Recent research in Northern Ireland examining the needs and circumstances of informal carers has highlighted the personal and financial costs of caring. In this paper it is argued that these studies have taken no account of the particular expectations and attitudes towards informal care that exist within farm families. In these families there is a strong expectation that care for older relatives will take place almost entirely within the family. The reputation of the farm family within the local community is strongly dependent on their treatment of the older generation. Help from the state and the voluntary sector is extremely limited. Rather than being described as burdensome and difficult, these family arrangements are described as beneficial for everyone involved. It is argued that expectations and attitudes towards care within farm families are significantly different from those in non-farm families and policy makers and practitioners must take account of this in the context of care in the community.

The concept of participation, introduced through models such as the International Classification of Functioning, Disability and Health, has become increasingly important in health and social care. However, it has not been consistently defined or operationalised, and there is very limited research into participation in the context of advanced age and disability. This article reports a study which explored participation from the perspectives of community-living people aged over 80 years with physical rehabilitation needs. Using a grounded theory methodology, 11 participants aged 81–96 years were recruited from a National Health Service Trust in the United Kingdom. The main finding was that participation was experienced as the enacting of values. Values provided the motivation for specific ways of participating in life, guided actions and behaviours, and were the means through which participation was interpreted. Commonly enacted values were: connecting with others; maintaining autonomy; affirming abilities; doing the best you can; being useful; maintaining self-identity; and pursuing interests. A process was evident whereby participation was challenged by deteriorating health and losses and the participants adapted (or not) to overcome these challenges. To promote participation in advanced age, health and social care policy and practice must consider the values important to older people. Interventions should be congruent with these values and promote strategies through which they can be enacted.

This paper examines the association between being in paid work and depression among older adults in three poor urban communities in Beirut, Lebanon. In view of the rapid ageing of Lebanon's population and the growing number of older persons, the deteriorating economic conditions and the lack of pension systems, paid work is an important source of income for older people and deserves special attention. The sample was 328 men aged 65 or more years. Depression was assessed using the 15-item Geriatric Depression Scale. The exposure variable was working for pay at the time of the survey, and the covariates included socio-demographic measures, health characteristics, financial resources and social capital. Around one-third of the men were working, and approximately the same fraction were depressed. Adjusted data showed a protective effect of work on depression (odds ratio 0.50, 95 per cent confidence interval 0.25–0.96). This study is an eye opener on the circumstances of disadvantaged older people in a relatively low-income Eastern Mediterranean Region country, a topic rarely addressed in this area of the world. Old age is viewed as a decline in abilities while in reality many older adults are still able and ready to work. Social policies for older people should promote opportunities to work, not only pension schemes.

This experimental study aimed to analyse the effects of an aerobic activity intervention delivered by specially trained instructors to a sample of Italian older people living in a residential care facility. We assessed intervention effects on general health perception, perception that one's health represents a limitation for moderate and heavy physical activity, and positive and negative self-perception. The 36-item Short Form Health Survey Questionnaire (SF-36) was administered at pre-test and post-test to a sample of 22 older people (ten in the control group and 12 in the intervention group) of both genders with an average age of 80.6 years. The findings showed that: (a) the perception that one's health can limit moderate and heavy physical activity decreased significantly in the older people belonging to the intervention group between pre- and post-test, while it increased in the control group; (b) positive self-perception was found to be stable in the intervention group, while it decreased in the control group; and (c) there was no interaction between group and time with respect to both general health perception and negative self-perception. The exercise programme seemed to have a particularly positive effect on older people's beliefs about their ability to master successfully the activities of daily living such as walking and moving objects.

Past research has documented the influences that ‘traumatic’ memories of war have on older people's mental health (e.g. Post-Traumatic Stress Disorder). However, fewer studies have explored the longer-term implications of wartime experiences for older men and women's everyday lives. This article explores the impact of Second World War experiences on older men and women living in the United Kingdom (UK), to provide an insight into how such experiences influence how they construct their daily lives. Forty UK-based participants born between 1914 and 1923 were interviewed as part of the ENABLE-AGE project that was undertaken in five European countries. The key concepts underpinning the interview schedule were: home, independence, participation, health and wellbeing, and societal supports. The data were analysed using a grounded theory approach. Participants emphasised how wartime experiences continue to hold significance within their lives and settings some 60 years later. Seven themes emerged from the analysis. Four of these reflect the way wartime experiences remain important influences on participants' present-day social worlds: comradeship, storytelling about the war, community and alienation, and long-term physical effects. A further three themes reflect how skills and personal characteristics defined by wartime experiences are embedded in the way many older people continue to negotiate and structure their practical lives: managing, resilience and adaptability, and independence.

