suggests gerontological assumptions about the role of societal norms and personal attitudes in parental care-giving should be questioned. It also suggests the need for further inquiry into unpacking those aspects of ‘cultural group’ that are related to behavioural differences, and the importance of examining multiple types of care-giving behaviours and of distinguishing task-oriented helping behaviour from other types of assistance.

In this paper, the impact of lifecourse family and labour market experiences on household incomes of older people in Belgium and the United Kingdom (UK) is analysed. To this end, panel data and life-history information from the Panel Study of Belgian Households and the British Household Panel Survey are combined. The results show that old-age income is indeed influenced by previous lifecourse experiences, and that differences between Belgium and the UK can be explained in terms of (the development over time of) welfare regime arrangements. Family experiences have a larger impact on old-age incomes in ‘male-breadwinner’ Belgium, while in Britain labour market events are more important. As social transfers in Britain are more aimed at poverty prevention and less at income replacement, a ‘scarring effect’ of unemployment persists even into old age. Also, the more of one's career is spent in blue-collar work or self-employment/farming, the lower the income in old age. A new finding is that, notwithstanding the high level of ‘de-commodification’ achieved by the Belgian welfare state, this effect turns out to be significantly stronger in Belgium than in the UK. Compared to the market, the welfare state is hence a more efficient ‘mechanism’ of stratification for incomes in old age.