Extra-care housing has been an important and growing element of housing and care for older people in the United Kingdom since the 1990s. Previous studies have examined specific features and programmes within extra-care locations, but few have studied how residents negotiate social life and identity. Those that have, have noted that while extra care brings many health-related and social benefits, extra-care communities can also be difficult affective terrain. Given that many residents are now ‘ageing in place’ in extra care, it is timely to revisit these questions of identity and affect. Here we draw on the qualitative element of a three-year, mixed-method study of 14 extra-care villages and schemes run by the ExtraCare Charitable Trust. We follow Alemàn in regarding residents' ambivalent accounts of life in ExtraCare as important windows on the way in which liminal residents negotiate the dialectics of dependence and independence. However, we suggest that the dialectic of interest here is that of the third and fourth age, as described by Gilleard and Higgs. We set that dialectic within a post-structuralist/Lacanian framework in order to examine the different modes of enjoyment that liminal residents procure in ExtraCare's third age public spaces and ideals, and suggest that their complaints can be read in three ways: as statements about altered material conditions; as inter-subjective bolstering of group identity; and as fantasmatic support for liminal identities. Finally, we examine the implications that this latter psycho-social reading of residents' complaints has for enhancing and supporting residents' wellbeing.

This paper examines how care-giving to adults and/or children and care-receiving is associated with the health and wellbeing of older people aged 50+ in rural South Africa. Data used are from a cross-sectional survey adapted from World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in 2009/10 in rural South Africa. Bivariate statistics and multivariate logistical regression were used to assess the relationship between care-giving and/or care-receiving with functional disability, quality of life or emotional wellbeing, and self-rated health status, adjusted for socio-demographic factors. Sixty-three per cent of 422 older people were care-givers to at least one young adult or child; 27 per cent of older people were care-givers due to HIV-related reasons in young adults; 84 per cent of participants were care-recipients mainly from adult children, grandchildren and spouse. In logistic regressions adjusting for sex, age, marital status, education, receipt of grants, household headship, household wealth and HIV status, care-giving was statistically significantly associated with good functional ability as measured by ability to perform activities of daily living. This relationship was stronger for older people providing care-giving to adults than to children. In contrast, care-givers were less likely to report good emotional wellbeing; again the relationship was stronger for care-givers to adults than children. Simultaneous care-giving and -receiving was likewise associated with good functional ability, but about a 47 per cent lower chance of good emotional wellbeing. Participants who were HIV-infected were more likely to be in better health but less likely to be receiving care than those who were HIV-affected. Our findings suggest a strong relationship between care-giving and poor emotional wellbeing via an economic or psychological stressor pathway. Interventions that improve older people's socio-economic circumstances and reduce financial hardship as well as those that provide social support would go some way towards mitigating this relationship.

Being married reduces the mortality risk of older persons. More generally, living arrangements that include co-residence with a source of support and a close care-giver are associated with a lower mortality risk. We build a detailed typology of private and collective living arrangements, including marital status, and check its association with mortality risks, controlling for health status. Using administrative data from the population register, we identify the living arrangement of all individuals aged 65 years and over living in Belgium as at 1 January 2002, and their survival during the year 2002. Data on health status are extracted from the 2001 census. We use binary logistic regression with the probability to die as outcome and living arrangement, health, age and gender as covariates. Our results show that mortality is more closely associated with actual living arrangements than with marital status. This association is age and gender-specific and remains even at very old ages. Living with a spouse is confirmed to be beneficial for survival but in older age living alone becomes more favourable. Of all living arrangements, older persons living in religious communities experience the lowest mortality risk whereas those living in nursing homes experience the highest risk.

