This study compared how older people use quality information to choose residential care providers in England, the Netherlands and Spain (Catalonia). The availability of information varies between each country, from detailed inspection and survey information in the Netherlands, through to a lack of publicly available information in Catalonia. We used semi-structured interviews and group workshops with older people, families and professionals to compare experiences of the decision-making process and quality information, and also to explore what quality information might be used in the future. We found that most aspects of the decision-making experience and preferences for future indicators were similar across the three countries. The use of quality information was minimal across all three, even in England and the Netherlands where information was widely available. Differences arose mainly from factors with the supply of care. Older people were most interested in the subjective experiences of other residents and relatives, rather than ‘hard’ objective indicators of aspects such as clinical care. We find that the amount of publicly available quality information does not in itself influence the decisions or the decision-making processes of older people and their carers. To improve the quality of decisions, more effort needs to be taken to increase awareness and to communicate quality in more accessible ways, including significant support from professionals and better design of quality information.

In this article, we draw upon interviews with 14 men and 15 women aged 51–92 to examine the embodied experiences of Canadian power mobility device users. In particular, we investigate how individuals ageing with mobility impairments perceived and experienced the practical impacts and symbolic cultural connotations of utilising a power mobility device. Our findings reveal that those participants who had begun to use their power mobility devices later in life were dismayed by and apprehensive about the significance of their diminishing physical abilities in the context of the societal privileging of youthful and able bodies. At the same time, the participants who had used a power mobility device from a young age were fearful of prospective bodily declines, and discussed the significance and consequences of being unable to continue to operate their power mobility devices autonomously in the future. We consider the ways in which the participants attempted to manage, mitigate and reframe their experiences of utilising power mobility devices in discriminatory environments. We discuss our findings in relation to on-going theoretical debates pertaining to the concepts of ‘biographical disruption’ and the third and fourth ages.

We reflect upon the practices of two projects working with older people – one involving health promotion and the other arts – in terms of the discourses deployed in their work. The material discussed is drawn from evaluations which, through their use of feminist and critical methodologies, were committed to revealing and challenging the layers of inequality often present in practice with older people. The familiar notions of friendship and conversation are shown to be useful in conceptualising the work of these projects. It is argued that the discourses within which these ideas are embedded offer the basis of progressive practice with older people even in routine settings such as housing, social care, recreation and social work. These concepts offer the possibility of thinking of older people as active subjects within, rather than passive objects of, practice and of challenging inequalities through reframing more functional discourses.

The purpose of this study is to develop and extend our understanding of dementia care-giving by introducing a typology of informal care-giving across four different diseases. Care-giving factors were examined with respect to specific dementia presentation in mild cognitive impairment, Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease-associated dementia. Informal care-giving literature in the four diseases was systematically searched to identify specific disease symptoms and resultant care-giving strains and outcomes. Key concepts were extracted and grouped thematically. The first classification, ‘role-shift’, reflects care-giving where cognitive deterioration results in changing roles, uncertainty and relational deprivation among married partners. The second classification, ‘consumed by care-giving’, refers to those caring for persons with dementia-motor decline that greatly increases worry and isolation. Finally, in the ‘service use’ classification, formal support is needed to help care-givers cope with daily responsibilities and behaviour changes. In each case, the dementia presentation uniquely impacts care-giver strains. A major conclusion is that the same support to all care-givers under the umbrella term ‘dementia’ is unwarranted; the development of targeted support is required.

The significant time older people typically spend at home affects both their level of physical activity and quality of life. This prospective cohort study was designed to identify the effects that living in a high-rise residence retirement community has on physical activity and quality of life in older people with leprosy. The relocation group was comprised of study participants who had relocated voluntarily to a high-rise apartment building. The comparison group was comprised of study participants who had chosen not to relocate to that building. Data were collected using a personal information survey, Modified Baecke's Questionnaire, and the brief version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). The groups were significantly similar in terms of household activities, leisure time activities, total physical activity score, and quality of life physical and social aspects, and significantly different in terms of quality of life overall (F=7.864, p=0.006), psychological (F=5.403, p=0.021) and environmental (F=23.099, p=0.000) aspects. This study indicates that living in a high-rise apartment environment does not decrease physical activity and may promote overall quality of life, and psychological and environmental aspects, in retirement community residents. The findings enhance understanding of the effect of different living environments on physical activity and quality of life. Greater health professional participation in retirement community design to ensure such designs facilitate residents’ health and quality of life is recommended.

