Given global population ageing and the fact that Australia is experiencing a significant increase in the proportion of older adults in its population, research into ageing issues has become a national priority. Whilst body image and self-esteem have been empirically linked, the relationship among older adults has been neglected. This study investigated several body-image variables and their relationship to self-esteem in a sample of 148 men and women aged 65–85 years who were living independently in the Perth Metropolitan Area of Western Australia. They completed the ‘Rosenberg Self-Esteem Scale’ and the ‘Multidimensional Body-Self Relations Questionnaire’. The results indicated, contrary to a common misconception, that body-image concerns are significant to self-esteem in older adulthood, but that these vary by age and gender. Whilst women appear to develop various strategies to counter the effects of ageing, men seem to be more negatively affected, particularly in relation to body functioning. The findings shed light on the meaning of body image in older adulthood. A better understanding of the meaning of body image, of the factors that influence the meaning, and of how these relate to older adults' self-esteem may help older adults develop a positive body image that will contribute to psycho-social strengths and enhance their quality of life.

Most adults do not achieve the levels of physical activity currently recommended for a healthy lifestyle. Population surveys suggest that there is a linear decline of activity levels with age, yet physical activity has many health benefits for older adults. If these are to be more widely adopted among older people, health policy and promotion require an understanding of the factors that influence decreasing activity with age. This study examined the patterns of physical activity of 699 participants in the West of Scotland Twenty-07 Study who were aged 60 years when interviewed in 1991 and followed up four to five years later. It examined the factors that influenced whether or not the subjects achieved currently recommended levels of activity, by applying random effects models with a seasonal adjustment. It was found that higher levels of physical activity associated with a healthier lifestyle, and that socio-economic factors played a minor role in determining the level of physical activity. A substantial amount of physical activity occurred at work but was lost by those who had retired, for while those who were not working were more physically active at home or at leisure than those in work, the majority of the sample did too little physical activity outside work to compensate for the loss of work-based activity. One conclusion is that health promotion initiatives that encourage people to become more physically active should be targeted at those who are about to retire.

Most published research on informal care for older people focuses on the support provided by relatives. The role of non-kin carers can, however, also be significant in supporting older people in their own homes. In this paper, we report the findings from an exploratory study of the support provided by friends and neighbours who are the main carers of frail older people. It draws on interviews with an opportunistic sample of friends, neighbours and older people, which explored their views about the support arrangements, the reasons why help was provided and any difficulties experienced. Several friends and neighbours provided intensive and frequent help, and some played a key role in co-ordinating other services. One of the main forms of direct support related to older people's quality of life, at a broader level than the practical help provided by statutory services. The flexibility of such support, and the friends' and neighbours' concern for older people as individuals, were particularly important to the people they helped. Nevertheless, such help was not provided without costs to the carers. The study highlights the need for policy-makers and practitioners not to take help from friends and neighbours for granted and, in line with the White Paper Modernising Social Services, to provide the support services they need.

This paper explores older women's evaluations of their weight as well as the perceived merits and detriments of weight gain and weight loss in later life. Using data from semi-structured interviews with 22 community-dwelling women aged 61 to 92 years, I examine the meanings that the women attribute to dieting, desired body weights and obesity. The women frequently offer unsolicited accounts for why they have gained or lost weight over time, and disclose their perceptions of and reasons for needing to alter their current body weights. I probe the tensions between weight loss for health concerns versus appearance goals. The women express dissatisfaction with their weight gain in terms of their physical appearance. However, they also tend to describe the need to lose weight in terms of health risks and benefits rather than in terms of approximating the beauty ideal or achieving a desired body size and shape. Health tends to be described as a valid justification for being concerned with one's weight, while an appearance orientation is deemed to be indicative of vanity. Many of the women suggest that while the health benefits of weight loss are often the stated reason for losing weight, the perceived appearance dividends are the key motivation behind altering one's body weight in later life.

This study focuses on the influence of objective living conditions on the life satisfaction of older Europeans living alone from a gender and cross-national perspective. The data were drawn from the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), which includes a single-item question for life satisfaction and a large set of health, family and socio-economic indicators. From a descriptive point of view, a lower proportion of women living alone declared themselves to be satisfied with life compared to men. When inequalities in living conditions were controlled for, the difference disappeared, but some determinants of life satisfaction differed for men and women and varied among countries. No limitations in daily activities, a high level of education, participation in leisure activities and an older age increased life satisfaction for both men and women living alone, but the existence of a child influenced only the life satisfaction of men, while income level (or home ownership) had an impact only for women. Moreover, a North–South gradient was clearly observable only for women living alone: all other things being equal, women had a higher probability of declaring themselves satisfied with life in northern European countries than in the South, and their determinants of life satisfaction were strongly linked to the socio-cultural context.