Although community services support ageing-in-place, older adults often report feelings of loneliness and social isolation. Unmet emotional needs are associated with poorer health, reduced functional abilities and increased mortality in this population. Pet ownership is an avenue worth exploring to reduce these adverse outcomes. This scoping review maps main findings and identifies key gaps with respect to the pros and cons of pet ownership in community-dwelling older adults pertaining to psycho-social, physical and functional outcomes. Scientific and grey literature published from January 2000 to July 2018 was searched. Data selection and extraction were performed by the first author and a sub-sample was co-validated by two co-authors. A total of 62 sources were included for descriptive and thematic analysis. A variety of pros (increased physical activity, wellbeing) and cons (grief, risk of falls) pertaining to psycho-social and physical outcomes were identified. Not many functional outcomes (support for daily routines) were mentioned, and few studies explored the simultaneous balance between the pros and cons of pet care. Further research exploring both clinicians’ and older pet owners’ perspectives is needed to deepen our understanding of the importance of considering companion animals in older adults’ daily lives and to strike a balance between perceived risks and benefits.

Nature-based adult day services (ADSs) in urban areas are relatively new services in the Netherlands. Since knowledge about these services is still scarce, this study aimed to elucidate their value for people with dementia and their family carers in terms of health and wellbeing. We interviewed 39 people with dementia attending nature-based ADSs in urban areas and their family carers, and 17 providers of these services. Respondents indicated that nature-based ADSs in urban areas positively affected the health and wellbeing of people with dementia. According to them, these services support contact with nature and animals, activity engagement, physical activity, structure, social interactions, healthy eating, a sense of meaning in life and a focus on normal daily life. Respondents further indicated that these services stimulate respite, reassurance and maintenance of family carers’ own activities and social contacts. We conclude that nature-based ADSs in urban areas have a wide range of benefits that might affect the health and wellbeing of people with dementia and their family carers. Worldwide, demand is growing for innovative practices in dementia care. It is therefore worthwhile monitoring the development of dementia care innovations, such as nature-based ADSs, and for countries to exchange lessons learned from these services.

Drawing on the accounts given by 163 relatives, friends and others who knew a sample of people who lived alone in the last twelve months of their lives, this paper examines a variety of strategies used by speakers to maintain their moral identities. Respondents sought to locate themselves as members of a community of care by stressing their activity in surveillance of the living conditions of those who lived alone, describing their part in the orchestration of help by members of a team of professional and lay carers, and in conducting negotiations over the placement in institutions of people who failed to maintain adequate reputations for independent living. A variety of strategies for justifying or excusing placement decisions—including criticisms of the behaviour of the people who lived alone—are described. At the same time, the accounts are read as a resource for understanding the perspective of the people who lived alone. People who live alone towards the end of life face particularly pressing threats to their capacity to maintain meaning and purpose. Declining physical capacity threatens loss of control and the onset of social death, conspiring to undermine ontological security. The struggle to maintain a reputation for independence in the face of neighbourly surveillance for signs of slippage is described. The paper concludes by identifying a central dilemma for carers: how to provide care that allows its recipient to manage self-identity independently.

With an increase in the proportion of Australians aged over 65, and high government expenditure on residential care, there is a strong imperative to find smart, safe solutions to support older people to stay in their own homes. There is a growing interest in Australia for assistive technologies that provide home monitoring to promote health and wellbeing. This solution will only be viable if it meets with the expectations of older residents and their families. In the first smart homes pilot in Australia, we sought to ascertain barriers and facilitators of this technology. There was an overall positive response to the system, despite a slight tendency for residents to modify their behaviour due to perceived surveillance. Positive outcomes included increases in family communication, health autonomy and advances in technology uptake. Our findings suggest that a combination of considered placement of in-home technology, straightforward medical devices and a supportive human element will ensure that the technology meets the balance of service provision and preservation of dignity. Smart homes could mitigate the challenges associated with aged care while affording peace of mind for seniors and families.

The purpose of this paper is to present a descriptive account and analysis of ethnographic research which focuses on gossip as an important social interaction between older people in sheltered housing. Analysis reveals that gossip plays a prominent role in the daily life of older people in the schemes studied, reinforcing social norms and values that assume great significance in a close-knit, predominantly female environment. Conclusions are drawn that while gossip may serve a useful social purpose in sheltered housing, it may also have important and paradoxical consequences for the individual. In particular, gossip is understood to be a form of interaction that encourages the individual to strike a balance between their personal and social needs in this communal setting.