This paper examines immigrant poverty at an older age in Sweden with an emphasis on late-in-life immigrants. We analyse tax data for the entire Swedish-born and non-Swedish-born population. The poverty status of a household is assessed using two criteria. First, the disposable income of the household in which the person lived in 2007 must be below 60 per cent of the median equivalent income in Sweden as a whole. Second, to be classified as ‘twice poor’ a household's net assets must be below SEK 10,000. The results indicate that three out of four Swedish-born older persons were not classified as poor by either of the criteria, and only 1 per cent by both criteria. In contrast, among older persons born in low-income countries almost three out of four were classified as poor according to one of the criteria and not fewer than one in three according to both. Results of estimating logistic models indicate that the risk of being considered poor according to both criteria is strongly positively related to one's age at immigration. Our results indicate that it is crucial that migrants, particularly those who arrive after age 40, be better integrated into the Swedish labour market. To alleviate poverty among those migrants who are already of older age, increased transfers are probably the only possible alternative.

In this paper, we explore ageist depictions of both young and older people as they emerge from discourses addressing ‘other people's’ digital media usage practices. We carried out eight focus groups (four with teenagers, four with people aged 65 or older) in two southern European cities (Rome and Barcelona). By negotiating the affordances and constraints of (digital) tools and platforms, people develop their own usage norms and strategies, which might – or might not – be intersubjectively shared. Discourses surrounding usage practices and norms tend to refer to what people understand as an appropriate way of using digital platforms: these discourses proved to be powerful triggers for expressing ageist stereotypes; ‘the others’ were depicted, by both teenage and older participants, as adopting inappropriate usage practices (with regard to content, form, skills and adherence to social norms). These reflections proved to have broader implications on how other age cohorts are perceived: participants tended to take discourses on digital media usage as an opportunity for making generalised judgements about ‘the others’, which address their manners, as well as their attitude towards communication and social life. Inter-group discrimination processes and ageist stereotypes play a major role in shaping the strong moralistic and patronising judgements expressed by older and younger participants towards ‘the other’ age cohort.

Technological interventions are increasingly popular methods of targeting and preventing loneliness in older adults. Research has identified various factors that influence the willingness and propensity of older adults to integrate technology into their social lives and the ways in which this may enhance their social connectedness. Given prevalence rates and negative outcomes associated with loneliness for this population, further research is warranted to clarify the mechanisms through which technological interventions may decrease loneliness. This study aimed to better understand the perspectives of older adults on the role of technology in their social relationships in later life. Four focus groups were conducted with 27 older adults, aged 65–80 years. Transcripts were analysed using thematic analysis, and results were validated via written participant feedback. Participants reported technology as one of many tools used to maintain their social relationships. Their choice to use technology for social interaction was influenced by their estimation of effort required, likely quality of the interaction, and the privacy and security provided. These factors were the same as those that influenced decisions to use other methods (e.g. face-to-face meetings). Based on the results, we recommend that loneliness interventions should be technology-agnostic and multifaceted, providing a wide range of tools that recognise the technological competencies of older adults and supporting different interaction types to meet the preferences of the individual.

Self-ageism has a significant negative impact on older people's ageing experiences and health outcomes. Despite ample evidence on cross-cultural ageism, studies have rarely looked into the way cultural contexts affect self-ageism. In this article, we compare expressions of self-ageism and its possible predictors across four European countries based on two questionnaires in a study sample of 2,494 individuals aged 55 and older. We explore how predictors of self-ageism are moderated by cultural values in a comparative fixed-effects regression model. We empirically show that similarly to ageism, self-ageism is not present in the same way and to the same extent in every country. Moreover, the level to which cultures value hierarchy and intellectual autonomy significantly moderates the association between self-ageism and individual predictors of self-ageism. Our study adds to the small existing body of work on self-ageism by confirming empirically that certain expressions of self-ageism and individual predictors are susceptible to change in different cultural contexts. Our research results suggest that self-ageism interventions may benefit from a culturally sensitive approach and imply that more culturally diverse comparisons of self-ageism are necessary to figure out fitting ways to reduce self-ageism.

