The decision to start a new career might seem an unusual one to make in later life. However, England has seen a steady rise in numbers of workers undertaking an apprenticeship in their fifties and sixties, through a government-funded policy initiative opening up training to adults at all stages of the lifecourse. At the same time, in most Western contexts, the amalgamation of ‘older’ and ‘apprentice’ presents a challenge to normative understandings of the ‘right age’ to undertake vocational training. What is it like to make a new start as an older worker? This paper draws on new qualitative research conducted in England with older apprentices, exploring how they found the experience and management of training ‘out of step’. Inspired by Elizabeth Freeman's temporalities approach, our findings reveal how powerful norms of age-normativity routinely structure understandings, experiences and identities of older-age training for both organisations and apprentices. While these norms demand careful negotiation by both apprentices and trainers, if managed successfully older workers gain significant benefits from their training. These findings have resonance not only for England, but for other international contexts considering expanding vocational training into older age. The paper concludes that if adult training schemes are to succeed, some fundamental changes may need to be made to understandings of age and ageing within contemporary workplaces.

Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants.

As in many developed countries, foreign care-givers have made up a short-term labour force to help shoulder the responsibilities of older adult care in Taiwan since 1992. This study uses the dual labour market and the occupational segregation theoretical frameworks and a mixed-method approach to examine whether foreign care-givers are supplementary or have replaced Taiwanese care-givers in Taiwan's long-term care (LTC) industry, and to understand better the status of care workers and their influx into the secondary labour market. As of 2012, 189,373 foreign workers joined the care services, compared to 7,079 Taiwanese, indicating they are no longer supplementary. The gap between the dual care system and workforce regulation has resulted in occupation segregation, and the secondary care labour market has been divided into ‘institutional’ and ‘home’ spheres, segregating care-givers into three levels: all Taiwanese care-givers, foreign institutional care-givers, and foreign home care-givers, the latter being the cheapest, most obedient and most adaptable LTC products. This case exhibits the ‘particularistic’ associations between nationality and care-givers’ workplace, which should be abolished. Only by squarely facing the changes and impacts caused by importing workers into the secondary labour market can one propose concrete, effective LTC labour plans and retention policies.

Using contributions from moral philosophy and sociology, this paper explores the decisions confronting care professionals when discharging frail elderly people from hospital. It is based on research into hospital discharge in South Glamorgan that has illuminated the nature of professional decision-making in multi-disciplinary ward meetings. Two key dilemmas are identified and examined in detail: first, the dilemma of discharging elderly people who, while thought by professionals to be incapable of looking after themselves and therefore ‘at risk’, nevertheless want to go home, and secondly, the dilemma of finding residential care for elderly people who are defined as being ‘partly sick and partly well’. Whilst the principle of autonomy may be used to support individual choice, it may also be interpreted as encouraging self-reliance, and as a way of denying a collective responsibility to elderly people's care needs. The dilemma of institutional care for the ‘partly sick and partly well’ is found to be a persisting problem, fraught with conceptual ambiguities and resource-boundary negotiations between ‘medical’ and ‘social’ care. An examination of both dilemmas serves to highlight the role of political ideology in discharge decisionmaking.

This study reviews theory and results from developmental psychology to examine age differences in workplace achievement goals. We investigated whether goal level decreases with age and, by comparing the relative strength of different goals within individuals, we examined whether dominant achievement goals are related to age. In a large sample of employees (N=747), older workers' higher affective commitment and intrinsic motivation compensated for age-related decline in the importance of achievement goals. Whether learning-approach and learning-avoidance were dominant goals was not related to age but instead to skill level, affective commitment and intrinsically satisfying work. Dominant performance-approach goals were more common among males. Performance-avoidance was most likely to be a dominant goal among older males. Moreover, with age, performance-goal orientations had increasingly maladaptive consequences for self-efficacy and affect at work.

This study applies Feldman and Beehr's three-step model to examine retirement as a decision-making process leading from retirement thoughts to retirement plans and from retirement plans to actual retirement. The results show that retirement thoughts have a clear independent effect on retirement plans as measured by intended retirement age. Furthermore, retirement plans have an isolated effect on retirement patterns. Intended retirement age is the strongest predictor of actual retirement age. Retirement intentions can be thought to represent the effect of unobservable characteristics on retirement, such as preference and motivation. Retirement plans materialise with quite high accuracy. Several key factors are associated with intended and actual retirement age in a similar manner. Unemployment and higher income are connected with earlier planned and actual retirement. Health has a pronounced effect: better health is conducive to later retirement while weaker health (sickness absences) is conducive to earlier retirement. This applies both to retirement intentions and actual retirement and to the difference between the two. The most important way for organisations to extend working lives is to look after the health of older employees. Giving older workers an increased sense of control and lowering job demands helps to prevent premature retirement. Supporting older workers’ continued employment is significant for the retention of older workers, while layoffs targeting older workers shorten working lives.

