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.

In this paper we examine associations between the fertility histories of older British women and men and their quality of life using data on a sample of 6,374 men and women born between 1923 and 1949 drawn from the British Household Panel Survey (BHPS). Quality of life in 2001 was measured using scores from the four subscales of the CASP-19 questionnaire: control, autonomy, pleasure and self-realisation. Fertility histories were derived using information on the births of children collected in all waves of the BHPS. The aspects of fertility history investigated were number of children born and parents' ages at birth of first and last child. Age, education, marital status, tenure status, smoking, co-residence with one or more children, perceived social support and health limitations were included as covariates. The results suggested that early entry to parenthood and to some extent high parity were related to poorer quality of life. These associations were mostly mediated by socio-economic, social support and health factors. Compared to women with two children, nulliparous women expressed a higher level of autonomy, and both nulliparous women and those with four or more children a higher level of self-realisation. Low parity was related to a lower level of pleasure, especially among men, but this relationship appeared weaker and among women was not significant when background factors were controlled.

In England, processes of regulation and inspection have been established to ensure that older people living in long-term care settings receive quality care. This paper describes how dying and death in care homes for older people is regulated and inspected. A documentary analysis was undertaken of the standard that addresses dying and death in the 2001 Care Homes for Older People: National Minimum Standards. Present in the standard is a ‘good death’ template drawn from constructions of best practice in palliative care. The way in which this national standard is enacted in the inspection process is described using a content analysis of the inspection reports from 226 care homes for older people. These present a narrow focus on dying and death, one that emphasises the older person's wishes and the degree of adherence to policies and procedures concerned with the dying and death event. A regulated death attenuates the ‘good death’ template and reflects both the inspection process and capabilities of the residents of care homes. If the regulation and inspection process is to integrate dying with living, a broader conception and regime of inspection is required. Only then will end-of-life care be provided that meets the diverse needs of older people who live in care homes.

Socio-economic inequalities in physical and mental health persist at older ages and previous studies have shown that partnership and parenthood histories are also associated with differentials in later-life health. These domains of adult life interact, and both may be influenced by earlier life circumstances, indicating a need for a holistic approach to understanding lifecourse influences on health at older ages. In this paper, we identify classes of lifecourse types for a United Kingdom (UK) cohort born 1933–1945 and investigate differences between the latent classes identified in physical and mental health, and changes in health over a five-year follow-up period. Data were drawn from Waves 1–5 (2009–2013) of the nationally representative UK Household Longitudinal Study. Multi-level models were used to analyse associations with summary indicators of physical and mental health measured using the SF-12, and changes in health, controlling for childhood circumstances and taking account of support from family and friends in later life. Lifecourses characterised by lower socio-economic position, early parenthood and large family size were associated with worse physical and mental health in later life, with respondents who had combined a high socio-economic position and two children being the most advantaged. The study indicates that socio-economic disparities in later-life health vary depending on the way in which individuals combine work and family life.

The present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care.

Our study aimed to enhance understanding of memory decline (MD) in old age by evaluating longitudinal effects of personal and national contributing factors. We used data collected by the Survey of Health, Ageing and Retirement in Europe (SHARE) from 12 European countries and Israel. Our sample included 11,930 retirees aged 50+, interviewed at baseline and four years later. MD was evaluated by the change in the number of recalled words from first to second interview. Except for gender, all of our explanatory variables had a significant unique effect on MD – age, education, type of occupation, European geographical region, early retirement, time elapsed from retirement, reason for retirement, active lifestyle, re-employment, health/function status, depressive symptoms, and decline in physical and mental health – over the four years of the study. Our findings indicate that MD can be postponed by national policies such as those which prolong years of education and participation in the workforce, and by social interventions directed to promote active lifestyles in late life, especially in Mediterranean and Eastern European nations.

There is a considerable body of literature on the importance of effective shift handovers in hospitals and other health-care settings but less is known about the transfer of information between staff starting and completing stints of paid work in care homes. In the first of two articles considering this under-explored topic, we report findings from a scoping review examining what is known about shift-to-shift handovers in care homes for older people and their equivalents. It is based on systematic searches of electronic databases of English-language journals on ageing and internet searches for material published between January 2005 and October 2016. Guidance from the regulatory body for health and social care in England, the Care Quality Commission, highlights the importance of handovers in care homes but the degree to which they are embedded into care home routines appears to be variable, influenced by factors such as workplace culture, shift patterns and the extent to which they involve all those on duty or just those with professional qualifications. Staffing shortages and whether or not members of staff are paid for their time attending handovers appear to be further constraints on their use. We conclude that there is considerable scope for further research in this field to identify and develop good practice.