Research on ageing in China has been preoccupied with the unsolved question of whether traditional filial piety is eroded or sustained by societal modernisation. This article engages with the ongoing debate on modernisation and family change, but seeks to go beyond the prevailing dichotomous conclusion. Rather than focusing on one intergenerational relationship between ageing parents and their adult children – a common formula in the existing literature – this article draws upon 120 life-history interviews, involving both genders and three generations in three cities, and examines how old-age support practices have shifted across three generations, as well as between sons and daughters across time. The findings indicate that while there has been a decline in everyday financial and instrumental support by adult children for their parents across all three generations, crisis-induced intergenerational solidarity has remained intact. As the market economy has matured, differences in ageing experience have widened between working-class and affluent families. The article also reveals that care for bilateral parents has characterised the behaviour of the three urban generations. The complex shifts and continuities are the outcome of a combination of state policies, evolving filial norms, gender and demographic forces, as well as reflecting the broader structural consequences of China's shift to a market economy. By systematically comparing old-age practices by generation and gender in both Mao and post-Mao eras, the article makes a major empirical contribution to the study of ageing in urban China. From a theoretical perspective, it contributes to the global debate on modernisation and ageing by emphasising the uneven processes in which social change interacts with family life within a single country, when viewed through generational and gender prisms. In so doing, it highlights the ways in which old-age support trajectories are firmly grounded in local history and cultural, economic and demographic forces.

Although women's appearance is theorised as being central to their identity and social currency, much prior research has argued that as women age, other aspects of their lives assume a higher priority than their appearance. Nevertheless, they continue to invest time in appearance practices. In undertaking these various appearance practices, older women have to negotiate a range of conflicting social norms of age-appropriate appearance, such as managing the balancing act between ‘letting themselves go’, on the one hand, and looking like ‘mutton dressed as lamb’, on the other. This paper contributes to the growing literature on older women's attitudes to their appearance and related practices. Drawing on data from a two-year research project in a hair-salon catering primarily for older clients, I examine the question of the importance to women of their appearance through the lens of their hair-care practices. Focusing on a group of nine female clients aged 55–90 in a small hair-salon in southern England, I show how participants in their talk and embodied presentation display shifting orientations of investment/interest (or lack of interest) in their appearance. Comparing participants’ appearance practices, with their talk in two sequential environments in which a possible interest in appearance is made particularly salient, I argue that these shifting orientations reveal participants’ subtle negotiation of competing social norms of appearance for older women.

This study examined the differences in the preference for long-term care (LTC) by age, period and cohort (A-P-C) in Japanese older adults through repeated cross-sectional surveys from 1998 – before the establishment of LTC insurance – to 2016, in a suburban city of metropolitan Tokyo. We analysed the direct effects of A-P-C on the preference for LTC, as well as the interaction effects of A-P-C on preference by gender, family structure and activities of daily living. Data were obtained at six time-points using repeated cross-sectional surveys for people aged 65 and older; surveys were conducted in 1998, 2002, 2004, 2010, 2013 and 2016. The preference for LTC was composed of three categories: informal care, community LTC services (CLTCS) and institutional LTC services (ILTCS). The cross-classified random-effect model was used to specify A-P-C effects. Informal care, CLITCS, ILTCS and other/no answer composed 35, 23, 33 and 9 per cent of preferences, respectively. In terms of the period effect, while there was an increase in levels of preference for CLTC between 1998 and 2010 as compared to informal care, the levels of preference were almost identical after 2010. In terms of the age effect, younger participants were more likely to prefer CLTCS and ILTCS over informal care. Moreover, the age influence was stronger in females and respondents who lived alone. We did not observe a cohort effect for preference. This study suggests that there are gaps by period and age between the preference for LTC services and the actual LTC use in Japanese older adults, and as a result, the use of actual LTC services cannot fully reflect the intentions and preference for LTC in them.