This article presents the results of a study that examines how older professional writers experience and understand creativity in later life. In psychological, humanities' and gerontological approaches to ageing and creativity, this question is still under-explored. The study's data-set consists of transcriptions of lengthy interviews conducted in spring 2015 with five Dutch poets over 65 who have achieved some eminence in the field. By means of interpretative phenomenological analysis, three superordinate and 12 subordinate themes came to the fore that offer an account of the ideas, thoughts and feelings characteristic of the way these writers perceive the later stages in their career. The first superordinate theme, Securing Sustainable Writing Practices, comprises the subordinate themes of maintaining continuity in writing approach; drawing on wealth of experience; emancipating from earlier literary conceptions; and reinventing oneself as artist throughout the years. The second superordinate theme, Negotiating the Literary Field, encompasses the following subordinate themes: challenges regarding finding or keeping a publisher in later life; developing self-acceptance and relativising literary awards; handling continuity of reception, or the way literary work is pigeonholed by critics; and staying visible in the literary scene. The third and final superordinate theme, Writing as Art of Living, refers to: not feeling old(er); writing as a practice of good living; writing as a way to recreate what is lost or unknown; and confronting cognitive decline. Together, these superordinate and subordinate themes diversify ideas of late-life creativity that are based on questionable generalising conceptualisations of the psychology of later life and artistic careers.

The objective of this paper is to specify the relationships between age and gender differentials in health among older people in China. The data were drawn from the 2002 Chinese Longitudinal Health Longevity Study (CLHLS), which included 15,789 respondents aged 65 or more years. The health indicators included the Activities of Daily Living (ADL) and Instrumental ADL scores, cognitive ability (using the Mini Mental State Examination), visual function, hearing or auditory function, number of natural teeth, self-reported health, and self-reported quality of life. The statistical significance of the age relationships was examined using Mann-Whitney U tests and Spearman's rank correlation coefficients. The principal results were that above 65 years of age, gender differentials were observed in most of the health indicators at most ages, although self-rated quality of life was an exception. For most of the objective (observer-rated) health indicators, the gender differentials increased with greater age, but that for the number of natural teeth decreased with age. Gender differentials in the two subjective health measures had no significant relationship with age. It is concluded that older Chinese women have poorer health than men and are in many ways disadvantaged, and that the relative disadvantage increases with age. Chinese women tend to live longer and suffer ill-health more than men.

Ageing of the population is posing new challenges for caretakers. This paper aims to examine: (a) age and gender differences in care provided by a domestic worker versus a family member in the performance of activities of daily living (ADL); (b) socio-demographic correlates of care during illness; and (c) self-reported physical, functional, and psychological health status in relation to care-giver. A cross-sectional household survey was conducted among 2,487 Kuwaiti nationals aged 50 years or older. This paper focuses on persons aged 70 or more. We found that domestic workers provided care to 28 per cent of men and 58 per cent of women who needed assistance with ADL; and to 14 per cent men and 51 per cent women during illness. These respondents ranked poorer on several health indicators and reported higher depressive symptoms score than those looked after by a family member. Logistic regression indicated that care by a domestic worker was approximately seven times more likely for women than men, about 10.8 times more likely for those without co-resident children compared with those who had three or more co-resident children, and 44 per cent less likely for the poorest compared with the richest persons. It appears that reliance on domestic workers is increasing and such reliance will remain necessary in the absence of culturally acceptable alternative institutional arrangements.

Informal (unpaid) care-givers of older people with dementia experience stress and isolation, causing physical and psychiatric morbidity. Comprehensive geriatric assessment clinics represent an important geriatrician-led model of dementia care. Our qualitative study examined the educational and support needs of care-givers of people diagnosed with dementia at a geriatric assessment clinic, resources used to address those needs and challenges experienced in doing so. We conducted structured thematic analysis of interviews with 18 informal care-givers. Participants’ narratives reflected four themes. First, care-givers sought information from varied sources, including the Alzheimer Society, the internet and clinic staff. Responsive behaviours, the expected progression of dementia and system navigation were topics of particular interest. Second, care-givers obtained assistance from public, for-profit and voluntary sources. Third, care-givers received little assistance. Two-thirds received fewer than four hours of help weekly from all sources combined, and none more than 15. Several received no assistance whatsoever. Publicly funded support workers’ tasks, and their timing, were often unhelpful. Finally, while numerous care-givers felt physical and emotional strain, and worried about how poor health impaired their care-giving, many hesitated to seek help. The needs of this unique population of informal care-givers can be met by improved home-care service flexibility, and access to trustworthy information about the expected progression of dementia and skills for managing behavioural and psychological symptoms.