The basis of an effective and satisfactory physician–patient relationship is found in the communication which occurs between these two individuals. By studying the interaction, we can learn much about the identities of the physician and patient, and how they view each other and the world. The interactional dynamics between physician and patient are unique. For example, even in initial medical encounters which involve the meeting of two strangers, patients and physicians deal with concerns as diverse as life and death as well as other intimate or personal issues. Researchers of physician–patient interaction seek to discover how communication evolves and how that communication reveals the multiple levels of meaning in the medical encounter.

Financial support and practical help between older parents and their middle-aged children vary greatly among the regions of Europe. Northern and Western Europe is characterised by a high likelihood of practical help to and financial transfers from parents, while in Southern and Eastern Europe these kinds of support are much less likely. Financial transfers to parents show an almost opposite distribution, with more children supporting a parent in Southern and Eastern welfare regimes. Using the second wave of the Survey of Health, Ageing and Retirement in Europe encompassing 14 European countries conducted in 2006–07, these country differences can be linked to different social policies. Controlling for different aspects of country composition in terms of individual characteristics and family structures impacting on intergenerational support, it was found that the more services and transfers provided publicly, the more people aged 50 or more years helped their older parents sporadically, and the less monetary support they provided. On the other hand, generous public transfers enabled parents aged 64 or more years to support their offspring financially. Thus, neither ‘crowding in’ nor ‘crowding out’, but a modification of private transfers depending on public transfers and vice versa is found, suggesting a specialisation of private and public support.

The ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

‘Promoting independence’ is a central theme of recent United Kindgdom health and social care policy development but is rarely defined. Instead it is generally assumed that we know what independence means. Based on a review of the literature on independence in older age, this paper examines the terms and meanings. While the most common conceptualisation equates independence with the absence of reliance on others, for older people themselves independence is a broader concept that encompasses not only self-reliance but also self-esteem, self-determination, purpose in life, personal growth and continuity of the self. Drawing on previous work in the field of health promotion, we therefore put forward a model that takes older people's views into account and that reconceptualises independence as two intersecting dimensions representing levels of dependence and levels of independence. While dependence equates with reliance on others, independence can be seen as subjectively self-assessed lived experience. Thus it becomes possible to combine high levels of dependence with high levels of experienced or felt independence, a particularly pertinent combination for service providers. Finally we examine the ways in which independence thus conceptualised can be promoted at the individual, institutional, community and societal levels.

This paper focuses on the circumstances of death and dying in old age. It considers the ways in which social policies and social gerontology reflect the values of independence, autonomy and citizenship, and it considers the implication of these values for older people who are dependent on others for care and support at the end-of-life. It discusses the complexity of the relationship between ageing and dying, by exploring recent research from the fields of social gerontology and the sociology of death and dying. Arguing that a long-term perspective is required to understand fully the circumstances of older people's deaths, it analyses the third age/fourth age dichotomy as a conceptual model. The task of developing knowledge about the links between ageing and dying requires consideration of moral and ethical principles. The article examines the conceptual frameworks developed by feminists who argue for an ethics of care as a central analytic referent in social policy. The feminist ethics-of-care approach provides a powerful critique of the moral framework of independence and autonomy as characterised in contemporary policies and practices. Feminist ethicists argue that the inter-relatedness of human beings and the importance of the social context have been overlooked in the preoccupation with individual rights – as reflected more generally in policies and social life. It is argued in the paper that the need for care at the end-of-life highlights these shortcomings. The feminist ethics of care has considerable potential to illuminate our understanding of dependency and care, and to generate both new approaches to policy and practice in health and social care and theoretical perspectives in gerontology.