Gender penalties in pension outcomes are widely acknowledged and have been documented for majority populations in various settings. A recurring finding is that the gendered impact of family formation on work–care trajectories adversely affects women's accumulation of pension rights over the lifecourse relative to men. Although maternal employment is particularly low in migrant populations, few papers have explicitly addressed pension protection of migrant women. Using longitudinal microdata from the Belgian Social Security Registers, we analyse whether entry into parenthood differentially affected the build-up of first pillar pension rights of working-age migrant women compared to natives between 1998 and 2010, further distinguishing by origin group and migrant generation. The results show that native women are most likely to build up pension rights through full-time employment both before and after parenthood. In contrast, first-generation women and women of Turkish and Moroccan origin are more likely to build up pension rights though assimilated periods or rely on derived pension rights after parenthood, even when controlling for type of pension build-up before parenthood. We conclude that policies reinforcing individualisation of pension rights based on employment or decreasing the importance of derived rights may erode pension protection of groups having limited access to the labour market, and require co-ordination with employment and family policies that support the combination of work and care responsibilities.

An extensive body of research documents marital status differences in health among older adults. However, few studies have investigated the heterogeneity in depressive symptomatology among older married adults living in developing countries. Our study investigates the interplay of gender and marital power dynamics for mental health among older Mexican adults. Our sample includes older married couples in the 2015 Wave of the Mexican Health and Aging Study (N = 3,621 dyads). We use seemingly unrelated regression to model the association between self-reported distributions of decision-making power within marriages and depressive symptoms for husbands and wives. For approximately 41 per cent of couples, the husband and wife both reported an equal distribution of power in the marriage. Compared to those who reported an equal power distribution, husbands and wives who reported an imbalance of power (having more power or less power than their spouse) reported more depressive symptoms. Levels of depressive symptoms were higher in marriages characterised by power inequality. The relationship between equality in power and depressive symptoms is not explained by health-care needs or living arrangements. Marital quality is an important factor for understanding depressive symptoms among older Mexican adults.

Older people, who have the major share of chronic illness, are also especially likely to encounter problems in carrying out regimens. The regimens themselves may be exhausting or complex. In addition, regimen management in the home takes place within a context characterised by personal and environmental, as well as illness related conditions. There is an interplay between this context and the illness management, giving rise often to problems of ‘overload’ and a ‘contest for control of management’. These may interfere not only with the management of regimens but have consequences for couples' personal lives and their marital relationships as well.

In many urban communities the fastest-growing groups of old people are those from the various minority racial and ethnic groups. This paper reviews the progress of a range of the new services, clubs and social centres which have been recently developed to meet the needs of the minorities. The services are examined in terms of their objectives, degree of specialisation (by ethnic group, gender and age) and adequacy of resources. As most of these projects have been initiated by voluntary groups and have experienced difficult development problems, the implications of this pattern of growth are assessed. In particular, reasons for the lack of sustained support from government and statutory organisations are discussed. Racial disadvantage affects all the minority groups, though different ethnic groups appear to be developing different strategies for the care of the old. However, prospects for either fully developed alternative services for the minorities or for multicultural services appear to be bleak in the forseeable future.

This paper presents results from a comparative project on the implementation of elder-care in France and Sweden. The transition to requiring care is understood as a process, and elder-care is seen as a part of a more general organisation of social care that reflects different welfare traditions. An overview of elder-care on the institutional level in the two countries is supplemented by case studies from the perspective of older people which identify ways of co-operation between actors, such as public eldercare providers, family members and help provided by profit and non-profit organisations. The interviews include approximately 20 older persons in each country as well as a small number of administrators and adult children. The study sheds light on how policies are implemented on the local level and puts the focus on who actually does what and when for older persons with care needs. The different roles played by the state, the family, the market and civil society are examined. Family members in France take on a more active role both as co-ordinators of care and as actual caregivers. The study shows that gender and social class remain associated with caring but that such differences are much larger in France than in Sweden.

