The number of elderly Commonwealth South Asian immigrants in Britain originating from the Indian sub-continent will grow substantially in the next few years, yet there has been little consideration of this group in terms of academic social research. Indeed, welfare agencies are only beginning to become aware of the possible needs of this group. A survey of the scanty British literature on elderly ethnic minorities reveals the paucity of existing knowledge. However, studies from other countries, notably Japan and the U.S.A., suggest a number of illuminating areas for research. The presence of a culturally distinct Asian ethnic minority group experiencing ageing in British conditions appears to afford a good opportunity to throw further light on an important aspect of gerontological theory: namely the respective weight to be attached to cultural factors, social structure and the degree of societal modernisation in shaping the ageing process of individuals and groups.

This study examines discursive constructions of older people by analysing the talk of members of parliament in parliamentary discussions in Finland. While the perceptions of older people that are constructed in various public and private arenas have been relatively widely examined, the talk of political decision makers has not been studied to any large extent. However, decision makers' understandings of older people are likely to influence the ways in which service systems are developed and services organised for older people. The parliamentary discussions examined in this study were related to the process of enacting legislation to secure services for older people. Using discourse analysis, three ways of constructing older people – as ‘the dependent’, ‘the active’ and ‘the deserving’ – are identified. Although the results are to some extent in accordance with previous findings, indicating that older people are constructed as either totally dependent and passive or extremely active, this study also breaks this dichotomous view and highlights the overlap between those constructions. Nonetheless, the picture of older people remains fairly one-dimensional. There was an absence of recognition of diversity among older people, which might inhibit the development of a customer-oriented service system.

In the development and deployment of health and ageing innovations, underlying values such as privacy or quality of life are often seen as a relatively stable starting point, if considered at all. However, values are neither stable nor singular. This paper introduces a valuation framework to explore the co-constitution of values and technological innovations. A careful and ongoing reflection on values and valuation, in particular in innovation practices targeted at older people, is crucial when aiming to increase sustainable innovations. Therefore, we include a Social Sciences and Humanities (SSH) perspective to technological development and innovation, to understand better the construction and co-constitution of ageing-in-place technologies. This framework is developed following a review of literature on values and valuation in the broad field of SSH. The proposed valuation framework consists of three core elements: (a) value multiplicity, (b) value dynamism, and (c) valuation implications. To demonstrate potential applicability of the framework, we conducted a thought experiment on values and valuation practices related to the development and potential further deployment of a COVID-19 health app in the Netherlands. This experiment pays special attention to multiple values at stake and implications for older adults who age in place. We argue this valuation framework provokes reflection on dynamic and multiple values underlying technology use and non-use, and contributes to responsible health and ageing innovations.

In 2012, three architectural competitions were held as part of the strategic programme ‘Living Well, Growing Old’, launched by the Swedish government in 2010. The intention was to use the innovative quality of the architectural competition in order to conceive future-oriented built environments for the ageing Swedish society. In Sweden, several architectural competitions with a focus on space for dependent and frail older people have been organised over the past century. Architectural design has been incorporated into reforms for social care of older people. This study focuses on the relationship between architecture and socio-political visions in three architectural competitions, realised in 1907, 1948 and 1979. The study demonstrates that architectural competitions within this field are more than a list of functional and spatial requirements for architects to respect. Instead, they are socio-political statements that define spatial frameworks within an ideological view on how ethically to provide care for dependent and frail older people in a welfare regime.

This study examined the causal relationship between knowledge, attitudes and discriminatory behaviour towards older people and further explored age-group differences using multi-group analysis. Data were collected from 1,500 Korean adults aged 20 and older in 2011 using the multi-stage quota sampling method. Trained investigators collected data with a developed survey questionnaire in person and a structural equation modelling method was used for data analysis. Attitudes towards older people was measured using two variables: ‘image of older people’ and ‘prejudice against older people’. The findings revealed that the younger and older generations demonstrated differences regarding the causal relationship between knowledge, attitudes and discriminatory behaviour towards older people. The paths model between independent and dependent variables in the structural equation modelling was non-equivalent in younger and older groups. For both groups, knowledge about ageing and older people led to a positive influence on their image of and prejudice against older people. The effect of prejudice on discriminatory behaviour was significant in the younger group, but not in the older group. Further implications for practice and future research to reduce ageism were discussed.

Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.

