In recent years, various authorities launched projects that aim to make their cities more age-friendly. Designing age-friendly cities is a complex and context-dependent process that requires clear implementation guidelines for policy makers. As one of the eight domains of age-friendly cities, transportation is a critical component of making our cities more liveable for older adults and their families. This paper contributes to the literature by exploring the travel behaviour of older adults with a focus on the factors that lead to sustainable mobility patterns. Our empirical analysis is based on survey data collected from 1,221 older adults as part of the Age-Friendly Columbus project in Columbus, Ohio in the United States of America. We develop multinomial logistic regression models to investigate the travel mode choices of older adults (auto only, non-auto options only and multimodal (auto and at least one non-auto option)). We include age and built environment characteristics as the key variables, with lifestyle-related factors and socio-demographics as controls in our analysis. We find older respondents were more likely to use autos only compared to younger respondents. Our analysis also reveals significant associations between built environment characteristics and travel mode choices. Interaction effects show that the relationships between built environment characteristics and travel preferences differed by age cohorts among older individuals. The primary contribution of this study is that it provides evidence on what built environmental improvements help to promote sustainable travel among older adults in mid-sized and auto-dependent metropolitan cities. We argue that these improvements contribute to older adults' sustainable mobility, as well as out-of-home activity behaviour, social engagement and individual health. The results of this study may especially benefit non-driver older adults who lack reliable non-auto alternatives for their daily travel.

Focusing on Swedish home care for older people, this article explores the discursive (re)production of home care as an institution. Equality and universal service provision have been described as defining features of the Nordic care regime. At the same time, Nordic research has highlighted a shift in social care policy, from a focus on universalism and egalitarian ideals towards a focus on freedom of choice, diversity and individualised services. This article takes as a starting point that home care for older people is formed by different and potentially conflicting ideas. We understand home care as a contested formation and define institutional change in terms of ongoing discursive struggles. The analysis draws on qualitative semi-structured interviews with key informants, including politicians, local authority officials and representatives of interest organisations. Informants were engaged in policy making, implementation or advocacy related to care for older people. We examine the meanings attached to home care for older people and the analysis reveals three different discourses – on choice, needs and equality. By comparing and contrasting discourses, we reveal silences, conflicts and tensions, and highlight the politics involved in (re)creating home care as an institution.

This research extends the study of social network analysis and labelling theory into the context of adult residential care facilities (ARCFs). Network density, reciprocity, and intensity are hypothesized to explain who labels the frail elderly ‘out of place’ in their homes and refers them to an adult residential care facility. Using data from interviews with 81 new, elderly ARCF residents and 75 of their closest others, logistic regression analyses indicate that network intensity is related to the differential involvement of professionals and informal network members in the ARCF entry process. Findings suggest further research on the networks of the elderly's relatives may explain the role of density in ARCF labelling and referral. Practice implications incorporating a network strategy are addressed.

In response to recent community care policies in Britain, co-ordinated, needs-led models of care have been introduced into day care services for older people. Whilst their introduction has prompted detailed consideration of the changes required in the organisation and management of these services, less attention has been paid to their implications for the design of day care premises. Yet design factors impinge on all aspects of service delivery and any shortcomings in design may undermine the effective delivery of new models of care. This article uses findings from recent research to explore how design factors may facilitate or constrain service delivery, focusing on two aspects of the new models of care – that services should meet the needs of individual users and be locally-based.

The life expectancy of people with Down syndrome (DS) has increased significantly over the last few decades. Consequently, they and their families face new ageing-related challenges, the first signs of which appear in people with DS around the age of 30. The goal of this study was to explore the perceptions of adults with DS regarding their own and their parents’ ageing and end of life, and to examine the views and concerns of the parents regarding the ageing of their children with DS. The unique approach used in our study was to convene not only the ageing people with DS but also their parents, to discuss the subject together. A total of 33 people with DS participated in the study. Most of them were interviewed with one or two parents. Participants with DS found it difficult to talk about their own old age and addressed the issue mainly through the decline in the functioning of an older person they knew. The parents emphasised the changes needed in terms of the official regulations, so as to ensure that their children with DS age with dignity and quality of life. Our study identifies the increasingly pressing need to prepare adults with DS for their own and their parents’ ageing and end of life in a timely manner.

