The social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents’ experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting.

The paper reports on a study carried out in 1990 for the Department of Health looking at the development of local authority multi-purpose residential homes for elderly people in England and Wales. A national survey showed that one in five public sector residential homes for elderly people would soon be multi-purpose. This proportion could be expected to increase in the 1990S. Many of these homes had become the centre for virtually all the community support services for elderly people in the neighbourhood. Despite some obvious management advantages in making use of residential home facilities for older people in the community, there have to be serious reservations about a multi-purpose model. Case studies in six multi-purpose homes suggest that residents themselves may gain little or nothing from this arrangement. Few interact with elderly people from the neighbourhood in the day centre. So much activity on the premises meant that invasions of residents' privacy and space were common.

Subjective wellbeing was examined amongst 274 adults living with HIV in Australia and the United States of America. There were 164 adults aged 49 years and under, and 110 adults aged 50 years and over. Participants completed a composite questionnaire comprising the Personal Wellbeing Index-Adult (PWI-A), the HIV-Unsupportive Social Interactions Inventory (USII), and demographic and health-related items. Participants reported mean PWI-A scores of 54.7 points, considerably below the Western population normative range of 70–80 points. Older adults reported significantly greater subjective wellbeing compared to younger adults, but still below the normative range. Experiences of unsupportive social interactions were a significant predictor of reduced subjective wellbeing amongst all participants. Qualitative comments provided a greater understanding of the characteristics and psychological devices that enable some older adults to maintain and/or increase subjective wellbeing, even in the face of negative stressors such as unsupportive social interactions. This provides valuable information for service providers and clinicians as HIV increasingly becomes recognised as a disease affecting older adults in developed nations. Rather than positioning the ageing HIV-population as a potential burden, it is proposed that learning more about the coping mechanisms employed by older adults with HIV could prove beneficial for the HIV-population as a whole.

Organisational priorities for health care focus on efficiency as the health and care needs of populations increase. But evidence suggests that excessive planning can be counterproductive, leading to resistance from staff and patients, particularly those living with cognitive impairment. The current paper adds to this debate reporting an Institutional Ethnography of staff delivering care for older patients with cognitive impairment on acute orthopaedic wards in three National Health Service hospitals in the United Kingdom. A key problematic identified in this study is the point of disjuncture seen between the actualities of staff experience and intentions of protocols and policies. We identified three forms of disjuncture typified as: ‘disruptions’, where sequenced care was interrupted by patient events; ‘discontinuities’, where divisions in professional culture, space or time interrupted sequenced tasks; and ‘dispersions’, where displaced objects or people interrupted sequenced care flow. Arguably disruption is an integral characteristic of care work; it follows that to enable staff to flourish, organisations need to confer staff the autonomy to address systemic disruptions rather than attempt to eradicate them. Ultimately, organisational representations of ‘good practice’ as readily joined up, impose a care standard ‘stereotype’ that obscures rather than clarifies the interactional problems encountered by staff.

This exploratory descriptive study investigated barriers and enablers to the provision of leisure activities for people living in three Australian residential aged care facilities (RACFs) that operated under a household model of care. This research is unique in the international context, as few studies have explored the understandings and experiences of personal care attendants' (PCAs) perceptions of what impacts leisure provision for people living in RACFs. Qualitative data were collected from 17 PCAs via four focus groups. Barriers to leisure provision were identified as PCA–resident ratios, competing demands of the PCA role and a prioritisation of physical care tasks over leisure-related activities. The severity of residents' dementia (cognitive and functional deficits) as well as behavioural and psychological symptoms of dementia were also framed as barriers to participation in and the provision of leisure. Participants identified enablers of leisure provision as related to perceptions of leisure, the experiential knowledge of staff, organisational support and resourcing. The study findings suggest that enhancing leisure provision for people living with dementia will require attention to system issues (i.e. staffing levels, ratios, PCA role demands) as well as PCA knowledge and capability to facilitate person-centred leisure.

That older people should be consumers and active agents has dominated policy discourse across health, social care and housing that has a core care function. This discourse has some established and long-standing critics, such as Gilleard and Higgs, and yet the central question(s) a consumerist discourse raises remains surprisingly relevant today. The purpose of this forum article is to reconsider the viability of active agency amongst older people in the context of empirical research on information-giving across health, social care and housing that has been published since the paper by Gilleard and Higgs in 1998. Information-giving is the key consumer choice mechanism, and yet research is currently located in separate literatures. Giving these separate fields some coherence engages with and provides important empirical commentary. There is little or no evidence that information alone triggers active agency for older people in regard to their health, social care or housing. However, there is consistent evidence that discussion, deliberation and dialogue – or the practices associated with Habermas’ theory of communicative action – are desirable to older people in the context of active agency. More research is needed to demonstrate efficacy beyond communicative approaches being desirable.

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.

Since the 2000s, migration within and into the European Economic Area (EEA) has increased significantly. Some migrants will retire in their destination countries. This makes questions about their retirement protection increasingly relevant for social policy. To address this, we examine past experience. Using the Survey of Health, Ageing and Retirement in Europe (SHARE), we compared the pensions of post-1945 migrants, who settled in their host country, with non-migrants. We considered migrants who moved into and within the EEA, from poorer and richer countries. Where pensions were lower we sought to explain this in relation to the migration literature. As expected, we found some evidence that migrants’ pensions were lower, although significant variations were observed between EEA migrants and non-EEA migrants. However, surprisingly there were few indications that migrant pensions were lower because migrants as a whole were disadvantaged through late labour market entry or employment discrimination. Instead educational disadvantage mattered most, particularly for the highly educated: all highly educated migrants received lower rewards for their human capital than comparable non-migrants. Migrants who settled in countries with less-protective pension systems were also disadvantaged. Making retirement outcomes for migrants more equal would, thus, mean improving career opportunities for highly educated migrants and steps towards more-inclusive pension systems everywhere.