Painters' self-portraits offer the opportunity to study signs of ageing through the centuries. In this paper, we examine 687 self-portraits by 506 European painters from the 15th to the 20th century. To qualify for the analysis, painters had to be unquestionably identified, have known years of birth and death, and the self-portraits had to be dated unequivocally. ‘Age scores’ for the characteristics of the lower face were developed. Ptosis of the upper eyelid, bags under the eyes and the characteristics of beards were also recorded. Among the main findings, the painters of self-portraits that exhibited ptosis of the upper eyelid had a higher actual age than those of portraits which did not (55 versus 38 years). Similarly, those that represented bags under the eyes were older painters (47 versus 33 years). The percentages of portraits with eyelid ptosis and bags under the eyes were similar through the centuries and in three zones of Europe. The age scores of the lower half of the face were also consistent in all centuries, except at ages 40–49 years. The painters' average lifespan significantly increased during the 18th century; and within Europe a north–south lifespan gradient has been evident since the 17th century. We conclude that ageing has had similar facial manifestations over the last five centuries, except between 40 and 50 years of age.

Despite rapid social change that has influenced the social status of older adults, expectations about their behaviour and whether such expectations differ across generations remain unexplored in Korea. Based on ageing theories of activity, disengagement and modernisation, this study investigated age norms among Koreans conceptualised as shared expectations of appropriate behaviours of older adults. Competing perspectives in intergenerational relations and prejudice toward older adults were examined to test if they influenced age norms and if such associations varied across different age groups. Data were analysed from a survey of 1,445 individuals aged 20 and above who resided in 16 administrative districts of Korea. Comparisons of age norms across age groups indicated that the older adult group (age 65+) held more restrictive attitudes about social participation and engagement in various behaviours in old age than the middle-aged adults (ages 45–64) and younger adults (ages 20–44). Respondents with more prejudice towards older adults tended to place more restrictions on the behaviour of older adults. A significant interaction indicated that respondents whose views were in line with a generational conflictive perspective, assessed as reporting more competitive perspectives between young and old people and being less supportive of intergenerational programmes, had a more restrictive view about older adults' behaviours among the middle-aged group but less restrictive attitudes in determining acceptable behaviour in later life among the older adult group.

As there is currently no cure for dementia, providing psycho-social support is imperative. Counselling and psychotherapeutic interventions offer a way to provide individualised support for people with dementia and their families. However, to date, there has not been a systematic review examining the research evidence for these interventions. This review aimed to examine the following research questions: (1) Are counselling/psychotherapeutic interventions effective for people with dementia?, (2) Are counselling/psychotherapeutic interventions effective for care-givers of people with dementia? and (3) Which modes of delivery are most effective for people with dementia and care-givers of people with dementia? A systematic literature search was conducted in MEDLINE (via PubMed), PsycINFO and CINAHL in March 2019. Keyword searches were employed with the terms ‘dement*’, ‘counsel*’, ‘psychotherapy’, ‘therap*’, ‘care’ and ‘outcome’, for the years 2000–2019. Thirty-one papers were included in the review, from seven countries. Twenty studies were randomised controlled trials (RCTs) or adopted a quasi-experimental design. The remaining studies were qualitative or single-group repeated-measures design. The review identified variation in the counselling/psychotherapeutic approaches and mode of delivery. Most interventions adopted either a problem-solving or cognitive behavioural therapy approach. Mixed effectiveness was found on various outcomes. The importance of customised modifications for people with dementia was highlighted consistently. Understanding the dyadic relationships between people with dementia and their care-givers is essential to offering effective interventions and guidance for practitioners is needed. Information about the cognitive impairment experienced by participants with dementia was poorly reported and is essential in the development of this research area. Future studies should consider the impact of cognitive impairment in developing guidance for counselling/psychotherapeutic intervention delivery for people with dementia.