Older adults consistently report young subjective age and provide high ratings of their subjective health. The current research examined which social comparisons older adults make when they assess their subjective age and health, as well as the effects of experimentally manipulated social comparisons on these assessments. In Study 1, 146 participants (aged 60 and over) reported to whom they compared themselves when assessing their subjective age or health. In Study 2, 100 participants (aged 60 and over) reported their subjective age and health after receiving feedback that compared them to younger adults or to their peers. Study 1 shows that participants compared themselves primarily to their peer group. Yet, individuals who selected a younger comparison group when assessing subjective age reported a younger subjective age, better self-rated health and more positive expectations regarding ageing relative to those who selected their peers as a comparison group. No equivalent differences emerged in any of the measures when participants were divided by their selection of comparison group after providing their self-rated health ratings. In Study 2, feedback that emphasised the performance of younger people led to reports of younger subjective age relative to feedback that emphasised peer performance, with no equivalent difference for self-rated health. These findings help explain why older adults feel younger and healthier than they actually are. We suggest that older adults use social comparisons as a strategy that protects them from the negative effects of ageing on self-perception.

Respite services have traditionally been viewed as services for carers mainly. Perhaps as a result, the perspectives of people with dementia have been largely ignored. In this study, we consider these perspectives in relation to day and respite services, and contextualise them in light of Kitwood's prediction that person-centred care would be adopted only superficially by such services. Convenience sampling was employed and semi-structured interviews were conducted with six community-dwelling people with dementia. A thematic analysis was conducted and four themes were identified: ‘acceptability of service characteristics’, ‘meaningful engagement’, ‘personhood’ and ‘narrative citizenship’. The findings suggest that day services were more acceptable than residential respite, though some people would prefer home-based models, if available. ‘Meaningful’ engagement must be individually defined; however purposeful and reciprocal activity was commonly invoked as meaningful. ‘Personhood’ and ‘narrative citizenship’ were quintessential markers of quality care; while some people experienced personhood being bestowed upon them, others reported distinct instances of malignant social psychology, discrimination and stigma. In conclusion, an implementation gap may still persist regarding person-centred care in some respite services, based on the perspectives of people with dementia. Delivering the vision for care outlined here would require greater flexibility in service provision, more resources and more one-on-one staff–client time. The fundamental shift in thinking required by some staff relies on us supporting them to develop a greater self- and shared cultural-awareness around dementia.

It is well established that carriers of the apolipoprotein E (APOE) ε4 allele run a greater risk of developing Alzheimer's disease, the most common form of dementia and a strongly age-related condition known to disproportionally affect women. Low educational attainment also stands out as a prominent risk factor, and it has been suggested that occupational class plays a similar role in disease susceptibility. Not yet fully explored, however, is the question of whether socio-economic status (SES) could moderate the effect of APOE ε4. In the present paper, we address this issue. As substantial inequities in workforce participation and educational opportunities have existed between men and women in previous generations, we further examine whether SES-related moderations of the relationship between dementia and APOE ε4 are sex-specific. Our analyses are based on a sample of 580 individuals from the H70 Birth Cohort Study and the Prospective Population Study on Women in Gothenburg, Sweden. Data were analysed using Cox proportional hazards regression, and the results suggest that while high SES postpones dementia onset among male APOE ε4 carriers, this is not the case for women. These findings underscore the long-term impact of social inequity on health as well as the importance of considering potential interactions between social and genetic risk factors if we are to understand better the complex aetiology of dementia.

Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our systematic review was to provide an analysis of existing mechanisms and measures for evaluating fall risk in older adults. The 43 included FRATs produced a total of 493 FRAT items which, when linked to the ICF, resulted in a total of 952 ICF codes. The ICF domain with the most used codes was body function, with 381 of the 952 codes used (40%), followed by activities and participation with 273 codes (28%), body structure with 238 codes (25%) and, lastly, environmental and personal factors with only 60 codes (7%). This review highlights the fact that current FRATs focus on the body, neglecting environmental and personal factors and, to a lesser extent, activities and participation. This over-reliance on the body as the point of failure in fall risk assessment clearly highlights the need for gathering qualitative data, such as from focus group discussions with older adults, to capture the perspectives and views of the older adults themselves about the factors that increase their risk of falling and comparing these perspectives to the data gathered from published FRATs as described in this review.

The authors use Structural Equation Modelling techniques to analyse the determinants of wellbeing amongst older adults using data from the first wave of the Irish Longitudinal Study on Ageing (TILDA), a rich source of data on people aged over 50 and living in private households. The analysis uses a two-group linear statistical model to explore the influence of socio-economic position on the wellbeing of men and women, with Full Information Maximum Likelihood estimation to handle missing data. The fit indices for the final model are highly satisfactory and the measurement structure is invariant by gender and age. The results indicate that socio-economic position has a significant direct influence on wellbeing and a strong indirect influence which is mediated by health status and lifestyle. The total standardised effect of Socio-economic Position on Socio-emotional Wellbeing is statistically significant (p ⩽ 0.05) and equal to 0.32 (men) and 0.43 (women), a very strong influence which risks being underestimated in standard multivariate models. The authors conclude that health, cognitive functioning and wellbeing reflect not just the ageing process, but also the impact of social inequalities across the lifecourse and how they are transmitted across different life spheres. These results can help to orient future research on factors which mediate between socio-economic position and wellbeing, an important policy-related issue.

The availability of informal care will remain a key factor influencing future demand for formal services and the analysis cannot be dissociated from formal care. Based on the ‘unpaid care work–paid work–paid care work circle’, proposed by the International Labour Office, this paper focuses on the individual, interpersonal and organisational determinants that most influence quality care. This paper is based on 40 semi-structured interviews with care workers, in 16 Portuguese care homes, in one council in the metropolitan area of Lisbon. In spite of social change processes in the care worker profession in Portuguese nursing homes, in the last decade, in terms of numbers, age and education, the interviews allowed me to unveil qualitatively what the numbers hid: precarious working conditions, insufficient staffing, excessive workloads and long working hours, high rotation and insufficient skills. All these determinants have consequences not only on the quality of the care that these care workers can offer, but also on their physical and mental health, job satisfaction and work environment. The high demand of care needs due to the ageing of the population, calls for continued efforts in improving working conditions, and a national strategy to promote recruitment of a diverse, younger and more-qualified workforce. The professionalisation of care work must be integrated with migration and employment policies (improvement of job quality and working conditions).

Older individuals who are in poor health or who lack spousal support are in many ways vulnerable in contemporary China. Declines in family size, combined with improvements in life expectancy and the out-migration of young adults from rural areas, have reduced the pool of potential care-givers for a growing number of older individuals. At the same time, state support for elderly people remains inadequate, further emphasising families’ role in care provision. This paper uses couple-level panel data from the 2012, 2014 and 2016 China Family Panel Studies to examine whether older couples with health-care or other needs receive help in the form of intergenerational co-residence. Multinomial logistic regressions are used to examine factors associated with the intergenerational solidarity framework from the older parents’ perspective that could motivate co-residence. Results show that when mothers report activity limitations or poor word recall at baseline, or when at least one parent has activity limitations in both waves, the probability of co-residence in both waves increases. Further, when both parents have depression at baseline, or when a parent loses a spouse, the probability of transitioning to co-residence increases. Findings suggest that adult children in present-day China do respond to parental needs by living together. Nevertheless, going forward, the state will likely have to play a greater role in old-age care provision.

