Although philosophical and contemplative traditions suggest that religiousness and spirituality are associated with wisdom, few empirical studies have examined the relationship. This paper investigates the associations between spirituality and mystical experiences and two types of wisdom: practical wisdom, primarily the ability to understand and resolve difficult life dilemmas (or an ‘expert’ knowledge system and the highest level of synthesised mental functioning), and transcendent wisdom, which goes beyond personal self-interests, biases and perceptions, and involves the ability to see things or others as they are directly. Two studies are reported. The first is of mostly older European-American and Vietnamese-American adults. It was found that mystical experiences promoted transcendent wisdom, but that the effect was moderated by self-enhancement values of power, status and achievement. The Vietnamese-American adults who reported mystical experiences and endorsed high self-enhancement values scored the lowest on transcendent wisdom. Being part of a religious or spiritual community positively associated with transcendent wisdom. On the other hand, religiousness, spirituality and mystical experiences did not relate to practical wisdom. The second study was of European-American and Vietnamese-American young adult students. It found that institutional and personal religious/spiritual practice was associated with two self-report measures of wisdom. Regardless of the mechanisms and processes associated with spirituality and mystical experiences, its fruits appear to be associated with transcendent wisdom.

This paper examines the impact of wealth and income on the likelihood of depression among persons aged 50 or higher in four European regions characterised by differences in the standards of living and welfare systems. To address possible effects, data from Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) have been used. Based on a sample of 60,864 persons resident in 16 European countries and a binary indicator of depression, probit and instrumental variable probit models were employed, the latter of which deal with issues of endogeneity and omitted variable bias. The findings show differences in the prevalence of depression across Europe, favouring the more affluent North/Western countries. Further, there is a difference in the role and the magnitude of the effect of income and wealth across different regions. First, though both measures exhibit a measurable effect, their impact is greater in the poorer Central/Eastern and Southern regions; this divide is more pronounced for wealth. Second, income seems to have a stronger effect compared to wealth in all instances: hence, it would seem that liquidity is more important among Europeans aged 50 or higher than assets. Nevertheless, neither income nor wealth are important among persons aged 65 or higher in Nordic countries which may be partly attributable to a more equitable welfare system.

The aim of this article is to investigate different ways in which nursing home scandals in Sweden have been framed, to discuss the relations between these existing frameworks, and to identify ways of describing the problem that are absent in the current debates. Data for the study consisted of media articles, television documentaries and internet debates, expert reports and court hearings, and interviews with representatives of organisations dealing with the issue of mistreatment in care services for older people. An analytical tool developed within social movement research was used to identify three ‘debates’ on such mistreatment in Sweden, where competing ways of framing the problem have been used: (a) a debate where staff are cast as either perpetrators or victims, (b) a debate on privatisation and profit as the motive for neglect of care recipients, and (c) a debate on deserving and non-deserving recipients of socially provided care centred around populist claims. The analysis highlights a need to introduce an alternative frame for interpretation where mistreatment in care for older people is regarded as involving scandalous cases of ageism. This anti-ageism frame would provide older people with a lead role in the drama – not just as victims but as stakeholders in relation to the problem.

There is a growing population of ageing individuals living with the human immunodeficiency virus (HIV). Older adults living with HIV often contend with intersecting stigmas including HIV stigma, ageism and, for some, homonegativity and/or racism. Although the HIV stigma literature is quite robust, research on the relationship between HIV stigma, social support and mental wellbeing among older adults living with HIV is limited. This study begins to address this gap by examining how intersectional stigma affects social support and mental wellbeing among rural-dwelling older adults living with HIV. Qualitative interviews were conducted by phone with 29 older adults living with HIV, over the age of 50, living in rural areas of the United States of America. Interviews were transcribed verbatim and analysed using thematic content analysis in MAXQDA qualitative analysis software. Analysis revealed three primary themes. The first had to do with gossip and non-disclosure of HIV status, which intersected with ageism and homonegativity to exacerbate experiences that fell within the remaining themes of experiences of physical and psychological isolation and loneliness, and shame and silence surrounding depression. The prevalence of social isolation and the effects of limited social support among older adults living with HIV are prominent and indicate a need for tailored interventions within the HIV care continuum for older adults living with HIV.