Understanding vulnerability matters because being vulnerable represents a profoundly undesirable state. People who experience vulnerability in old age are of obvious humanitarian concern, as their insecurity and heightened exposure to certain threats is likely to be compounded by reduced capacities for coping independently. Comprehension of the causes and consequences of vulnerability is important for the development of social policies as it indicates ways of avoiding and alleviating bad outcomes. Policies which have the concept of vulnerability at their heart encourage the development of preventive and targeted measures, which is crucial in conditions of financial constraints and competing demands. By studying vulnerability we investigate processes of relative disadvantage or exclusion and, for purposes of comparison, absolute differences in socio-economic or policy context can be set aside. This makes the study of vulnerability particularly germane to cross-cultural and cross-national research on old-age and elderly support.

This study sought to examine the motivations middle-aged women give for belonging to an outdoor adventure group. As part of this, how the women were negotiating the ageing process was also examined. Fourteen women aged 36–64 (average age 51.4 years) were individually interviewed with the purpose of exploring their perceptions, values, motivations and the beliefs they attach to their participation. Findings highlight the women's belief that participation delays the ageing process, gives them confidence in their lives and offers social support from other group members. In addition, pride, satisfaction and pleasure were expressed in the belief that they challenged the cultural norms and expectations of older women. Whilst delaying the ageing process, they also highlighted that they thought about a time in the future when they would not be able to continue to participate. The study emphasises that more adventurous activities are becoming more normalised and can be undertaken by women in middle age. This may also suggest that more needs to be done to promote diverse activities such as outdoor adventurous activities to women.

The present study investigated the changes that occurred within the interpersonal environments of a sample of socially isolated older Europeans after four years. Based upon data from the Survey of Health, Ageing and Retirement in Europe (SHARE), the inquiry looked at 834 older people who were socially detached at baseline, at follow-up or at both time-points. The analysis traced changes in relation to the social network types that they acquired or left. The findings indicate that respondents more frequently moved from no-network status at baseline to close family-based social network types at follow-up than to other network types. In comparison, the loss of a network at follow-up was seen to originate from close networks and from other network types alike. Multivariate analysis revealed that those who moved from socially detached status to close-family networks had fewer depressive symptoms compared to those who moved to other network types. However, the move from a close-family network to the no-network status was about as depressing as was being chronically isolated. The effects of network transitions were more varied in relation to the life satisfaction outcome. In sum, the findings suggest that a transition out of social isolation in late life is possible and it may be beneficial as well.

Maintaining physical, psychological and social wellbeing is integral to older adults being able to age well in their community. Therefore, an environment that facilitates and supports ageing well is imperative. The aim of this study was to explore the views of older people about their preparation for ageing well in a rural community. Forty-nine community-dwelling older people aged between 65 and 93 years participated in a semi-structured and digitally recorded interview. The resulting qualitative data were analysed using a thematic approach. Three main themes were identified: (a) ‘sensible planning: the right place and the right people’; (b) ‘remaining independent: “it's up to me”’; and (c) ‘facing challenges: “accepting my lot”’. Findings from this study identify that across all age groups, these older people were actively and realistically preparing for ageing well. All valued their independence, believing individually they were responsible for being independent and planning for their future. Consequently, environmental planners, policy makers and practitioners need to understand that older people are a heterogeneous group and ageing policies should be geared towards older people's individual abilities and circumstances. Consideration of diversity enables inclusion of older people with a wide range of abilities and needs to achieve the perceived goals of ageing well.

Communication between elderly people and their health care providers is becoming more important due to the chronic nature of geriatric health problems and their impact on quality of life. At the core of the challenge of improving this dialogue are factors related to essential human values and the clash between two different cultures – one scientific and the other personal. Only by gaining an understanding of this clinical decisionmaking interaction can new approaches to bridge the communication gap be developed. The purpose of this paper is fourfold: (1) to summarise the fundamentally different bases for communication between health care provider and patient, (2) to discuss the shortcomings of various methods (such as advance directives) to embody patients’ wishes about their care, (3) to review new models of geriatric care that have implications for this communication process, and (4) to develop a framework – based on biographical methods and the concept of empowerment – that suggests some potential solutions to these communication problems. Such methods reflect new approaches to developing life stories and themes suggestive of ways to retain the personal life voice of the individual in the development of a clinical partnership with the health care provider.