The aim of this article is to analyse 20 Finnish working carers' perceptions of their sibling relations and the sharing of the responsibility for parental care. The main focus is on the interviewees' rationales for the participation or non-participation of their siblings in the parents' care. Almost all the interviewed carers stated that the division of care responsibilities is unequal and that they are the primary carers, but the majority did not convey any clear intention to try to persuade their siblings to increase their participation in parental care. In many cases, the siblings were described either as entirely absent or as providing occasional backup, but some interviewees reported that caring for the parent(s) was shared with their other siblings. Consequently, three participation patterns were identified: ‘absence’, ‘backup’ and ‘togetherness’. All the interviewees offered rationales for the unequal division of care tasks and responsibilities among the siblings. The discussion focuses on these rationales and their variations by participation patterns, and considers the similarity of the findings to those from previous American and British studies. The study concludes that social-care services should take the primary carer's siblings into consideration, although not always as a ‘resource’. It should not be taken for granted or assumed that the primary care-giver receives help from her or his siblings, even if their relationship is otherwise close and unproblematic.

Loneliness is a significant health risk for older people, linked with bereavement, living alone and declining health. Previous research suggests loneliness is common amongst residents of English retirement housing, who show a relatively high incidence of these factors. This invites the question, what can providers of retirement housing do to help their residents avoid loneliness, thus remaining healthier and less likely to need care services? Through a survey of 326 retirement-estate managers, we investigate the role of staff and residents' groups in developing organised social activities for residents in retirement housing, and the potential of these activities for generating social contacts which may provide a pathway to avoid loneliness. The survey was informed by a literature review with two objectives: firstly, to consider the nature and causes of loneliness amongst older people and how these apply to retirement housing residents; secondly, to identify good practice models of previous interventions designed to widen social interactions for older people or provide emotional support. The sample was drawn from the all-England property portfolio of a major provider of retirement housing for people over 55. The sampled estates, mostly social rented but including some with a mixture of leasehold and rented dwellings, represent a sector also described as sheltered or supported housing, which has over 550,000 dwellings in the United Kingdom. It is characterised by having some form of staff support for people who are frail, immobile or isolated, such that they may occasionally need help available on call. In the literature review, we consider how different kinds of social contact can help develop friendships and meet social support needs, in retirement housing and elsewhere – in particular, organised group activities (clubs, classes, etc.) and specific interventions designed to address loneliness. The fieldwork suggests that organised activities in retirement housing have considerable potential to meet residents' social support needs, but that this potential is often not fully realised. A wider range of activities is needed, which may require the support of housing management staff, volunteers and community organisations.

Drawing on data from in-depth interviews with 35 men and women aged 73–91, this article examines the ways in which older adults with multiple chronic conditions talk about and prepare for death and dying. While the focus of the original study did not include questions concerning the end-of-life, the majority of our participants made unprompted remarks regarding their own and others' mortality. The participants discussed the prevalence of death in their lives as it related to the passing of significant others, as well as their own eventual demise. Additionally, the men and women expressed hopes and fears about their impending death, in particular with respect to prolonged pain and suffering, institutionalisation, and a loss of mental acuity and independence. Many of our participants also described their end-of-life plans, which included making funeral arrangements, obtaining living wills, and planning their suicides. They further reported a number of barriers to their planning for death, including a lack of willingness on the part of family members to discuss their wishes as well as a scarcity of institutional resources and support. We discuss our findings in relation to the extant research concerning older adults' experiences of death and dying, as well as Glaser and Strauss' (1971) theory of status passage and Marshall's (1986) conceptualisation of authorship and the legitimation of death.