Decision-making among older patients with stroke, their families and professionals has been extensively studied in a Western context, but there has been little prior work in China. The study reported here explored how decision-making took place between older people with stroke, their family carers and professionals in an acute care context in mainland China using a constructivist grounded theory approach. Data were collected through semi-structured interviews, participant observation and documentary analysis. Constant comparative analysis of the data was carried out. This paper focuses on the key social process of ‘hiding’ and its dynamic relationship with the core category ‘keeping the peace’. In order to meet the traditional Chinese cultural value of ‘maintaining harmony’, both family carers and professionals hid essential information from older stroke survivors who, as a consequence, were effectively precluded from playing an active role in major decisions. In understanding ‘hiding’, the paper draws upon both Chinese cultural values and ‘awareness context theory’ and in so doing questions the relevance to the Chinese context of key Western notions such as involvement in health-care decision-making. A better understanding of the experiences of decision-making processes between older people with stroke, their family carers and professionals in China will help professionals to provide the best possible support and care whilst promoting informed decision-making amongst all concerned.

Previous research shows the benefits of volunteerism to individuals and communities. The purpose of this study was to determine whether lower perceived neighbourhood safety is associated with reduced volunteerism and whether this association differs by sex. Data from the 2008 Health and Retirement Study in the United States of America were used (N = 13,009 adults 60 years and older). Multivariate logistic regression models were estimated to assess the association between perceived neighbourhood safety and volunteerism while controlling for potential confounders. Perceived neighbourhood safety was associated with volunteering. The odds of volunteering were higher for those rating their perceived neighbourhood safety as excellent compared with those rating their perceived neighbourhood safety as fair/poor. Those rating their perceived neighbourhood safety as very good also had greater odds of volunteering than those rating their perceived neighbourhood safety as fair/poor. Results differed somewhat by gender. Men who perceived their neighbourhood safety as excellent had increased odds of volunteering. The association of neighbourhood safety with volunteerism was significant for women rating their perceived neighbourhood safety as excellent or very good. Among men, being married was associated with increased odds of volunteering; being completely or partly retired was associated with increased odds of volunteering among women. Initiatives aimed at improving older adults’ perceptions of safety would help improve volunteerism, which is beneficial to both older adults and communities.

This paper assesses the impact of disturbing life events over five years on the wellbeing of 340 people aged 80–84 years at baseline, by analysing data from a longitudinal survey in Switzerland. The guiding proposition was that the negative effect of life events is moderated by the event domain, i.e. health, deaths and changes in family setting and relationships, and by cognitive adaptation to one's own health state (adopting a more or less optimistic view). Multi-level regression that controlled for the effect of socio-demographic and health factors was used. Corroborating the first hypothesis, a model that differentiated the event categories, instead of their additive inclusion, gave the best fit. In support of the second hypothesis, it was shown that the positive impact of self-rated health reduced the negative effect of life events on wellbeing for survivors, but not for those who died within five years. This suggests that the former made more optimistic appraisals of their mental and physical health, while the latter adjusted their subjective health rating to their functional abilities. Survivors had better psychological resources for coping with disturbing life events, while the deceased lacked these resources, which buffered the impact of negative events. The psychological meaning of stressful events at the end of life is discussed. By encouraging optimistic self-evaluations of health, and raising awareness of the range of normal functioning of older people, health- and social-care practitioners can promote the maintenance of meaningful lives in old age.

It has been argued that without some system in which future generations of users are able to pay for their care the cost of services for an increasingly large group of older people will be borne by a declining base of economically active younger people. Is the answer a user pays approach to the financing of aged care, as promoted by recent changes to aged care financing? This paper reviews this concept and its recent history in Australia. On the basis of a brief review of alternative funding systems, it also considers the potential of public and private insurance schemes to increase funding by potential service users and underwrite the long-term viability of funding for aged care services.

This article is based on an analysis of national data on morbidity and disability in Britain, covering a 15 year period.