The aim of this study is to specify the concept of ‘healthy ageing’ from both western and non-western cultural perspectives, and to compare the views of academics and lay older people. Thirty-four published peer-reviewed full papers in English and Chinese (traditional characters) were identified using electronic database searches. The key components of their definitions of healthy ageing were extracted and categorised into 12 domains. The results show that, in general, lay definitions (as described in 11 studies) included more domains (independency, family, adaptation, financial security, personal growth, and spirituality) and more diversity in the healthy ageing concept than academic views (which tend to focus more on physical and mental health and social functioning in later life). Certain domains were valued differently across cultures. As shown in previous studies, the findings affirm that healthy ageing is a multi-dimensional and complex concept and that there are substantial differences in different cultures. Moreover, we found that there are pronounced variations in the conceptualisation of healthy ageing as between academic and older lay people. Generally, older lay people perceive healthy ageing more broadly than the maintenance of physical, mental and social functioning. We suggest that academic researchers should integrate the more holistic perspectives of older lay people and cultural diversity into the classical ‘physical–mental–social’ healthy ageing concept.

Self-reported altruistic activity and social capital were examined as predictors of perceived happiness and life satisfaction among a sample of 4,486 Canadians aged 65 or more years from the 2003 Canadian General Social Services Survey, Cycle 17. Altruistic behaviour was measured by number of volunteer hours per month and helping others (not including family and friends). Social capital was measured using dimensions of belonging to one's community, community and neighbour trust, and group activities. Drawing on generativity and role-identity theories, it was hypothesised that altruistic behaviour and social capital are positively associated with well-being (using perceived happiness and life satisfaction), and that social capital mediates the relationship. For both perceived happiness and life satisfaction, after controlling for demographic, health status, and social support variables, measures of altruistic behaviour demonstrated statistically significant associations. Once measures of social capital were entered into the analysis in the final block, however, the altruistic behaviour variables were no longer statistically significant. Robust associations were found for social capital and the two measures of well-being, particularly between sense of belonging, trust in neighbours, and perceived happiness and life satisfaction. The findings suggest that altruistic behaviour is mediated by social capital. The implications of these findings are discussed with respect to understanding the well-being of older Canadians.

The end of the ‘Golden Age’ of welfare capitalism in the 1970s was the prelude to a period of greater individualisation within societies and was accompanied by an increase in the importance of consumption as a way of organising social relations. During the same period there was also an expansion in the discourses aimed at enhancing the government of the autonomous self. One such discourse operates around what has been termed the ‘will to health’: it suggests that health has become a required goal for individual behaviour and has become synonymous with health itself. The generational groups whose lifecourses were most exposed to these changes are now approaching later life. We explore the extent to which social transformations related to risk, consumption and individualisation are reflected in the construction of later-life identities around health and ageing. We examine how the growth in health-related ‘technologies of the self’ have fostered a distinction between natural and normal ageing, wherein the former is associated with coming to terms with physical decline and the latter associated with maintaining norms of self-care aimed at delaying such decline. Finally, we consider anti-ageing medicine as a developing arena for the construction of later-life identities and discuss the implications of the social changes for researching later life.

This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care.

Most studies of retirement migration in the United States focus at the national level, and there is comparatively little information about the retirees who cross international borders in their search for new homes. Retirement migrants are unusual in that many select destinations in less-developed countries, contrary to the general pattern of migration from poor to rich countries in search of jobs, higher incomes and a better standard of life. This study has examined the reasons for retirement migration from the United States (US) to the Lake Chapala area of the Mexican state of Jalisco. A non-random sample of 211 US retirees was surveyed using a self-completion, semi-structured questionnaire that included items about the decision to move to Mexico, the quality of life at the destination, cultural adaptation, and aspects of personal identity, financial security and health-care. Four major reasons for migrating to Mexico were identified: financial circumstances, the natural environment, a sense of community and friendship, and a better quality of life. While the migrations contradict much taken-for-granted and popular knowledge about migration patterns around the world, they have important implications for the ways of life, social relationships and welfare of the most recent cohort of older people. More in-depth multidisciplinary studies are needed to increase understanding of this evolving phenomenon.

The purpose of this article is to review, contrast and synthesise several major intellectual streams that have guided theoretical development and empirical research in the area of intergenerational family support to older people: (a) normative-integrative approaches that focus on cohesion between family members based on bonds of solidarity and norms of filial obligation, and (b) transactional approaches that are primarily concerned with identifying motives for resource transfers across generational lines. We propose the concept of moral capital – defined as the stock of internalised social norms that obligate children to care for and support their older parents – the transmission of which lies at the intersection of self-interest (for parents) and altruism (for children). Using data from a multigenerational family study, we present an empirical analysis showing that a strong positive correspondence in the filial obligations of adult children and their older mothers – arguably the result of intergenerational transmission – elevated the supportive behaviour of children. We suggest that moral capital may be a useful unifying concept that bridges disciplinary and theoretical divides in the study of intergenerational transfers to elderly people by helping resolve the paradox of how self-interest and selflessness can co-exist within families.