Socio-economic circumstances influence later-life employment participation, which may take different forms as retirement processes are complex. We aimed to explore the diverse effects of various socio-economic sub-domains on pre- and post-retirement employment. We used Finnish register data to examine socio-economic predictors of time to retirement (i.e. receiving the statutory pension) using Cox regression analysis and on time spent in post-retirement employment using repeated negative binomial regression analysis over a follow-up between the ages of 63 and 68, i.e. the flexible pension age range. An average wage earner still employed at age 62 spent 13.5 months in pre-retirement employment (this corresponds to time to retirement) and 4.8 months in post-retirement employment. Those with tertiary education retired later, but the educational differences in the total time spent in employment were small when post-retirement employment was also considered. There was little variation in the timing of retirement by household income, but those in the highest quintile spent the longest time in post-retirement employment. Upper non-manual employees, home renters and those with high household debt retired later, and those with high household debt also spent a longer time in post-retirement employment. In a national flexible pension age system, high occupational class and household income thus appear to encourage either later retirement or participation in post-retirement employment. However, economic constraints also appear to necessitate continued employment.

In imagining how their lives might turn out, 100 young New Zealanders aged between 16 and 18 years wrote descriptions of their future lifecourse. Their descriptions of themselves at the nominal age of 80 years form the basis of the research reported in this paper. For these young people, ageing and old age are understood as accomplishments in the context of an imagined lifecourse. They see personal ageing as shaped by a common temporal ordering of life events that ensures material security, financial success, and an enduring intimate relationship. In imagining themselves aged 80 years, three key themes that constitute a discourse of ‘accomplished ageing’ were identified: the experience of old age would be contingent on achievements throughout the lifecourse; old age would be a time for harvest; and while people may look old they can continue to ‘be’ young. Although their images of bodily appearance included some negative stereotypes of old age, appearance and bodily function were understood as amenable to life-long self-management. The young people imagined themselves as life-long active agents, and framed a positive image and homogeneous social identity for older people. The ‘accomplished ageing’ discourse has implications for how ageing is understood by young people. In particular, the social identity that accomplished ageing implies may shape how they relate to those who do not accomplish ageing in the imagined optimistic and homogeneous way.

Older workers are often placed in an unenviable position in the face of stereotypes which define them as increasingly marginal in the work force, and view retirement in terms of status loss and disengagement. Yet voluntary early retirement schemes have been a recent feature of work organisations of all types in Britain, Western Europe and North America. The nature of the decision-making processes of those involved in such schemes has not been widely researched and such studies as have been conducted have not drawn on the existing framework of decision analysis. This paper reports the findings of two linked studies into the early retirement decisions of men working in Britain for a large multinational company in the manufacturing sector. The first investigated the factors deemed to be important for a group of men at the point of decision whilst the second investigated both the factors deemed to be important and the quality of life of a group of men who had taken the decision to retire early between 18 months and 3 years previously. Both studies indicated that the decision-making process is complex and cannot be reduced to single-factors like health or financial status. The most important factor in the quality of life of early retirees was the matching of expectations of further work at the point of decision. The studies illustrated the utility of a decision analysis approach to the study of early retirement.

This paper considers developments in long-term care that are increasingly focused around the individual. Recent decades have seen massive changes in the way that care is understood and provided. Yet in Australia, as in Europe, North America and Asia, we are still a long way from a stable state of agreed services and provisions. Emphasising the social theory behind the shift, it is argued that understanding the individualisation of care cannot be reduced to a simple dichotomy of good or bad. Individualised care promises much, but the concept is applied to a wide range of phenomena, often in ways that conceal rather than reveal the character of the transactions involved. For individualisation to become meaningful it must be developed as a condition of recognition that is equally applicable to those who provide and those who depend on care. It is also important to distinguish individualised care finance arrangements from real attainments in the practice of providing care. These distinctions are necessary if we are to distinguish its use as an ideological justification for welfare cutbacks and the restructuring of care provisions as markets from the liberating potential that the approach can present when care practices are more truly based around the recognition of the individuals concerned: those who receive and depend on assistance as well as those who provide it.

Previous research has demonstrated that the generally positive relationship between age and the presence of charitable giving becomes negative at the oldest ages. We investigate potential causes of this drop in charitable giving among the oldest old including changes in health, cognition, egocentric networks, religious attendance, and substitution of charitable bequest planning. A longitudinal analysis of data from the United States Health and Retirement Survey indicates that the drop in charitable giving is mediated largely by changes in the frequency of church attendance, with only modest influences from changes in health and cognition.