This study examined the association between childhood conditions and arthritis among middle-aged and older adults in China. The data were derived from the 2015 wave and the life-history module of the China Health and Retirement Longitudinal Study. Face-to-face interviews were conducted with respondents age 45 and over across China. Multiple imputation was used to handle the missing data, generating a final analytic sample of 19,800. Doctor-diagnosed arthritis was the main outcome variable. Random-effects logistic regression models were used to test the proposed models. Approximately 8 per cent of the respondents had better family financial status in childhood than their neighbours. Close to 8 per cent had been hospitalised or encountered similar conditions (e.g. confined to bed or home) for at least one month in childhood. Around one-third reported better subjective health in childhood than their peers. The majority of the respondents (80%) reported that they had stable health resources, and that their mothers were illiterate during their childhood. Childhood family financial status, subjective health, mother's education, access to health care and medical catastrophic events were found to be significant factors associated with arthritis in later life, after controlling for adulthood and older-age conditions (family financial status: odds ratio (OR) = 0.885, 95 per cent confidence interval (95% CI) = 0.848–0.924; subjective health: OR = 0.924, 95% CI = 0.889–0.960; mother's education: OR = 0.863, 95% CI = 0.750–0.992; access to health care: OR = 0.729, 95% CI = 0.552–0.964; medical catastrophic events: OR = 1.266, 95% CI = 1.108–1.446). The study results highlight an important role that childhood conditions play in affecting the onset of arthritis in late life in China. Health-care providers may consider childhood conditions as a valuable screening criterion to identify risk populations, which could be used to guide health promotion and prevention programmes, and promote healthy ageing.

Older adults have more health-care needs and higher financial burdens but fewer income resources compared to other age groups in China. Meanwhile, substantial inequalities exist between rural and urban older adults in terms of welfare benefits level, access to health care, quality of care and financial resources to pay for health-care services. Using 2011–2013 panel data from the China Health and Retirement Longitudinal Study and a difference-in-differences methodology, this study examined the association between the incidence of catastrophic health expenditure (CHE) and health-related quality of life among older adults in China. To distinguish the dynamic of CHE and generate rigorous estimates, we categorised the older adults into four groups: CHE entry group, non-CHE group, CHE exit group and CHE persistent group. Overall, we found that entry into CHE was associated with poorer physical and mental health for both rural and urban older adults, but this association was more consistent and robust for physical than for mental health. Exiting CHE was found to have a weak and sporadic positive association with physical and mental health across rural and urban areas. The results suggest that financial resources and social services are needed in China to support older adults who experience CHE persistently or periodically to help improve their health outcomes.

This paper examines the role of musical engagement in later-life spiritual development and ageing. The nexus of music, spirituality and ageing has been relatively unexplored. Change of styles, means of expression and ways of engagement are among the transformation that older musicians often encounter. Based on an ethnographic study of Japanese music practitioners, the paper introduces a community music practice in which spiritual cultivation is a collective goal of musical pursuit. A case introduced in this paper suggests that music helps to develop a sense of purpose and enhance the meaning of life by instilling the feeling that people are still able to develop musically and spiritually. Some of the transformation identified in the study included changes of repertoire, the purpose of practice and the meaning of progress, all of which was characterised in the dictum of less-is-more. The paper highlights the process in which spiritual development and musical growth are linked and support positive ageing.

Little is known about the experiences of people living alone with dementia in the community and their non-resident relatives and friends who support them. In this paper, we explore their respective attitudes and approaches to the future, particularly regarding the future care and living arrangements of those living with dementia. The study is based on a qualitative secondary analysis of interviews with 24 people living alone with early-stage dementia in North Wales, United Kingdom, and one of their relatives or friends who supported them. All but four of the dyads were interviewed twice over 12 months (a total of 88 interviews). In the analysis, it was observed that several people with dementia expressed the desire to continue living at home for ‘as long as possible’. A framework approach was used to investigate this theme in more depth, drawing on concepts from the existing studies of people living with dementia and across disciplines. Similarities and differences in the future outlook and temporal orientation of the participants were identified. The results support previous research suggesting that the future outlook of people living with early-stage dementia can be interpreted in part as a response to their situation and a way of coping with the threats that it is perceived to present, and not just an impaired view of time. Priorities for future research are highlighted in the discussion.

This article looks at how retirement timing is changing in Italy. A first aim is descriptive and it is to identify recent trends in retirement age, following the pension reform. Then the focus is on factors which may favour or hinder the extension of the working career of older workers. They are studied by looking at the reasons for retirement, introducing the distinction between voluntary and involuntary retirement, and some predictors of retirement. Some of them relate to the work history of individuals, in particular the stability/instability of careers due to episodes of unemployment. The level of education and gender, two variables that may affect the employability of older workers, have also been considered. The study is based on a longitudinal analysis (Kaplan–Meier survival estimates of transition to retirement and binomial logit discrete-time model for the analysis of retirement predictors) of the Survey of Health, Ageing and Retirement in Europe (SHARE) Job Episodes Panel data. They refer to a sample of 1,999 individuals born between 1911 and 1959. Although the various pension reforms initiated in Italy in the 1990s have not yet been fully implemented, retirement age is rising, even in the case of involuntary retirement. Regarding work history, the advantages of a working career with a small number of unemployment episodes emerge from the study.