Lifelong learning is believed to have physical, social and emotional benefits for older adults. In recognition of this, numerous programmes encouraging learning in later life exist worldwide. One example is the University of the Third Age (U3A) – a lifelong learning co-operative rooted in peer-support and knowledge sharing. This article is based on a collaborative study conducted by university researchers and members of a U3A in North-East England (United Kingdom) investigating the social inclusivity of the group in light of low attendance levels among those from social housing and non-professional backgrounds. A qualitative approach comprising semi-structured interviews and focus groups was adopted to explore knowledge and experience of lifelong learning and the U3A. Sixty individuals aged 50+ were interviewed. The demographic profile of participants largely reflected the socio-economic make-up of the area, with the majority living in areas of high socio-economic deprivation. Several barriers to lifelong learning were revealed, including: poor health, insufficient transport and caring responsibilities. Regarding U3A participation, three exclusionary factors were outlined: lack of knowledge, organisational name and location. Poor comprehension of the purpose and remit of the U3A can result in the development of ‘middle-class' myths regarding membership, perpetuating poor participation rates among lower socio-economic groups. Such perceptions must be dispelled to allow the U3A to fulfil its potential as a highly inclusive organisation.

In the midst of a ‘care crisis’, attention has turned again to families who are viewed both as untapped care resources and as disappearing ones. Within this apparent policy/demographic impasse, we test empirically theorised trajectories of family care, creating evidence of diverse patterns of care across the lifecourse. The study sample, drawn from a Statistics Canada national survey of family care, comprised all Canadians aged 65 and older who had ever provided care (N = 3,299). Latent Profile Analysis yielded five distinct care trajectories: compressed generational, broad generational, intensive parent care, career care and serial care. They differed in age of first care experience, number of care episodes, total years of care and amount of overlap among episodes. Trajectories generally corresponded to previously hypothesised patterns but with additional characteristics that added to our understanding of diversity in lifecourse patterns of care. The five trajectories identified provide the basis for further understanding how time and events unfold in various ways across lifecourses of care. A gap remains in understanding how relationships with family and social network members evolve in the context of care. A challenge is presented to policy makers to temper a ‘families by stealth’ policy approach with one that supports family carers who are integral to health and social care systems.

Improving responsiveness to the needs of older people from minority ethnic communities has been emphasised as a goal in England since the publication of the National Service Framework for Older People in 2001. Despite this, people from minority ethnic groups consistently give poorer ratings of their health services than ‘majority’ populations, both in England and across many other health-care systems. Language barriers have been shown to play a particularly important role, and appear to be a stronger predictor of perceived quality of care than ethnic origin per se. This paper reports findings from a larger study exploring older people's experiences of care transitions, focusing on the findings from one case study area which explored the hospital and discharge experiences of older people from minority ethnic communities. A participatory approach was adopted, with older people from the local area collaborating in the design, delivery and analysis of the research as ‘co-researchers’. Twenty-four in-depth narrative interviews were carried out with people who had experienced a recent hospital stay as a patient or a family member providing care and support. Our findings show that many aspects of the hospital experience, including the desire for personalised and humanistic approaches to care, are important to older people irrespective of ethnic background. However, older people from minority ethnic communities can also face language and cultural barriers which negatively affect the quality and experience of care. People who had limited English proficiency struggled to understand, communicate and participate in their care. Where professional services were not available or requested, interpreting was provided informally by other patients, family members, hospital staff in clinical and domestic roles, or not at all. We conclude that targeted strategies are required to ensure appropriate and effective hospital services for a multicultural population.

Transfer from a private home to an assisted living facility has been pictured as a major change in an older person's life. Older people themselves tend to perceive the change as something eventual that breaks the bonds and familiarities of previous life. The aim of this article is to shed light on residents’ chances to reach affiliation (as Nussbaum defines it) in their new living surroundings, and thus adjust to that social environment. Based on ethnographical data gathered in a Finnish sheltered home in 2013–14, we studied residents’ affiliations through ruptures, namely residents’ perceived social isolation. Social isolation was found to be connected with two separate social worlds: the one inside the facility and the one outside. Social isolation resulted from different factors connected to the quality of social interaction with co-residents and the staff, daily routines of the institution and residents’ personal life histories. Also, residents’ older friends seemed to avoid visiting care facilities which caused perceived social isolation. This article deepens the insights into the perceived social isolation of assisted living and thus helps care providers to create new strategies to enable due affiliation for their residents.

This article reports case study research which addresses the gap in knowledge about dementia in the workplace. Receiving a diagnosis of dementia whilst still in employment may have negative consequences for a person's identity, further compounded by loss of employment. This study is the first to explore the employment-related experiences of people with dementia and their employers to determine the potential for continued employment post-diagnosis. Sixteen case studies centred on a person with dementia who was still in employment or had left in the previous 18 months. Each involved interviews with the person with dementia, a family member and a workplace representative. This triangulation of the data promoted rigour, allowing the experiences to be viewed through a variety of lenses to build a clear picture of each situation. Thematic analysis was carried out and three themes were developed: (a) dementia as experienced in the workplace; (b) work keeps me well; and (c) wider impact of dementia in the workplace. These findings have the potential to initiate changes to policy and practice related to supporting employees with dementia. The implications of this research are multifaceted and need to be considered in terms of the individuals’ wellbeing, organisational support, as well as the wider theoretical, economic and societal consequences of supporting an employee with dementia.