Research shows that older people tend to not only be underrepresented on television (TV), but also to be represented within a number of fixed types. These correspond to cultural myths about ageing, which emphasise vulnerability and decline but also increasingly stress the individual's responsibility for successful ageing. This paper analyses the representation of older people on Flemish public TV, using qualitative content analysis to identify patterns of representation in a sample of 44 programmes broadcast in 2019 and 2020, including the first months of the COVID-19 pandemic. To complement our own analysis, we also interviewed eight experts on ageing. Our research shows that representations of older people on Flemish public TV tend to gravitate towards two types related to different age groups: vulnerable and passive old-old people (over 80 years old), particularly those in nursing homes who feature prominently in reporting on the COVID-19 pandemic; and dynamic and active young-old people (65–80 years old), connected to the ideals of successful ageing. The two predominant types correspond to cultural myths about ageing and are also connected to recurrent themes: sexual intimacy, loneliness and death. Our research highlights the need for a more diverse representation, reflecting the variety of individual life conditions and the functional age of older people.

Similar to their younger counterparts, older adults (age 60+) are increasingly turning to online dating sites to find potential romantic and sexual partners. In this paper, we draw upon qualitative data from a thematic analysis of 320 randomly selected online dating profiles posted by Canadian heterosexual older adults who self-identified as Asian, Black, Caucasian or Native American. In particular, we examined how the older adults’ self-presentations varied according to race/ethnicity, age and gender, and how the language they used to describe themselves and their preferred potential partners reflected and reinforced idealised images of ageing. Our analysis identified five primary ways in which the older adults portrayed themselves. They depicted themselves as active and busy with cultural/artistic, social and adventurous activities; and also as physically healthy and intellectually engaged. Third, they emphasised the ways in which they were productive through work and volunteer activities. Fourth, they accentuated their positive approach to life, identifying themselves as happy, fun-loving and humorous individuals. Finally, they highlighted their personable characteristics, portraying themselves as trustworthy and caring. We discuss our findings with a particular focus on gender differences, drawing on literature on masculinity and femininity, and also look at capital and power relations by considering the online dating setting as a field in the Bourdieusian sense.

As Indonesia experiences rapid growth of the ageing population, the government's attention has turned to the wellbeing of older people. This study aims to review critically the construction of older people's identity and care within regional ageing policies in Indonesia. Working from a critical gerontology perspective, a critical discourse analysis of 16 regional ageing policies identified two constructions, labelled ‘material’ and ‘cultural’ ageing, which were used to position older people. The analysis showed that ‘material ageing’ positions older people at the intersection of ‘decline’ and ‘successful ageing’ discourses, while ‘cultural ageing’ positions older people's welfare at the intersection of ‘public responsibility’ and ‘family obligation’ discourses. These discursive constructions in the policy documents have both micro (interpersonal) and macro (structural) constructive effects. At the micro-level, the regional ageing policies stand at a crossroad between empowering and marginalising older people and their families. While the dominant discourse of ‘successful ageing’ encourages older people to be healthy, it marginalises those who do not, or cannot, meet its criteria, undermining a rehabilitative approach as a policy priority. In addition, the rights of the family are overlooked, despite being a pivotal element of cultural ageing. At the macro level, a moral dilemma appears in defining the public and private domains of older people's welfare. Eligibility requirements for state assistance (due to budgetary constraints) ensure that elder care is often relegated to the private sphere, without support. Recommendations for policy improvement are discussed, including the recognition of families’ rights and the importance of local cultural practices in providing care for older people.

Changes in population and family structures are altering the provision of care for dependent older people. In Southern European countries like Spain, such care is still largely provided by family, typically spouses and adult daughters. However, an increasing proportion of women have entered the labour force, thereby affecting their availability. To study the demand and supply balance of informal care and to quantify the need for formal care when there is a deficit, we have developed a mixed microsimulation–agent-based model (ABM). Based on nuptiality, fertility and mortality levels of cohorts born at ten-year intervals between 1908 and 1968, the model starts with a microsimulation of the lifecycle of individuals and their close relatives until death. The ABM then determines the amount of time available or needed to care for family members, starting from age 50. Estimates are derived from Spanish survey data on employment, disability and time of care received. Surprisingly, results show that the family care deficit was greater in the older cohorts due to higher mortality and thus a greater impact of widowhood. However, for future elderly persons, we foresee that persistent below-replacement fertility and, paradoxically, the prolongation of the lifespan of couples will increase the demand for formal care as there will be more couples with both members incapacitated but without children to take care of them.