The Consumer Choice Index – Six Dimension (CCI-6D) is a new instrument designed specifically to evaluate the quality of care received in long-term care from a consumer perspective. This study aims to demonstrate the construct validity of the CCI-6D. Older residents living in long-term care facilities and proxy family carers (where severely impaired cognition precluded resident consent) participated as consumers of long-term care. Data collected included the CCI-6D instrument, quality of life, physical function and characteristics of the care facility. Relationships between these variables and the CCI-6D dimensions were assessed and analysed through chi-squared and Kruskal–Wallis tests to assess the construct validity of each dimension. Of 430 eligible consumers, a total of 253 completed the questionnaire, of whom 68 (27%) were residents and 185 (73%) were informal carer proxy participants. There was strong evidence of construct validity of the dimensions relating to adequacy of individual care time, access to outside and gardens, access to meaningful activities and flexibility of care. There was more moderate evidence of validity of the home-like own room and shared spaces items, which may be in part due to difficulty in identifying strong discriminatory variables for comparison with these items. The results also indicate a strong association between ‘processes’ of care delivery (as measured by the CCI-6D) and quality of life of care recipients.

Transportation is critical to older adults’ ability to participate in social activities in their community. We examined the association between modes of transportation and restrictions in social activity (i.e. visiting with others, religious attendance, clubs and organised activities, and going out for enjoyment), with particular attention to the moderating effects of economic vulnerability. We used logistic regression to analyse data from 7,197 community-dwelling older adults from the 2011 wave of the National Health and Aging Trends Study, a representative sample of adults aged 65 and over in the United States of America. Economic vulnerability moderated the association between transportation mode and social activity restrictions. Findings suggest that even when economically vulnerable older adults have access to driving, walking or public transit, they may be at a higher risk for social exclusion than their counterparts with more financial resources.

This paper is a contribution to the debate on how to make health-care services in the United Kingdom more responsive to the needs of older people who are members of recent immigrant groups. The focus is on the Chinese-origin elders, and the objective is to demonstrate their diverse migrant histories, cultural backgrounds and attitudes to both ‘traditional’ and Western health-care practices. The underlying argument is that if National Health Service staff had a better understanding of the diversity of Chinese older people, this would make an important contribution to making the service more sensitive to their needs. To develop this argument, this paper carries out three main analytical tasks. The first is to discuss the range of strategies adopted by Chinese people in general and Chinese older people in particular to improve their health. The second is to study Chinese people's heritage of exploring different methods to organise health in response to foreign culture. The third considers the ways in which the sensitivity of British health-care services to the needs of ethnic-minority groups can be improved, with a focus on the culturagram instrument and procedure. Three contrasting examples are presented.

Lifecourse approaches to healthy ageing recognise that health in older age is affected by long-term cumulative inequalities between socio-economic status (SES), gender and ethnicity groups, which begin in childhood. Combining longitudinal survey data with lifecourse history interviews from 729 older New Zealanders aged 61–81 (mean = 72, standard deviation = 4.5), we tested a lifecourse model of predictors of physical, mental and social health in older age. Latent growth curve and mediation analysis showed that the link between childhood SES and late-life health (over 10 years) was mediated by education, occupation and adult wealth. To account for the moderating effects of gender and ethnicity, we modelled the effects for sub-groups separately (225 non-Māori women, 158 Māori women, 219 non-Māori men and 127 Māori men). Childhood SES was an important predictor of later-life health, mediated by education and adult SES for all participants and for non-Māori men. However, there were significantly different pathways for Māori men and for women. Māori men and women and non-Māori women did not attain the same health benefits from higher childhood SES and education as non-Māori men. Findings point to the importance of considering the mediators of lifelong impacts on health in older age, and recognition of how membership of different socially structured groups produces different pathways to late-life health.