The promotion of choice and control for older people is a policy priority for social care services in the United Kingdom and is at the heart of recent drives to personalise services. Increasingly, we are seeing a move away from institutionalised care (e.g. in care homes) towards enablement, with more services being delivered in community-based settings. Extra care housing has been promoted as a purpose-built, community-based alternative to residential care for older people. However, whilst accounts of users' experiences in particular service types are plentiful, the use of different instrumentation and measures makes comparison between settings difficult. We combined data from four studies where participants were older people either living in care homes or extra care housing or receiving care at home. All of these studies asked participants to rate their control over daily life, using the Adult Social Care Outcomes Toolkit (ASCOT). This paper presents the results of an ordinal logistic regression analysis indicating that, after controlling for differences in age, ability to perform activities of daily living and self-rated health, setting had a significant effect on older people's sense of control. Residents in care homes and extra care housing report similar levels of control over daily life but consistently report feeling more in control than older people receiving care at home. Implications for policy and practice are discussed.

Recent long-term care (LTC) reforms in the Netherlands are illustrative of those taking place in countries with a universalistic LTC model based on extensive provision of state-supported services. They entail a shift from de-familialisation, in which widely available state-supported LTC services relieve family members from the obligations to care for relatives in need, to supported familialism, in which family involvement in care-giving is fostered through support and recognition for families in keeping up their caring responsibilities. Using data from four waves of the Netherlands Kinship Panel Study (N = 2,197), we show that between 2002 and 2014 the predicted probability that adult children provide occasional household support to impaired parents rose substantially. Daughters more often provided household support to parents than did sons, but no increase in the gender gap over time was found. We could not attribute the increase in children's provision of household support to drops in the use of state-supported household services. The finding that more and more adult children are stepping in to help their ageing parents fits a more general trend in the Netherlands of increasing interactions in intergenerational families.

The number of relatives and geographical proximity between them affects informal support provided to older persons. In this study, we investigate whether (a) childless persons and parents living remotely from their adult children experience similar shortages in informal support, and (b) whether neighbours, friends and other non-family helpers compensate for these shortages. On the basis of Survey on Health, Ageing and Retirement in Europe (SHARE) data for 12 European countries, we estimate the probability and amount of informal non-financial support received by persons aged 65 and over who remain childless or live at different distances to their children. The contribution of non-family individuals is rather complementary to the help from family. Parents residing in the proximity of their children rely almost exclusively on family; as the geographical distance between adult children and older parents increases, the probability and amount of non-family support increase as well. But childless individuals differ from parents of remotely living children: the former rely on smaller support networks and resort more often to other relatives than the latter. Non-family individuals compensate for the scarcity of informal support only in the case of parents of distant children, but not in the case of childless individuals.

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.

This study examines the characteristics of parent-child relationships after childhood from a theoretical attachment perspective. It describes how relationships between adult children and their parents vary by age group of the child on three dimensions that were derived from attachment theory: direction, penetration and quality. Data from 4,589 respondents to the Netherlands Kinship Panel Study were analysed to describe relationships between adult-children and their parents. Analyses of covariance were used to specify differences by age group. The results showed that age had notable effects on relationships between adult children and parents, especially their direction and penetration or centrality. The direction was reversed for parents of children in the two oldest age groups. The level of penetration was lower for the older age groups, and quality was higher in the younger age groups, but the effect size was small. The age effects on the dimensions were qualified by the personal circumstances of the adult children. Having one's own children was associated with different patterns of attachment at different ages. Adult children may be an important source of support for their elderly parents and may even become ‘attachment figures’. Given the current increases in longevity, there could be increasing pressure on adult children to support their parents. Attachment theory is a useful framework for studying the characteristics of inter-generational relationships, also after childhood.

The present study set out to identify how the experience of being old in Hong Kong is represented through images commonly recurring in the print media. A case is presented for how the media not only reflect social images and views on ageing, but actively participate in the social construction of views about being old. Two newspapers in Hong Kong, the South China Morning Post (English medium) and the Sin Tao (Chinese medium), were surveyed and contents of stories depicting old age were analyzed, using a qualitative and quantitative methodological design. Dominant amongst the themes was vulnerability in old age. Newspapers used stories according to journalistic formulae to present both negative and positive depictions of old age; however, positive stories carried a sense of the exceptional rather than ordinary life. Results were analysed through a comparison between the two Hong Kong newspapers as well as a comparison with a similar study undertaken on the Australian print media.