This paper discusses the policy implications for encouraging a high quality of service provision in hospital for elderly people with dementia. Contemporary policy is examined and the continuing need for long-stay beds is highlighted, particularly in Scotland. The measurement of the quality of care in nursing is reviewed and concern is expressed over whether the patients or only the audit score will benefit from any change in practice. Ways of improving both work satisfaction and the quality of care are recommended on the basis of a study of psychogeriatric wards in NHS hospitals in Scotland.

As an increasing number of Government services have moved away from traditional modes of provision to online formats, there has been a corresponding need to ensure greater access to the internet. Although older people (those over 60) are least likely of all age groups to have access to the internet in their homes, the internet holds much potential as an information and advice resource for those older people who may find it difficult to access advice over the telephone or in person. Realising this potential extends beyond issues of physical access; consideration must necessarily be given to issues of internet literacy and the inclination of this cohort to utilise what may be new and unfamiliar technology. This paper examines these matters in the context of the resolution of everyday problems with a legal dimension. Looking first at the use of the internet for information and advice seeking related to such problems, we find that those aged over 60 demonstrate the least use of the internet for problems with a legal dimension. Simultaneously, those aged over 60 are also the group with the lowest level of home access – a particular issue given that for over 60-year-olds, home access is a far stronger determinant of internet use for problems than it is for other age groups. Examining use of the internet for advice seeking over the last decade, findings demonstrate the existence of a general increase in use amongst all age groups over time, albeit with a lower rate of growth amongst those currently over 60. As an indication of future growth, this will have implications for the provision of services. Whilst the ‘young old’ will utilise the internet to a greater degree and will require websites which are tailored to their needs, those individuals at the older end of the age spectrum may best be served by continued access to face-to-face or outreach advice. The implications these findings pose for policy makers in setting priorities in the remit of online service provision are discussed, with results having particular relevance in England and Wales given planned changes to civil legal aid.

Despite the growing use of retirement communities and ageing care facilities, little is known about how residing in retirement residences may impact aspects of older adult wellbeing. Living in these communities may hold particular influence on residents’ sense of purpose, if they feel limited in their opportunities for individual action, or could serve to promote purposefulness depending on the social connections available. The current study sought to explore contributing factors as well as barriers to purpose in older adults living in three continuing care retirement communities. Using brief semi-structured interviews, 18 older adults were asked to describe their purpose in life, community-related activities and any perceived challenges limiting their ability to pursue this purpose. Thematic analysis was used to examine themes common across interviews. Interviews presented a mixed picture of the nature of purposefulness in retirement facilities. Residents espoused several benefits of community living such as social and leisure opportunities, while also noting several obstacles to their purpose, including health concerns and the belief that purpose in life was not relevant for older adults. These findings provide insight into how older adults can derive a sense of purpose from activities within their retirement community and how facilities can better tailor programmes to promote purposefulness and support personally valued roles for residents.

Dementia is a growing issue in the United Kingdom (UK) with over 800,000 people affected. Of these people, in excess of 40,000 are aged under 65 years. Thus, a significant number of individuals may be experiencing symptoms of dementia while in employment. In addition, as working lives extend, the potential impact of dementia on the workplace could be substantial. However, to date, there has been little research on experiences of dementia in the workplace. The research that exists highlights the lack of support for workers with dementia. Dementia may be considered to be a disability under the Equality Act 2010. Therefore, the legislation potentially provides a framework for individuals to request that their employer make reasonable adjustments to support their continued employment. International human rights law is potentially another tool that could be utilised to obtain necessary adjustments. This paper argues that in developing the evidence base on workplace experiences of dementia, it is important that the legal framework be considered. This paper reviews the existing literature on dementia in the workplace and embeds this in the legislative framework in order to establish a cross-disciplinary research agenda. While the paper focuses on the UK legal context, the argument presented in the paper is still relevant to other national contexts.

Older people living in long-term facilities (nursing and residential homes providing 24-hour care) spend the majority of their time inactive, despite the known health and wellbeing benefits of physical activity and reduced time spent sedentary. In order to successfully embed interventions that aim to increase physical activity or reduce sedentary behaviour, it is necessary to understand the features of the care environment that influence residents’ routine patterns of movement. Drawing on an organisational perspective, this paper explores the structures and mechanisms that shaped different care practices concerning residents’ movement in two contrasting care homes in the north of England. This study adopted an ethnographic approach, using a combination of qualitative observations, informal conversations and interviews. A grounded theory approach to data analysis was adopted. The findings illustrate the importance of translating espoused values of care into tangible and acceptable care practices, systems of management, staff training and development, and the use of care planning in residents’ routine patterns of movement. Understanding how organisational factors shape routine movement among care home residents will help inform the development of embedded and sustainable interventions that enhance physical activity and reduce sedentary behaviour. This study is part of a wider programme of research developing and testing a complex intervention, embedded within routine care, to reduce sedentary behaviour among care home residents.