This paper overviews a series of recent investigations of the sociopsychological meanings of older people's language and communication. The first set of studies investigated young people's perceptions of younger and older voices. Older voices were, in general, downgraded relative to younger voices by young people. In addition, younger people's messages were recalled significantly better than older people's messages. The next set of studies was concerned with whether people seek information differently from people of various ages. The findings indicate that different questions were posed depending on the target's age. Further studies show that young people's information-seeking strategies draw on various ageist assumptions to formulate questions to both younger and older targets. The next investigation examined how young people address both younger and older people when they are requesting different kinds of assistance from them. Not only do we find ageist assumptions mediating the kinds of compliance-gaining young people use with older people, but also negative stereotypes emerge when younger people are asked what kinds of compliance-gaining strategies older people themselves usually adopt. Finally, the above findings are meshed with a new model being developed concerning the relationships between language, health and the elderly.

After a review of current conceptual models used in nutrition studies, we develop and test a ‘Dietary Change Model’ based on a sample of older rural adults. Predictor variables include socio-demographic, social network, and nutritional risk/support constructs; mediating variables include number of dietary changes attempted and whether the changes are successfully made; and criterion variables focus on psychosocial outcomes. The model is tested on a sample of 298 randomly selected respondents aged 60 years or more residing in five rural communities in Oregon. We find that those most likely to make dietary changes are women, married, and living in smaller households. The social network factors of density, range, and frequency of interaction negatively impact healthy dietary change. Among the most important nutritional support factors to have positive effects on dietary change are having a physician recommend changes in diet, and participating in a community food programme (women only). Successfully changing diet most clearly related to life satisfaction; results of other criterion variables were often complicated by marked gender differences.

Partners and children play a key role in home care for persons suffering from dementia. When we compare the burdens placed on these relatives, we find large differences. On the one hand, these result from actual differences in the care situation. On the other, they arise from the differences in the way the people involved experience more or less comparable circumstances. To determine the sources of the differences in the burden on the relatives, a distinction was made between objective and subjective care-giver burden. Qualitative research, therefore, aimed to provide an understanding of the personal interpretation by the people involved. This was realised in about 40 case studies involving relatives.

The experiences of maturing and ageing constitute a rather unexplored field within Gerontology. The ‘inner’ aspects of ageing have been left relatively untouched by researchers, largely out of methodological considerations. The ‘outer’ aspect of ageing, or ageing defined as behaviour, has been considered more fruitful due to its consistency with criteria for science created by logical positivism. Psychogerontologists in particular have been mesmerized by this research paradigm. However, this trend has also, for some time now, been criticized for underestimating the perceptions of the reality upon which we form our reasons for action (Runyan 1982; Carr 1986). Further, there are exceptions to this main stream of research. For example, the German psychogerontologist Thomae created a theory of ageing in 1970 based on the perceptual, evaluative and meaning – giving processes within the individual (Thomae 1970). In a series of studies (The BOLSA studies), he has been able to lend support to most of his theoretical claims (see Kruse and Schmitz-Schertzer 1995). Also the Canadian gerontologists Reker and Wong (1988) belong to the group of pioneers advocating the importance of personal meaning in successful ageing.

Twenty-two elderly retired people were interviewed for their beliefs about the sources of wellbeing in old age. Manual and Professional social class responses were compared, controlling for age, gender and health status. Respondents' free discourse was characterised by spontaneous social comparisons of the self with other people. In Social Comparison Theory, these serve as a means of self-assessment or wellbeing-enhance-ment. The comparison statements were analysed by Direction, Target, Dimension, and Wellbeing Yield. Significant class differences were apparent. Both groups compared Downward with others on the Dimensions of ageing, longevity, keeping active, security, and money. The Manual group derived less wellbeing from their Downward comparisons, many of which focused on entitlement to money benefits. The Professional group made more Upward comparisons, focusing on the younger self as Target, and yielding neutral or negative wellbeing. The predominant Upward Dimensions were perceived cognitive and physical condition. The Professionals tended to rationalise cognitive decline, but neither group showed psychological defence against physical decline, using social comparison as a means to objective self-assessment rather than self-enhancement.

