The distinct needs of lesbian, gay, bisexual and trans (LGBT) residents in care homes accommodating older people have been neglected in scholarship. On the basis of a survey of 187 individuals, including service managers and direct care staff, we propose three related arguments. First, whilst employees’ attitudes generally indicate a positive disposition towards LGBT residents, this appears unmatched by the ability to recognise such individuals and knowledge of the issues and policies affecting LGBT people. Statements such as, ‘We don't have any [LGBT residents] at the moment’ and ‘I/we treat them all the same’ were common refrains in responses to open-ended questions. They suggest the working of heteronormativity which could deny sexual and identity difference. Second, failure to recognise the distinct health and social care needs of LGBT residents means that they could be subject to a uniform service, which presumes a heterosexual past and cisgender status (compliance with ascribed gender), which risks compounding inequality and invisibility. Third, LGBT residents could be obliged to depend largely on the goodwill, knowledge and reflexivity of individual staff (including people of faith) to meet care and personal needs, though such qualities were necessary but not sufficient conditions for inclusion and no substitute for collective practices (involving commitment to learn about LGBT issues) that become integral to care homes’ everyday functioning. A collective approach is key to advancing inclusion, implementation of legal rights to self-expression and securing equality through differentiated provision.

The paper considers a process of developing evidence-based design guidelines to be used in environments where people with dementia and sight loss are living. The research involved a systematically conducted literature review and a series of consultations with people affected by dementia and/or sight loss who lived or worked in care homes or in domestic settings. Findings from the literature and the consultations were used in an iterative process to develop the guidelines. The process is outlined, providing examples from the guidelines about lighting and colour and contrast. In discussing the research findings and the development process, the authors consider implications of the work including the weakness of the evidence base, the challenges of improving this and the need for innovative approaches to understanding the complexities of design for people with dementia and sight loss. They highlight the emphasis in the literature on independence for people with sight loss and the focus on control of people with dementia, arguing that this falls short of a genuinely person-centred approach, which recognises the active participation of people with dementia and sight loss.

Despite reported benefits of Telecare use for older adults, uptake of Telecare in the United Kingdom remains relatively low. Non-users of Telecare are an under-researched group in the Telecare field. We conducted 22 qualitative individual semi-structured interviews to explore the views and opinions of current non-users of Telecare regarding barriers and facilitators to its use, and explored considerations which may precede their decision to accept, or reject, Telecare. Framework analysis identified a number of themes which influence the outcome and timing of this decision, including peace of mind (for the individual and their family), the strength and composition of an individual's support network, the impact of changing personal and health circumstances, and lack of communication about Telecare (e.g. advertising). A cost–benefit decision process appears to take place for the potential user, whereby the benefit of peace of mind is weighed against perceived ‘costs’ of using Telecare. Telecare is often perceived as a last resort rather than a preventative measure. A number of barriers to Telecare use need to be addressed if individuals are to make fully informed decisions regarding their Telecare use, and to begin using Telecare at a time when it could provide them with optimal benefit. Although the study was set in England, the findings may be relevant for other countries where Telecare is used.

The literature is divided with regard to how older persons cope with traumatic situations of war and terror, and few studies have focused on continuous exposure to traumatic situations. To fill the gap in existing knowledge, the present study examined how older people cope with a continuous security threat which includes periods of intensive attacks. Three focus groups were conducted among older residents of rural localities situated near the Israeli border with Gaza. Content analysis of transcripts from the group sessions revealed four main aspects that concern the older participants when they cope with situations of war: (a) moral issues; (b) emotional issues; (c) intergenerational issues; and (d) resilience and future challenge. The analysis revealed that the older participants’ coping patterns derive from a combination of their stage of life, the changing lifestyle in their communal rural localities, and the ways that the older residents and younger residents of the communities cope with exposure to a continuous security threat. The theoretical framework for discussion of the findings is based on social theories of trauma and resilience. In addition, recommendations are provided for interventions at the individual and community levels.

Intergenerational help and care among members of the family belong to the most important dimensions of contemporary welfare regimes. Recent research has indicated that a major part of caring responsibilities is placed on the middle-aged generation. The ‘pivot generation’ is expected to provide help to their adult children and grandchildren as well as to their ageing parents. It has been hypothesised that people helping their parents are discouraged from looking after their grandchildren because they experience lack of energy and time. Using data from the four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper analyses the effect of providing help to ageing parents on the likelihood and intensity of looking after grandchildren. It takes a four-generation perspective: grandchildren, children, parents and grandparents. The results show that the support of parents is not associated with less-frequent and less-intense care of grandchildren. On the contrary, a positive association between caring responsibilities has been observed. The highest tendency to care for grandchildren has been found for people regularly helping their parents. This effect holds after controlling for grandparents’ characteristics and country effects. It is suggested that caring responsibilities tend to accumulate rather than compete with one another and therefore could represent a potential risk of overburden for those who have a general tendency to care.

This study investigated whether five positive psychological constructs (self-efficacy, gratitude, grit, hope and optimism) had a combined effect on levels of depression. The co-occurrence of these psychological factors, defined as an example of covitality, was examined in relation to predicting lower levels of depression. Participants were 278 retirees living in Brisbane, Australia. Each participant completed either an online or hard-copy self-report, related to positive psychological functioning. A standard multiple regression found that self-efficacy, grit, optimism and hope were individually all significant predictors of depression (small effect sizes); however, the combinatorial relation of all these four factors with depression was substantial (R2 = 0.34; large effect size). Gratitude was not a significant predictor. While no causality can be inferred from this cross-sectional study, having a combination of positive psychological factors might have an effect on levels of depression in retirement.

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.

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.

Issues stemming from differences and similarities in cultural identities affect residents and workforces in care homes in Scotland, as they do across the United Kingdom. Theoretical guidance and policy drivers emphasise the importance of considering cultural diversity when planning or enacting person-centred care processes, regardless of where health or social care takes place. Nevertheless, there is a recognised worldwide dearth of research concerning the intersections of culture, dementia and long-term care. This being so, a recent research study found that inadequate understandings of issues stemming from cultural diversity could be seen to constrain person-centred care in some Scottish care homes. In addition, the study uncovered little-recognised socio-cultural phenomena which were observed to positively enhance person-centre care. This article will focus on that, and will lay out findings from the study which lead to the following broad assertion: there is a broad lack of understanding of the power, and potential utility, of shared identity and community as a bulwark against the erosion of personhood which is often associated with dementia. This article describes these findings in some detail, thereby providing fresh insights into how shared cultural identity, and the sense of community it may bring, bears upon the interactions between workers and residents with dementia in Scottish care homes. It then suggests how the school of ‘person-centred care’ may be developed through further research into these phenomena.