Elder law is often approached in terms of a ‘body’ of law. In this article, I argue for a contextualised and externalised perspective on the ageing individual as the subject of elder law. Elder law relates to the implications of law as an institutionalisation of society seen through the lens of older persons. The aged subject is a contested and differentiated social construct to be studied in relation to an externalised social ‘problem’ and properly contextualised. Whereas the ageing individual in the context of labour law and anti-discrimination regulation turns out to be remarkably young, the specific history of LGBT persons in society comes to the fore in cases where age intersects with a ground such as sexual orientation. The ‘ageing’ worker must thus be understood in relation to work as the dominant distributive order in society, and in relation to institutions and developments associated with work. Due to the role of age as a traditional social stratifier, the prohibition against age discrimination has been given a weaker format than have prohibitions against other kinds of discrimination, and the ban on ageism has failed to achieve a clear legal status. Deficiencies in the measures taken against age discrimination are also evident in their incapacity to address situations where age intersects with other grounds, resulting in a compartmentalised application and interpretation of discrimination bans, leaving vulnerable sub-groups without protection. In sum, elder law is very much a field in process and – although arguing for the added value of a contextualised perspective – it may for the time being suffice to say that ‘elder law is what elder law researchers do’.

The aim of this paper is to review the social constructionist view of age and ageing that emerged in the late 1970s and early 1980s. It begins with a general consideration of social constructionism as an epistemological framing of the world, before turning to its use in social gerontology. It considers two distinct social constructionist approaches treating later life as a social reality: (a) as a structural consequence of the rise of the modern state and its organisation of the labour market and (b) as a consequence of shifting cultural and social representations. Arguing that the earlier more structuralist accounts have gradually become overshadowed by concerns over age as identity, socially constructivist approaches now place as much emphasis upon the social representation of age as on its social-structural organisation. The paper then reviews the costs and benefits of social constructionism in general and its becoming a key part in the study of ageing. Its benefits arise from drawing attention to the salience of the cultural and the social in fashioning age and ageing and thereby advancing the sociology of later life. At the same time, social constructionist approaches to old age risk neglecting an other personal and social reality arising from corporeal decline and fear of the body-to-come. The paper concludes by noting how, whether approaching ageing and old age as natural kinds or as human kinds, adopting biological or sociological methodologies, all such methods privilege the externality of age – whether as a social or a biological fact. What is not captured by either is the problematic internality of age. What might be called the subjectivity of age will remain a topic for cultural representation, beyond the methods of both biological and social science.

The subjective experience of ageism among older men has received little research attention. This study examines older Canadian men's experiences with and perceptions of ageism during interactions with physicians. In-depth, face-to-face interviews were conducted with 21 men aged 55 years and over. The findings indicate a seeming lack of awareness of ageism among many, and many did not believe ageism was likely to occur during patient–physician interaction. Negative stereotyping of older patients was common. A large majority of the participants reported that they had not personally experienced ageism during a medical encounter, nor were they concerned about it. Numerous rationales were proffered as explanations of why a particular participant had not experienced ageism and who was more likely to be a target.

While research on men's mental health is increasing, it has not typically focused on the intersections between ageing, masculinity and mental health in a rural context. Given the significant increase not only in our global ageing population, but also our growing awareness of mental health problems in the general population, understanding men as they grow older in relation to mental health is a notable gap in research. In this paper, the authors explore the ageing experiences of male participants over 50 with self-identified mental health problems in rural Manitoba. We draw on semi-structured qualitative interviews from a larger project which focused on the diversity of rural men's perceptions, experiences and expressions of mental health and wellness. Specifically, we explore how these men reflect on their mental health and wellness. Participants in the study described their experiences as a cumulative process of making meaning, developing strategies, resources and a more positive sense of self – but sometimes also simply for survival. Men's sense of time over time – looking back and reflecting on the present and the future – appears to be a critical resource and a positive coping strategy for these men associated with ageing. The main themes include sustaining relationships; work, retirement and volunteering; and reflections on physical and emotional health. Our paper concludes with a discussion of the implications for new research on ageing men's mental health in a rural context.

The large proportion of people living in residential aged care services with dementia necessitates that any instrument used to measure quality of care is meaningful and practical to be completed by this group. This study assessed the external validity of using the Consumer Choice Index Six Dimension (CCI-6D) instrument to assess quality of care in a large sample of people living in residential aged care, including those with dementia. We applied the CCI-6D with 446 residents along with a range of measures of clinical and functional status and a measure of dementia-specific quality of life, the Quality of Life in Alzheimer's Disease (QOL-AD). Resident's cognitive abilities ranged from no evidence of cognitive impairment through to severe dementia. A high proportion of participants reported they felt very at home in their own room (82%, N = 367), while a lower proportion reported they could undertake meaningful activities that made them feel valued often (37%, N = 163). We identified moderate correlations between quality of care and quality of life, as measured through the QOL-AD utility score. Those with moderate dementia were significantly more likely to report poorer quality of care than those with no or mild dementia. This study provides further evidence for the use of the CCI-6D instrument to assess quality of care from the perspective of the individual receiving care even among those with living with dementia. Residents living with moderate dementia reported lower quality of care than those living with mild or without dementia, indicating the risks of poor care quality among this group.