Personal development through the lifespan takes place in the context of the family, which is itself changing over time. Change occurs at three different levels – the institution of the family, dyadic relationships within it, the developing individual. Change at different levels and affecting different individuals is sometimes coordinated but often unsynchronised, with consequences for family members' sense of control and well-being. Using autobiographical material from the Mass-Observation Archive it is possible to examine a range of subjective experience, some of it illuminating themes in the literature of social gerontology, some of it prompting new lines of enquiry. The use of autobiographical material is justified by its richness and capacity to illustrate the uniqueness of experience. The case study method is appropriate for the study of sensitive issues, ambiguous concepts and uncharted areas of experience.

Previous research finds that members of the working class have a higher risk of early retirement compared to professionals because they are pushed into early retirement. This indicates that not all workers can respond to incentives to extend their working life. Yet, little previous work has been conducted to quantify systematically the extent to which push factors explain why members of the working class have a higher risk of early retirement compared to professionals. Using longitudinal data on Danish workers, the results suggest that members of the working class have an increased risk of early retirement compared to professionals, but poor health, previous spells of unemployment and low job quality mediate a large part of this effect. Among men, the push factors mediate 57 and 86 per cent of the effect of social class on early retirement for skilled manual and unskilled manual workers, respectively. Among women, the push factors mediate 43 and 55 per cent of the effect of social class on early retirement for skilled manual and unskilled manual workers, respectively. Overly physical work demands is the most important mediator, which explains between 23 and 31 per cent of the total effect of belonging to the working class on early retirement. Moreover, the magnitudes of the indirect effects of the push factors depend on the particular pathway into retirement.

A notable feature of most recent policy statements regarding care of the elderly is a reference to the costs of care. Public expenditure cuts at a time when the numbers of old people, and dependent old people, are increasing have heightened the already growing concern about the resources needed for providing care. This paper has two basic aims. The subsidiary aim is to examine this growing concern, with particular reference to the British experience since 1948 and with an especial focus on residential care services. This examination provides an historical and contextual basis for the discussion which is the principle aim of the paper. This aim is to explain how information on costs which is currently available to the policy maker and care provider can be gainfully employed in the planning of care services for the elderly. Again, attention is mainly focussed on residential care, but the approach has more general relevance. The starting point for this discussion is an examination of why costs vary – either between homes or between areas or between providers. A fairly comprehensive review of previous costs studies in this area is provided.

This paper explores the challenges that female elder carers in the United Kingdom face in combining paid work with elder care, and the implications of this care for their current and future working lives. In-depth interviews with 11 working women from a large organisation were conducted, and five of the women were re-interviewed after a period of one year to examine any changes in their situation. The interviews revealed the precarious nature of their daily schedules, which required constant effort to maintain, the intrusion of elder care into their working lives, and the impact it had upon their career development and future aspirations. The findings provide insight into the reasons why carers, especially women, are more likely to reduce their working hours, do not take advantage of training opportunities and retire early. The findings are discussed in relation to the expectation of an extended working age and gender equality.

Alex Marsh and Moyra Riseborough, Making Ends Meet: Older People, Housing Association Costs and the Affordability of Rented Housing, National Federation of Housing Associations, London, 1995, 93 pp., no price, ISBN 0 862 97307 4.

Anthea Tinker, Fay Wright and Hannah Zeilig, Difficult to Let Sheltered Housing, Her Majesty's Stationery Office, London, 1995, 174 pp., £17.50, ISBN 0 113 21964 4.

Moyra Riseborough (ed.), Opening-up the Resources of Sheltered Housing to the Wider Community, Anchor Studies 3, Anchor Housing Association, Oxford, 1995, 32 pp., £7.50, ISBN 0 906 17827 4.

Bill Randall, Staying Put: The Best Move I'll Never Make, Anchor Housing Association, Oxford, 1995, unpaginated, £5.99, ISBN 0 906 17829 0.