This article compares treatment of the elderly today and in the mid-nineteenth century. The starting point is David Thomson's recent claim (Ageing and Society, 4, 1984) that welfare-state pension benefits are not as valuable, relative to the incomes of non-pensioners, as were the poor-law pensions of Dickensian England. Thomson's calculations of incomes and of the value and availability of pensions in the mid-nineteenth century are critically reassessed. It is argued that welfare-state pensions are superior to poor-law pensions not only in absolute terms but also as a proportion of average working-class incomes. The paper concludes with some comments on long-term trends in pensioners' living standards and the implications for pension policy.

Retirement villages are an increasingly popular senior housing option that aims to comprehensively integrate accommodation, care services, social activities and interaction opportunities for ageing people. The research literature about retirement villages and communities is extensive, but less studied are the contextually varying spatial, legal and political processes of how such villages and other intermediate housing-with-care solutions for older people are initially constituted, especially in novel national and local contexts. In this paper, a spatio-legal approach is employed to study the many legal possibilities and barriers that have arisen while developing retirement villages in Finland. As a specific case, I examine the new Finnish Virkkulankylä retirement village concept and its implementation process. As the key result of my study, I identify three major spatio-legal barriers to developing retirement villages and other intermediate senior housing solutions, which are (a) the polarised division between the fields of elderly care and housing in both law and practice, (b) the prevalence of ‘local law’ in spatial planning and service provision for elderly people, and (c) the inflexible funding system regarding alternative housing-with-care solutions for seniors. I argue that although the ‘in-betweenness’ of retirement villages may facilitate a more comprehensive understanding about the housing and care of older adults, in practice their intermediary position translates into many ambiguities and challenges.

Social engagement has powerful effects on wellbeing, but variation in individual engagement throughout the lifecourse is wide. The trajectories may differ by gender and be affected by socio-economic status (SES). However, long-term development of social engagement is little studied and the effect of childhood SES on later-life social engagement remains obscure. We aimed to describe the social engagement development from childhood to middle age by gender and test the effect of childhood SES on middle age social engagement. Data (N=16,440, 51.3% male) are drawn from the on-going National Child Development Study, following British babies born in 1958. Social engagement was measured by social activities, voluntary work and social contacts, with follow-ups at age 11, 16, 23 and 50. SES was measured by father's occupational social class and tenure status. Structural equation modelling suggested inter-individual stability in social engagement, showing that development of social engagement started in childhood and increased social engagement in middle age through adolescence and early adulthood. Longitudinal effects were detected within and across the social engagement domains. Lower childhood SES was significantly related to a lower level of voluntary work and social activity in middle age, but to higher levels of social contacts. Although stability in social engagement is moderate over the lifecourse, variation within and across the different social engagement domains is shaped by differences in childhood SES.

Awareness of risk factors for loneliness is a prerequisite for preventive action. Many risk factors for loneliness have been identified. This paper focuses on two: poor health and widowhood. Preventive action by developing a satisfying social network requires time and effort and thus seems appropriate for people unexposed to risk factors, i.e. third agers and non-lonely persons. The third age is the period in old age after retirement, before people's social relationships deteriorate. This paper addresses three questions: Are older adults aware of poor health and widowhood as risk factors for loneliness? Are there differences in awareness between third and fourth agers? Are there differences in awareness between lonely and non-lonely older adults? After being introduced to four vignette persons, 920 respondents from the Longitudinal Aging Study Amsterdam were asked whether they expected these persons to be lonely. Older adults, especially third agers, expected peers exposed to the risk factors to be lonely more often than peers who were unexposed. The results indicate that awareness of loneliness-provoking factors is high among third agers, which is a first step towards taking actions to avoid loneliness. Compared to lonely older adults, non-lonely ones expected peers to be lonely less often, suggesting the latter's lower awareness of the risk factors. The results provide evidence for policy makers and practitioners that combating loneliness might require early action.