Loneliness has proved to be common in long-term care facilities (LTCF) and is associated with adverse health outcomes. Although older residents have expressed their experiences of loneliness in previous studies in various ways, researchers have rarely distinguished or explored the three dimensions of loneliness: social, emotional and existential. Furthermore, descriptions of existential loneliness in LTCF is still a neglected area of research. The aim of this study was to explore how the experiences of loneliness of older people in LTCF are manifested and divided into these dimensions. We used an ethnographic multi-method approach. The analysis leaned on abductive reasoning. In terms of social loneliness, the respondents missed company and lacked peer support, but also felt lonely in a crowd. Emotional loneliness felt miserable and could not be shared with anyone. It was related to a feeling of meaninglessness of life and a lack of meaningful others. Existential loneliness was characterised by waiting and a feeling of emptiness. It reflected the fundamental issues of humanity. The present study is one of the first to explore the dimensions of the experiences of loneliness among frail and cognitively impaired older people in LTCF. According to the voices of the lonely respondents, loneliness has many social, emotional and existential aspects. These features of loneliness should be recognised in studies, care practices and interventions.

Over the past 50 years, self-neglect among older people has been conceptualised in both social policy and the academy as a social problem which is defined in relation to medical illness and requires professional intervention. Few authors, however, have analysed the concept of self-neglect in relation to critical sociological theory. This is problematic because professional judgements, which provide the impetus for intervention, are inherently influenced by the social and cultural context. The purpose of this article is to use critical theory as a framework for interpreting the findings from a qualitative study which explored judgements in relation to older people in situations of self-neglect made by professionals. Two types of data were collected. There were 125 hours of observations at meetings and home assessments conducted by professionals associated with the Community Options Programme in Sydney, Australia, and 18 professionals who worked with self-neglecting older people in the community gave in-depth qualitative interviews. The findings show that professional judgements of self-neglect focus on risk and capacity, and that these perceptions influence when and how interventions occur. The assumptions upon which professional judgements are based are then further analysed in relation to critical theory.

The impact of disparities in socio-economic status on the health of older people is an important issue for policy makers in the context of population ageing. As older people live in different types of economic circumstances and because, as people age, their desires and needs are different to those of younger generations, measures of living standards need to be appropriate for older people. This paper reports on the validation of a measure of living standards for older people based on Sen's Capability Approach. Using this approach, living standards are conceptualised as varying from constraint to freedom rather than from hardship to comfort. Using the New Zealand Longitudinal Study of Ageing omnibus survey of 3,923 adults aged 50–87 years, the validity of the measure was assessed. The results indicate that this measure assesses what older people are able to achieve. In addition, this measure discriminates better at the higher end of the living standards spectrum than an existing measure that assesses living standards from hardship to comfort in terms of what people possess. From this, a short form of the measure has been developed which offers a conceptually based and valid measure useful for survey research with older people. This measure of living standards provides future avenues for improved understandings of socio-economic position in later life.

Grandmothers serve as primary care-givers for a significant number of South African children. Previous research has documented that South African grandmothers experience physical, financial, emotional and social adversity. However, less attention has been given to South African grandmothers' resilience, or their capacity to respond to the challenges associated with raising their grandchildren. Utilising Walsh's (2003; 2012) family resilience model, this qualitative study examined resilience and resilient processes among 75 Black South African grandmothers raising grandchildren. Grandmothers participated in structured interviews during a weekly visit to a local luncheon (social) club. Results indicated that the grandmothers perceived themselves as engaging in a number of resilient processes, including relying on their spirituality, accessing sources of instrumental support, and seeking emotional support and companionship from their grandchildren and larger communities. Grandmothers also believed that focusing on their grandchildren contributed to their sense of resilience. This involved maintaining a sense of responsibility to their grandchildren, having hope for their grandchildren's futures and finding enjoyment in the grandmother–grandchild relationship. The findings reveal that, by engaging in various resilient processes, South African grandmothers raising grandchildren perceive themselves and their families as having strategies they can utilise in order to successfully cope with adversity. Findings also highlight the need for prevention and intervention efforts designed to promote grandmothers' resilience, as well as the resilience of their grandchildren.