Throughout the industrialised world, promoting the retention of older workers is high on the agenda of governments, employers, unions and the media, but not at any price. If persuading older workers to stay at work longer is to benefit companies and wider society, then the employees should be committed and satisfied with their decision. This study explores the factors that keep older workers satisfied and committed at work by contrasting samples of older (aged 50 or more years) and younger workers (up to 25 years) in favourable (Sweden) and unfavourable labour markets (Belgium). The core research question is whether the influential factors are different for the two age groups, after controlling for country, gender, educational level, employment sector, supervisory position, and the employee's financial contribution to the household. The predictors included workers' self-reports of skill discretion (i.e. the range of skills used on the job), organisational fairness, and perceived job insecurity. Hierarchical linear regressions revealed that, across age groups, skill discretion and organisational fairness predicted both job satisfaction and organisational commitment. For older workers there was a negative impact of perceived job insecurity on job satisfaction and organisational commitment. The national context only affected younger workers. In the unfavourable Belgian labour market, they were more satisfied and committed to their organisation.

Comments made by a UK Government minister in 1989 concerning poverty, or rather the lack of it, amongst elderly people once again reflected the idea that the majority are well-off and less in need of State support than was the case in the past. The idea of a new group of Woopies (well off older persons) has been used as justification for debate about the introduction of means-testing for certain benefits directed at the elderly population. This paper challenges that view. It traces the evolution of the Woopie using published data and then examines the socio-economic characteristics of such a group. In a series of logit estimates to determine what factors are of importance in determining ‘Woopie status’, unsurprisingly receipt of income from assets and from an occupational pension are the most significant variables. Finally the scope for policy changes is examined.

Private residential care homes in the United Kingdom have undergone a variety of management changes in recent years, many resulting from the impacts of national policy changes. During the 1980s, the private residential sector for older persons enjoyed substantial financial support for the care of residents. However, since the 1990 National Health Service and Care in the Community Act was implemented in 1993, homes have had to compete with each other in a market, for a finite number of clients funded by limited local budgets held by local authority purchasers. Based on a three-stage quasi-longitudinal survey of over 100 residential care homes in one county, this paper considers changes in the overall size and structure of a local sector and discusses the specific management strategies that have been adopted by proprietors. The withdrawal of guaranteed state support has impacted heavily on residential home businesses. Indeed, many homes have multiple vacancies and have been facing financial hardships. The paper concludes with a discussion of the ethical and moral issues associated with certain management decisions and their possible effects on residents.

Although general family involvement is heralded as critically important for the elderly, the importance of the specific family involvement of grand-parenthood remains surprisingly little understood. The present study integrates qualitative and quantitative methodologies: 11 grandparents completed a series of five open-ended interviews, 19 grandparents participated in single open-ended interviews, and 286 grandparents completed lengthy quantitative questionnaires. In contrast to previous studies reporting that there is little relationship between grandparenthood experience and life satisfaction, current findings indicate that grandparenthood serves a compensatory function with respect to life satisfaction and morale, particularly for those individuals who are most deprived and who have fewest sources of satisfaction. Ageing persons seem to use grandparenthood to enhance their mental health; in grandparenting they capitalize on their existing strengths and re-work existing weaknesses.

In recent years, we gerontologists have been forced to re-examine the conceptual base of our work – both in the wake of developments in postmodernist thought, and following the emergence of ageism as a media issue. Two particular problems have been addressed: one is how we recognise and define age in the context of the partly-disaggregated individual human being: body, mind, self, identity, etc. The second is how we relate to popular sentiments, judgements and objectives regarding age: thinking positively, being prejudiced, remaining active, being a burden, etc. On both fronts there has been a shift away from emphasising the significance of age, and one often reads such arguments as: people do not change, they remain the same; but they can continue to develop; but there is a massive diversity; so we must not generalise about age or prejudge older people; and so on. It is not difficult to associate these trends with powerful ideological movements. There is a third issue that lies just beneath the surface: how we gerontologists theorise our own personal experience of ageing.

Sweden has in the last 20 years undergone an extensive process of marketisation of its home care sector. Where the public sector once was the only provider of home care services, there is now a wide array of different, private alternatives for older people to choose from, using their publicly funded voucher. The publicly funded home care services in Sweden are, in other words, to a large extent organised according to the principles of a quasi-market. Older people with care needs are therefore now considered to be consumers of home care since they are expected to make an informed choice of home care provider according to their own preferences. This paper studies the extent to which older people with care needs assume this role and how they do it, using Hirschman's well-known theory on ‘exit, voice and loyalty’ and theory on the difference between care and market logic. The study is based on results from a research project using telephone interviews to ask a large number of older people in three Swedish cities about their experience of making this choice. The results show that they had difficulty understanding how to choose and what the purpose of the choice was. The conclusion of this study suggests some possible reasons why policy makers in Sweden continue to favour the freedom-of-choice model in spite of these poor results.