The post-war history of hospital care for older people in Britain in the first phase of its National Health Service (NHS) emphasises a detrimental Poor Law legacy. This article presents a regional study, based on the South West of England, of the processes by which Victorian workhouses became the basis of geriatric hospital provision under the NHS. Its premise is that legislative and medical developments provided opportunities for local actors to discard the ‘legacy’, and their limited success in doing so requires explanation. Theoretical perspectives from the literature are introduced including political economy approaches; historical sociology of the medical profession; and path dependence. Analysis of resource allocation decisions shows a persistent tendency to disadvantage these institutions by comparison with acute care hospitals and services for mothers and children, although new ideas about geriatric medicine had some impact locally. Quantitative and qualitative data are used to examine policies towards organisation, staffing and infrastructural improvements, suggesting early momentum was not maintained. Explanations lie partly with national financial constraints and partly with the regional administrative arrangements following the NHS settlement which perpetuated existing divisions between agencies.

Scholars and policy makers have expressed concern that social and economic changes occurring throughout Asia are threatening the wellbeing of older adults by undercutting their systems of family support. Using a sample of 1,654 men and women aged 45 and above from the Chitwan Valley Family Study in Nepal, we evaluated the relationship between individuals' non-family experiences, such as education, travel and non-family living, and their likelihood of receiving personal care in older adulthood. Overall, we found that among individuals in poor health, those who had received more education, travelled to the capital city, or lived away from their families were less likely to have received personal care in the previous two weeks than adults who had not had these experiences. Our findings provide evidence that although familial connections remain strong in Nepal, experiences in new non-family social contexts are tied to lower levels of care receipt.

The objective of the study was to discover what fairly independent residents living in long-term residential care think about home care as an alternative. A stratified systematic sample was drawn from a one-day census of patients in all residential homes in Finland on 2 December, 1991. A postal survey was used for data collection in December, 1992. Respondents who preferred home care were compared with respondents preferring residential care according to length of stay, health, functional ability and health-related quality of life. Most respondents preferred institutional care. Preference for home care was explained most strongly by emotional factors, unwillingness for residential care at admission, and still having a home to return to. Shorter length of stay also predicted preference for home care. Those who preferred home care admitted they would need much formal care after discharge. People living in residential homes are rarely ready for discharge home, because of limitations in their physical ability or of their unwillingness to change their site of care.

The aim of this study was to gain an understanding of the experiences of extended longevity as perceived by centenarians. Centenarians (people over 100 years of age) are the fastest growing group of the ageing population in developed countries. Ten centenarians aged between 100 and 106 years, living in the Lower North Island of New Zealand, participated in the study. The biographical narrative interpretive method of inquiry guided data collection through face-to-face interviews, and thematic analysis was subsequently undertaken. Four themes were identified: (a) ‘becoming a centenarian: ‘Just another day’; (b) ‘growing up in a privileged environment’ that revealed four sub-themes: ‘having freedom and choice’, ‘being loved and nurtured’, ‘living healthy lifestyles’ and having ‘good education prospects’; (c) ‘unique opportunities in adult life’; and (d) ‘positive ageing and celebration of longevity’. The centenarians spoke nonchalantly about their experience of turning 100 and positive personalities were prominent features of the participants, who all expressed a sense of acceptance and satisfaction with life and contentment with living in the present, a feature throughout their lives that was ongoing and at an intergenerational level. This study has provided further insights into the existing literature on longevity and through the narratives of the centenarians has demonstrated the value of Erikson's psycho-social stages of development and Tornstam's theory of gerotranscendence when considering positive ageing.

Analysis of intergenerational contact and solidarity patterns has generally focused on the family. However, the unprecedented co-existence of a high number of different generations raises the challenge to delve into how such patterns may develop inside and outside the family. To understand better intrafamilial and extrafamilial intergenerational contact and solidarity in Spain, three national surveys were initially studied using cross-tabulation tables and measures of association. Then, factor analysis and logistic regression of most recent data focused on explanatory variables behind two dimensions of intergenerational solidarity. Regarding intergenerational co-residence, the results point to a highly relevant difference between intrafamilial and extrafamilial habits. As regards regular, but non-residential, contact between the generations, two gaps have been identified. The first gap appears between family practices and non-family practices, with a significant and progressive reduction of the latter being detected. According to the second gap, while intergenerational contact drops outside the family, levels of intragenerational contact are comparable in both settings. In this context, patterns of associational and functional intergenerational solidarity towards older relatives and non-relatives have been identified, with age, distance, civil status and especially gender being the key explanatory variables. The paper argues that there is good reason to pay combined attention to both intrafamilial and extrafamilial forms of intergenerational contact and solidarity, something that has been done very little to date.