Research on older workers and retirement has yet to adjust fully to an environment influenced by a combination of demographic change, technological developments and economic recession. A key dimension to the changing relationship between ageing and work is the tension between policies to extend working life and the increasingly fragmented nature of late working life, with the emergence of varied transitions, including: bridge employment, second/third careers, part-time working, early retirement and other variations. These developments indicate both the challenge of conceptualising new forms of work-ending, and – in policy terms – the extent to which these can successfully accommodate longer working lives. The paper provides a critical perspective to the policy of extending working life and the narrative which underpins this approach. The paper argues that retirement has become a ‘contested’ institution in the 21st century, fragmented across different pathways and transitions affecting people in their fifties and sixties. The paper argues the case for improving work quality and security as a precondition for supporting policies for encouraging working in later life. An essential requirement for this will include linking debates on extending working life with technological developments and changes affecting the workplace, creating differentiated paths to retirement and labour force exit, enhancing the provision of training and continuing education, and re-thinking the idea of the ‘older worker’.

Life expectancy has been increasing rapidly in many parts of the world, including Hong Kong. A longer life can be welcome as an opportunity to fulfil as yet unmet aspirations, or to take up new challenges and projects, but it may also be a burden, especially for individuals who are unprepared. A pressing question for longer-life societies is: how may older people live their longer lives to the full positively? This article reports a qualitative study of Hong Kong Chinese people's views about ‘positive ageing’, as expressed and discussed in 15 focus groups of middle-aged and older people. Two themes emerged: first, the participants considered that positive ageing should comprise good health, having a positive life attitude, active engagement with an activity or with society, feeling supported by their families and friends, being financially secure, and living in a place with emotional ties; and secondly, several key factors that enable positive ageing were identified, namely, adopting a healthy lifestyle, thinking positively, promoting family and inter-personal relationships, and building up financial resources. The views of the participants about ‘positive ageing’ are compared with those reported from western studies, and the policy implications are considered.

The objective of this paper is to present the findings of a quantitative study of Swiss elderly residents on the Costa Blanca (in the Province of Alicante, Spain) and of an ethnographic study of their British counterparts in Fuengirola and Los Boliches on the Costa del Sol (in the Province of Málaga). We examine the German concept Heimat and its value as an organising construct for understanding the aspirations and actions of foreign retirees resident in Spain, and explore whether globalisation undermines locality to the extent that being in a particular geographical place is no longer a prerequisite for feeling at home. The paper describes the social life and patterns of association of these groups of retired people, in terms of social clubs, leisure activities, voluntary associations, charity groups and self-help groups, relations with home, and relations to Spaniards and people from other countries. It compares the results of the two studies in an analysis of the strategies that the two groups adopt for constructing social communities and for finding a new home. This paper thus provides some insights into what older people seek in later life in terms of their residence, co-resident groups, social contacts and lifestyle choices.

This paper uses work and caring history information from the British Family and Working Lives Survey (1994/5) to examine the provision of family care and its impact upon the employment and the subsequent state and private pension entitlement among mid-life men and women. Combining paid employment with care-giving was not an option for a significant minority of women with caring responsibilities in mid-life. One-in-five mid-life women who have ever had caring responsibilities reported that, upon starting caring, they stopped work altogether, and another one-in-five reported that they worked fewer hours, earned less money or could only work restricted hours. Fewer men and women who stopped work as a result of caring were members of an occupational pension scheme than other groups; and they had accumulated fewer years of contributions than their counterparts who continued working, with direct implications for their level of pension income in later life. The extension of employers' schemes to help workers balance paid work and family responsibilities would facilitate more carers remaining in the labour market, as would an explicit carers' dimension within the new ‘Working Tax Credit’. Consideration should also be given to extending credits for second tier pensions to working carers who provide care for over 16 hours a week and who earn below the lower earnings limit. This will ensure that carers who juggle low paid work and care are not penalised for working, and that their unpaid contribution to society is recognised.