For the last twenty years sheltered housing has dominated debates about housing and old age in Britain. There have recently been signs that its pre-eminent position may be threatened by the wider agenda stimulated by the community care reforms. But just when we thought the whole debate had run out of steam, back comes sheltered housing to dominate the policy debate and to re-capture the attention of housing officers. The nature of the debate now differs: gone are the heated discussions over whether sheltered housing is the answer to all our problems; rather, the key question is what to do with the increasing number of ‘difficult-to-let’ sheltered housing flats. Does this mean that the sceptics (including myself) were right all along and that sheltered housing really was ill-thought out and over-provided? After all, the main defence against these charges was that it was popular. Have older people turned against it too?

As a result of the gerotranscendence process, marital satisfaction becomes especially important in old age. At the same time, researchers emphasise that the effect of seniors’ personality on their marital satisfaction depends on many mediators. The analysis of literature suggests that one such variable might be forgiveness. Thus, the aim of the present research was to investigate whether forgiveness mediates the relationship between personality traits and marital satisfaction in late adulthood. The study involved 315 participants aged 60–75. Three psychological methods were used: (a) the Marital Satisfaction Questionnaire for Older Persons; (b) the NEO-Five Factor Inventory; and (c) the Marital Offence-Specific Forgiveness Scale. The analyses that have been undertaken revealed a number of significant associations. Neuroticism was positively related to resentment-avoidance and negatively to benevolence and marital satisfaction, whereas extraversion, agreeableness and conscientiousness were negatively correlated with resentment and positively with benevolence and satisfaction. The results also showed that both dimensions of dyadic forgiveness mediated the relationships between personality traits and marital satisfaction in ageing persons. They suggest that forgiveness of a spouse, when enhanced, could work as a buffer against the negative impact of neuroticism on marital happiness, as well as allowing the transfer of positive aspects of extraverted, agreeable and conscientious tendencies into marriage. Practical implications of the study for counselling older adults are recommended.

Recent public and policy interventions aim to recognise formally the contributions of family care-givers to long-term residential care in Canada, with some arguing family carers are more than visitors and should be recognised as essential care-givers. These developments call for reconsidering how family care roles are understood and operationalised. Drawing on ethnographic research conducted in three care homes in Ontario, Canada, we present an in-depth feminist rhetorical analysis of the narrated lives and work practices of 12 unpaid family carers. Specifically, we explore how unpaid family carers themselves draw on broader discursive ‘ruling metaphors’ to interpret their roles and activities (e.g. as essential care-givers, visitors, team members), and how these metaphors invoke, organise and/or give rise to particular practices, responsibilities and relations. We contrast the stories of a family member who positioned herself as an essential care-giver and expressed a more onerous sense of individual responsibility with the stories of people who enjoyed the pleasures of visiting, who contributed as team members in ways that went beyond caring for their own relatives' care needs, and who embraced the possibilities that came with volunteering and with being able to influence change. Our analysis situates and contextualises participants' stories of their involvement and unpaid work in relation to their everyday material conditions and circumstances. We elaborate how different ways of understanding caring roles shape the nature of carers' unpaid work, as well as their options to share responsibility or set limits on that work. We also raise questions about the organisational conditions needed to help enact care as a shared collective responsibility.

With the increase in personal mobility and improvements in living standards, seasonal mobility for health reasons is a well-observed phenomenon among retired people worldwide. Existing studies have shown that there are relationships between seasonal retirement mobility and wellbeing, and this study attempts to explore the effects of gender on these relationships. The framework of therapeutic mobility, which includes daily activities, sociality and context, was used to analyse this relationship. Qualitative methods including semi-structured interviews, non-participatory observation and mobile ethnography were used to collect data. This study finds that female seasonal senior migrants in Sanya have more abundant and meaningful daily activities and receive more emotional supports, and as a result, gain more benefits than males, and that these differences are related to their gender roles. Furthermore, while gender itself cannot explain all the differences, it works within the intersection of economic condition, age and family support. This study has enriched the literature on therapeutic mobility and has practical implications.