Discussions of the position of the elderly have typically been cast in terms of demographic considerations and/or level of industrialisation. In contradistinction to this approach we employ a political economic perspective which reveals the contradictions present in the situation of aged small farmers in southern Italy. Using a dialectic approach, it is argued that the function performed by the small farm sector, that of keeper of the surplus labour force, is extended to deal with the elderly population. Within this context, rurality assumes a permanent posture as the aged farmers are maintained at the margin of the labour market and are eventually expelled from it. At the same time, this farming segment substitutes for other social agencies as a caretaker for a portion of the older population. This function, however, creates social tensions for it mandates continuous State support for the survival of these farms, demands which are resisted by the bourgeoisie and certain segments of the working class. Even if it were deemed appropriate, the State cannot extend its support to small farms without simultaneously calling forth a fiscal and legitimation crisis stemming from its policy coverage.

This review paper has two major aims, first to synthesise recent research findings and conceptual developments in the field of psychological gerontology in Germany and in German language publications, and secondly, to argue that the field's research findings deserve greater attention, for both their substance and their relevance to social policy. The review focuses on three major fields of psychological gerontology: (1) cognitive development in old age; (2) personality development in old age; and (3) social relationships in old age. It highlights the major findings generated by German scholars since the 1990s. Although numerous and diverse, a common thread is the move away from a focus on the limitations and decrements of later life, and increased attention to the continuing capacities and developmental achievements of older people. The discussion elaborates the view that there is considerable merit in considering the broader social implications of these results. In conclusion, and from a general rather than disciplinary perspective, it is argued that there is a strong need for geropsychological research to be designed and interpreted with explicit attention to the cultural and social contexts in which the subjects live.

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.

From the confrontation of fiscal austerity and growing needs in the United Kingdom has come a new ideology: ‘efficiency-focused mana-gerialism’. Common arguments and the adaptation of structures to reflect them can be seen in all areas of policy, but nowhere more clearly than in the long-term social care of the elderly, the subject of this paper. Perhaps the strand of policy analysis which most influences and epitomises the new managerialism is the work of the Audit Commission for Local Authorities in England and Wales, whose arguments and proposals have gained great and widespread influence. The commission's ‘three Es’ – economy, efficiency and effectiveness – have become among the most fashionable slogans of our time.

This study develops and tests a causal model of social service use by USA Puerto Rican elderly. Andersen and Newman's Health Framework was employed to classify and test a model of social service use by a national random sample of mainland USA Puerto Rican elderly. The findings indicate that 7 of the original 27 variables (i.e. need for social services, awareness, functional literacy, functional ability, mobility, income and contact with friends and neighbours) accounted for 43% of the variance in use. Counter to our theoretical assumption the need factor accounted for more variance than the enabling factor. Moreover, the predisposing factor and informal support variables were important predictors of utilisation.

This study aimed to investigate the relationship between the unemployment experience and depressive symptoms among mid-aged (ages 45–59) and elderly (ages 60 or above) persons and to examine further the effects of unemployment insurance, industrial accident compensation insurance (IACI) and national pension on the stated relationship. Data were used from the Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2012. A total of 1,536 individuals employed at the 2006 baseline were followed. The association between employment status change during 2006 to 2008, 2008 to 2010 or 2010 to 2012 and depressive symptoms in years 2008, 2010 or 2012 were analysed using a generalised estimating equation model. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D 10) scale. The results showed that the ‘employed to unemployed’ group had statistically significant increases in depression scores in the mid-aged (β = 0.4884, p = 0.0038) and elderly (β = 0.8275, p ⩽ 0.0001) categories, compared to the ‘employed to employed’ group. Findings were maintained in groups without a social safety net. Contrastingly, the ‘employed to unemployed’ groups with unemployment insurance and IACI did not show statistically significant increases in depression scores. The ‘employed to unemployed’ category of individuals enrolled in the national pension system exhibited a lower increase of depression. Therefore, an enhanced focus on the mental health of unemployed individuals is required, in addition to the provision of a reliable social safety net.