China has been undergoing dramatic socio-economic and demographic changes in the last few decades. The rapid growth of the ageing population will pose tremendous challenges to its public health and social welfare system. This study aims to examine how urbanisation has impacted cardiovascular disease (CVD) risks among middle-aged and older Chinese in two decades, from 1991 to 2011. Data were drawn from a nationwide longitudinal data-set of the China Health and Nutrition Survey (CHNS) (sweeps 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011). Participants aged ⩾45 years old were included. A dynamic urbanisation index was created for each community (village or neighbourhood) based on community-level data that can reveal the heterogeneity within and across places and capture dimensions of social, economic and physical characteristics of urban living over time and space. Multi-level modelling analyses (level 1: occasions; level 2: individuals; level 3: households; level 4: communities) were performed on outcomes of CVD risks such as body mass index, waist circumference, and systolic and diastolic blood pressure. The results show upward trends in all CVD risks for both genders over 20 years of urbanisation after adjustment for socio-economic and demographic confounders. Urbanisation in China is associated with absolute increases in CVD risks over time among its middle-aged and older people, despite its contribution to relative reduction of the rural–urban gap over time. This is particularly true for women from the least urbanised areas. It is relevant to inform policy-making processes to target the most vulnerable groups of older people in China during its rapid urbanisation process. There is a possibility for policy intervention to reduce inequality during the process of China's planned urbanisation.

The concept of intergenerational fairness has taken hold across Europe since the 2008 financial crisis. In the United Kingdom (UK), focus on intergenerational conflict has been further sharpened by the 2016 ‘Brexit’ vote to take the UK out of the European Union. However, current debates around intergenerational fairness are taking place among policy makers, the media and in think-tanks. In this way, they are conversations about, but not with, people. This article draws on qualitative interviews with 40 people aged 19–85 years and living in North-East England and Edinburgh, Scotland's capital city, to explore whether macro-level intergenerational equity discourses resonate in people's everyday lives. We find widespread pessimism around young people's prospects and evidence of a fracturing social contract, with little faith in the principles of intergenerational equity, equality and reciprocity upon which welfare states depend. Although often strong, the kin contract was not fully ameliorating resentment and frustration among participants observing societal-level intergenerational unfairness mirrored within families. However, blame for intergenerational inequity was placed on a remote state rather than on older generations. Despite the precariousness of the welfare state, participants of all ages strongly supported the principle of state support, rejecting a system based on family wealth and inherited privilege. Rather than increased individualism, participants desired strengthened communities that encouraged greater intergenerational mixing.

Caring for a patient with dementia is a stressful life event, and care-givers carry a heavy psychological burden. However, the extent to which care-givers are affected by the stressful aspects of care-giving may depend on a variety of factors. This study examined the relationships between cognitive emotion regulation strategies, social support and depression among Turkish dementia care-givers. Research questions explored whether different coping strategies and social support were related to levels of depression, as well as whether social support moderated this relationship. We used a hierarchical multiple regression analysis consisting of three blocks as the primary statistical technique to examine our expectations. In total, 141 dementia care-givers (108 women, 33 men) were recruited to the study. The mean age of the sample was 59.74 years old (standard deviation = 12.70). Hierarchical regression analysis indicated a significant negative main effect for positive refocusing strategies and significant positive main effects for catastrophising and blaming others. Social support moderated the relationships between catastrophising, rumination and symptoms of depression. Our results show that cognitive emotion regulation strategies and social support can play significant roles in alleviating care-giver depression. In the light of these results, it may be suggested that interventions focusing on the effects of positive refocusing, catastrophising and blaming others, as well as providing social support, may be helpful in alleviating depression in care-givers.

The associations between socio-economic position (SEP) and physical functioning have frequently been investigated but little is known about which measures of SEP are the best to use for older people. This study examined how different SEP indicators related to the physical functioning of men aged 50 or more years in England and Greece. The data derived from Wave 1 of the English Longitudinal Study of Ageing (ELSA) and from the Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported physical functioning limitations and mobility difficulties were combined and categorised into ‘no disability’, ‘mild disability’ and ‘severe disability’. The SEP indicators studied were: wealth, educational level and occupational class. The findings indicate that respondents with less wealth, fewer educational qualifications and lower occupational class were more likely to experience mild or severe physical disability than those of high SEP. When all three measures of SEP were adjusted for each other, in both samples wealth maintained a strong association with mild and severe disability, while education was associated with severe disability but only among English men. Occupational class was not strongly associated with physical disability in either case. Hence, among English and Greek older men, wealth was a more important predictor of physical functioning difficulties than either occupational class or education.