Caring for elderly relatives has predominately been explored from the standpoint of the needs and experiences of the hegemonic culture in multicultural countries like Australia, Canada and the United States of America. Australia, in particular, has paid scant attention to cultural and linguistically diverse groups in relation to caring for the aged. In this paper we focus on Chinese-Australian families caring for elderly relatives. We explore the traditional value of filial piety which is said to underpin social norms and beliefs about caring for aged parents in Chinese cultures. Specifically we draw on four in-depth interviews with Chinese-Australian care-givers of elderly relatives to identify meanings of filial piety and practices of filial piety. Findings indicate that while filial piety is still an important value in caring for the aged, meanings about how to practise filial piety are changing and vary across families.

Whilst there is increasing acceptance that social inequalities have implications for mental health, there is minimal acknowledgement of their effects on the development and treatment of mental ill health in older people. This paper focuses on older women, as they are the majority sufferers of mental illness in later life, and are particularly vulnerable to the cumulative effects of lifelong and age-related inequalities. The authors, who draw upon literature from the fields of gerontology and mental health, argue that for effective care to be developed, older women's mental ill health needs to be seen within the context of their past and present experience of social inequalities. Evidence particularly relates to socio-economic disadvantages as well as to the consequences of discrimination. It is argued that psychological vulnerability is further compounded by the gendered effects of social policy, and by a care system which constructs mental health needs as unrelated to oppression, and dislocated from their economic, social and historical roots. Finally, the authors outline the key components of a care and service system which takes account of social inequalities, and which accords centrality to the experiences, views and opinions of older women with mental health problems.

The ability to perform the instrumental activities of daily living (IADLs) is an important focus for the promotion of independent living in old age. If strategies to enable older people to remain in their own homes are to be developed, advances must be made in understanding the demands associated with IADLs. This paper reports on a study of how activity demands – the body postures, actions and hand functions involved in cooking, housework, laundering and shopping – relate to the capabilities of a sample of older people in Great Britain. Task data were analysed for 4,886 community-dwelling 55–93-year-olds who were enrolled in a follow-up survey to the 1996/97 Family Resources Survey. Logistic regression models were used to calculate adjusted odds ratios for associations between functional limitations and IADL difficulty. Attributable fraction estimates were also used to assess the population impact of the functional limitations. Comparable effect sizes were observed across activities for limitations in body postures (standing, reaching and bending/stooping), actions (lifting/lowering and holding/carrying) and hand functions. Most of the difficulties were attributable to limitations in body postures, primarily bending/stooping, whereas actions and hand functions accounted for much less difficulty. We present a matrix of the potential impact that design changes to alleviate each limitation would have on the ability to perform the activities studied. This can help to prioritise interventions aimed at supporting continued independent living.

At the intersection of increasing social support needs due to population ageing and the promotion of older age as a time of contribution and social connection, volunteering is an important focus with advantages for older people. One service that addresses both these imperatives is home visiting services. Home visiting services connect home visitors with isolated older people. To examine how older people navigate volunteering for a home visiting service, six visitors were interviewed and the interviews were analysed using discourse analysis. A professionalism discourse was used to construct home visiting as a structured social support service that improved the lives of isolated older people. A personal relationship discourse constructed home visiting as an opportunity to forge long-term relationships that benefit both parties. At times these two discourses created tension for home visitors. Examining how the home visiting service is described by the service organisation online explains these tensions. The online materials construct active older volunteers as providing professional services while those they visit are constructed as receiving friendship. These discourses provide different ageing identities for visitors from those they visit, which contributes to the difficulties in navigating home visiting services. Addressing these tensions will enable service co-ordinators to better meet the needs of both visitors and clients in the context of increasing need for such services.

Researchers and programme champions alike have identified older adults as key contributors to age-friendly community change efforts. There has been very little scholarship, however, to characterise the nature of older adults’ engagement in age-friendly community initiatives (AFCIs). To help address this gap, we drew on five waves of data from semi-structured interviews with core group members of eight AFCIs in a Northeast region of the United States of America. Interviews were conducted as part of a multi-year, community-engaged study on the development of philanthropically supported AFCIs. We iteratively coded segments of the interviews in which core group members described the involvement of older adults, as well as their efforts to engage older adults in the initiatives. This analysis resulted in an inductive-analytic typology with five qualitatively distinct categories, including older adults as: (a) consumers (receiving information, goods and services through the AFCI), (b) informants (sharing perspectives on ageing in the community with the core group), (c) task assistants (assisting with project-oriented tasks under the direction of the core group), (d) champions (contributing ideas and implementing action on their own initiative), and (e) core group members (holding primary responsibility for driving the work of the AFCI forward). We discuss implications of the typology for research on AFCI implementation and evaluation, as well as opportunities for AFCIs to enhance the engagement of older adults from historically marginalised groups.