This article is based on a study that used a validated care-giver assessment instrument known as ‘The C.A.R.E. (Caregivers’ Aspirations, Realities, and Expectations) Tool’ to understand its usefulness in working with older adults caring for a spouse with cognitive impairment. It draws on data collected as part of a larger, quasi-experimental pre- and post-test study examining the impact of a care-giver assessment on older spousal care-givers of a partner with cognitive impairment. One hundred community-living individuals (average age of 74) participated in the study. Participants met with a third-year nursing student who administered The C.A.R.E. Tool. Within three to seven days following this, a research team member conducted a semi-structured interview by telephone. This interview provided participants with the opportunity to comment on their experience and the usefulness of The C.A.R.E. Tool. Transcriptions of the interviews were analysed using a thematic analysis. Results indicate that the assessment experience was evaluated positively by most participants. Two broad themes emerged: assessment encourages care-givers to take stock of their situation, and it provides a relationship with a caring professional. In particular, the assessment experience gave these care-givers to have the opportunity to reflect, while expressing emotions and developing awareness, and provided them with an appreciated relationship with a caring professional who helped to validate and normalise their situation. For care-givers, the results suggest that assessment may serve as a catalyst for taking action in their care-giving situation or turning to services for help. For practitioners, assessment may increase awareness of the experience of spousal care-givers, potentially leading to interventions to support them. This study found that the attitudes and knowledge of practitioners play a role in care-givers’ experience of the assessment as positive. However, the goal of assessment must be clarified, as outcomes of other tools will differ depending on the aims.

The primary aim of this scoping review was to explore the contribution of housing adaptations to supporting everyday life for people with dementia living at home in the community. The study adopted a scoping review methodology which was guided by the Joanna Briggs Institute Reviewers Manual. Four review questions were developed which subsequently informed the inclusion criteria and search terms. Eight databases were searched resulting in 2,339 records, with 13 papers being included in the review. Evidence from the review found that the most common adaptations were recommended and/or implemented to compensate for a person's physical limitations and for safety reasons, rather than adaptations to support activities of daily living for a person with dementia. Support to implement adaptations was provided by a range of professionals coupled with ‘trial and error’ approaches adopted by the person themselves, and these were seen as key enablers. Barriers to implementing and using adaptations were fourfold: (a) access to information, (b) knowing when to make changes, (c) carer resistance, and (d) the unsuitability of the home. It would appear that housing adaptations have a positive impact on both the person with dementia and the carer (where one is present), with some adaptations having a relatively sustained impact and being particularly effective if implemented early in the lived trajectory of dementia.

Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70–85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises.

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.

A. Sagner. 1998. The 1944 Pension Laws Amendment Bill: old-age security policy in South Africa in historical perspective, ca. 1920–1960. Southern African Journal of Gerontology7, 1, 10–14.

S. van der Berg. 1998. Ageing, public finance and social security in South Africa. Southern African Journal of Gerontology7, 1, 3–9.

The latest issue of Southern African Journal of Gerontology traces the origins of the South African social pensions system and addresses contemporary issues. In her editorial, Monica Ferreira (1998) notes that South Africa is one of only two countries in Africa that operates a social old-age system. Although the value of the South African social pension system is low in terms of real income (R490 in July 1998 – approximately US$100), the pension is generous in comparison with other developing countries. The take-up rate of the pension is virtually 90 per cent in the case of Africans, who historically were the most disadvantaged group under apartheid.

An understanding of the psychosocial impact of deafblindness on older people is impoverished by a dearth of research in the field. Particularly limited are studies adopting a salutogenesis perspective, in which older deafblind people's coping capacities are explored. Much research focuses on vulnerability to unfavourable outcomes, which may perpetuate negative stereotypes of deafblind people as passive and dependent. Identifying deafblind people as a vulnerable group gives rise to misunderstanding of the impairment, perceptions of incapability and neglect of deafblind people's agency. This paper draws on data from the first United Kingdom-based study of vulnerability from the perspectives of older adults ageing with deafblindness. Findings presented here relate to participants’ experiences of managing and coping with their felt vulnerability and ageing with deafblindness. The study adopted interpretative phenomenological analysis (IPA) as its qualitative approach. In-depth semi-structured interviews were undertaken between October 2014 and July 2016 with eight participants, aged between 48 and 83 years. Data were analysed using an iterative six-step IPA process. Three superordinate themes were identified: taking action to protect self; psychological coping strategies; and accessing and using care and support. Participants’ managing and coping strategies, and the care and support they value, respond to elements identified as generating felt vulnerability. Professionals should seek to bolster coping capacity and provide support in ways valued by those ageing with deafblindness.