It is argued that a spiritual outlook on life may help elderly people to cope constructively with the vicissitudes of life. Many persons who are now in late adulthood and old age developed a relationship with a transcendent reality. This relationship is a core element of their global personal well-being. This paper briefly elaborates some thoughts about the relationship between personal well-being and spirituality in old age. Six themes are focused upon: I. personal well-being as a subjective experience of evaluation; 2. psychological, physical, social, material, cultural and existential well-being as components of global personal well-being; 3. religious or humanistic spirituality; 4. a life enhancing relationship with a transcendent reality in old age; 5. spirituality and spiritual growth require self-care and social support; 6. some possible lines of research.

The hallmark of sociology is its emphases on first, people, secondly, structures and, thirdly, their interrelationships. Similarly, we see sociological research on age as concerned with (1) people over their life course; (2) age-related structures and institutions; and (3) the dynamic interplay between people and structures as each influences the other. Guided by our ‘aging and society paradigm’, we review the research legacy as it has focused more on (1) than on (2), and is only now concerned with understanding the interplay between them (3). Hence our challenge to future researchers is to devise strategies for understanding and analysing this interplay and its possible contributions to the ever-accumulating research legacy.

The overall goal of the study reported in this paper was to examine differences in the perceived occurrence of abuse and neglect as between older care recipients, their family carers, and foreign home-care workers in Israel. Overall, 148 matched family members and foreign home-care workers and 75 care recipients completed a survey of abuse and neglect. Significant discrepancies in their reports of neglect were found, with the foreign home-care workers more likely to identify neglect (66%) than the older adults (27.7%) or their family members (29.5%). Although the rates of reported abuse ranged between 16.4 and 20.7 per cent and the differences were not statistically significant, the different parties assigned the responsibility for the abuse to different perpetrators. The independent variables that significantly associated with abuse and neglect also varied by the three groups of participants. The findings suggest that even with round-the-clock home care, the basic needs of many older adults are not met, and that many experience substantial abuse. The study emphasises the subjective nature of abuse and neglect, and suggests that more education about what constitutes elder abuse and neglect may lead to more accurate and consistent reports across reporting sources. Incorporating data from the various stakeholders may enhance the early identification of elder abuse and neglect.

Few studies have explored the combination of individual and contextual conditions that influence psychological health among older people. This study aimed to analyse the sense of coherence (SOC) in a sample of Italian senior citizens in relation to gender, educational level, living arrangements and former employment, when controlling for age. The short version of the SOC scale (Antonovsky 1987), which has items for the ‘comprehensibility’, ‘manageability’ and ‘meaningfulness’ components, was administered to a sample of 198 senior citizens of both genders and with an average age of 68.5 years. The findings showed that: (a) senior citizens with a higher level of education and who had retired from jobs with a high level of responsibility perceived reality as more controllable, manageable and meaningful; (b) with greater age, the perception that life's challenges are worth facing decreased; and (c) there was an interaction between living arrangements and education level, viz. those with higher education, and those with lower education living with a spouse or partner, perceived reality as more meaningful and their life challenges as worth facing. It is important to investigate further the activities that help maintain a high sense of coherence throughout the life span, and to design social policies that support senior citizens who live alone, because they appear psychologically weaker than others.

Across literature on loneliness and ageing, little attention is given to the intersection of ageing, sexuality and masculinities, and how this shapes the social connections of older men. We report findings from a qualitative study of older men's experiences of loneliness and social participation, focusing on perspectives from two groups who are single and/or living alone: men identifying as (a) heterosexual and (b) gay (not bisexual). We present findings generated from semi-structured interviews with 72 men residing in England (65–95 years). We discuss three prominent themes: (a) loneliness, loss and social dislocation; (b) diverging life-events that trigger loneliness; and (c) variations in visibility and exclusion across social settings. Embedded within men's descriptions of loneliness is a running theme of social dislocation that speaks to a wider sense of social separation and estrangement. Unique to gay men's accounts are the ways in which experiences of loneliness and social isolation are compounded by living in heteronormative social environments and their encounters with ageism in gay social settings. Older men's accounts convey anxieties about visibility and anticipated exclusion across social settings shared with other men that vary according to sexual identity and context. We discuss how sexuality and being single and/or living alone impact on older men's social participation as we seek to move beyond a heterocentric understanding of loneliness.