Older people have increasingly been using the new information and communication technologies (ICTs), namely the internet. Seeking to contribute with substantive information on their digital inclusion, this paper focuses on the adoption and use of ICTs by older adults, highlighting their experiences and considering their plurality. Taking a qualitative approach, the core goal of the empirical research underlying this paper was to understand what mechanisms and modalities configure the relationship of older internet users with the new ICTs. With that objective in mind, interviews were conducted with 20 internet users over the age of 60. Those interviews, which included a biographical element, were subjected to multi-categorical analysis. Results suggest a typology of modes of relating to the new ICTs among older internet users that reflects different trajectories, practices, skills, significances and impacts. The analysis shows how life trajectories and differentiated uses are reflected in equally differentiated impacts for older adults, contributing to their quality of life in different ways and to different degrees. Digital skills play a fundamental role in enhancing or limiting those effects. The results of this research help break down the stereotypes associated with the older generations and may have relevant implications for the design of digital inclusion policies and initiatives.

Violence to elderly people in residetial institutions is well documented. In this paper both violence and resulting death are examined in the German context. A thesis is put forward that is not lack of humanity but lack of professional routine which is the main cause.

Nursing homes in the United States have for over 40-years been riddled with evidence of poor performance. To combat problems in this industry, state and federal governments developed an elaborate monitoring and regulatory structure. At the same time, an important citizens' movement involving nursing-home consumer advocacy groups (CAGs) came to life. This paper presents the results of a postal survey of 47 active nursing-home consumer advocacy groups. They indicate that the majority of these organisations were started by an individual dissatisfied with the care provided to a family member. The political arena in which these organisations were most active was State legislatures. Though they varied considerably, the average CAG operated on a thin financial margin, largely supported by member contributions and donations. These organisations defined their success in terms of their ability to generate policy changes at the State level. Unfortunately, as they pursued these changes, they often failed to develop the organisational infrastructure necessary to assure the CAGs' continued operation. When CAGs ceased operations, it was in most cases the loss of the organisation's original leader or the cumulative effects of the constant struggle to maintain adequate financial resources.

Hypertension is a major cause of premature death in China. Understanding risk factors including behavioural and predisposing factors may help to prevent development of hypertension and control the extent of premature mortality. In this case-control design conducted in Hunan province, 416 hypertensive subjects were matched with an equal number of normotensive persons from nearly 9,000 volunteers. A self-report questionnaire was employed to collect demographic and lifestyle information, and fasting serum biomarkers related to lipid profile, renal function, glucose level and uric acid were assessed. When age and sex were stratified, serum biomarkers such as blood urea nitrogen and triglycerides showed a significant difference for hypertension, while lifestyle behaviours including university degree, alcohol use, Body Mass Index and psychological stress (job and married life) were also associated with hypertension. After adjusting for covariate confounding factors, only elevated triglyceride levels were strongly linked to high blood pressure, odds ratio = 1.55, 95 per cent confidence level = 1.16–2.06. To control high blood pressure, hypertriglyceridemia should be included in hypertension treatment and followed up to assess the substantial risk of cardiovascular diseases.

This paper examines the provider side of the care-home sector and focuses on managers' and owners' motivations for providing care-home services for older people, and whether those motivations changed between 1994 and 2003. There were a number of significant policy changes over that time, including an increased ‘marketisation’ of the sector, coupled with an increase in regulation. Critics of these changes argued that they could adversely affect the motivational structure of the principal provider agents. Previously altruistic or public-service motivations might turn into more self-interested concerns: ‘knights’ might become ‘knaves’. To test this proposition, data were collected across eight English local authorities using face-to-face interviews and postal questionnaires. The results indicate that, although local care-home markets underwent some major changes, individuals' motivational profiles remained relatively stable. Further analysis of the relationship between motivations and the social-care market environment suggests that, while voluntary-sector providers are primarily driven by caring motivations and less concerned with income maximising and professional development, private-sector home manager and owners seemed to be more focused on the financial aspects of providing care services, professional motivations, and on their independence in running a care home. The policy implications of these findings are discussed.

In a southwest coast Newfoundland fishing village elderly outporters are accorded special licence to behave in ways considered inappropriate for younger generations. Capitalising on their status as folk heroes and heroines of traditional outport culture, older people challenge each other to redress old wrongs or actively create new issues for dispute. The entire family may reluctantly become involved in these imbroglios. This case study of a land feud between an elderly woman and man demonstrates how aggression is mediated by the structural confines of local sex roles and outport egalitarianism, which severely limit the potential of octogenarians' altercations to disrupt village life.

To the existing ways of categorizing elderly individuals we here add a reasonably objective approach using recent survey data and statistical methods of multivariate analysis. The groupings obtained have been surprisingly clear-cut, so that simple rules can be devised for discriminating between clusters. We suggest this analysis as a useful way of gleaning information about elderly people, information which may help in the efficient allocation of services.

The problems of introducing change in long-term care settings for elderly people are discussed in relation to social, psychological and organisational factors operating within the institution. It is argued that the poor maintenance and generalisation of many behavioural interventions is in part due to researchers adopting too narrow a framework. Four issues are discussed and illustrated: 1. The role of the researcher in relation to care staff. 2. Relationships with elderly patients. 3. Change as criticism. 4. Conflicting policies within the institution.

In this paper, we present findings from a recent national study of elderly persons in Israel which cover two related questions: I. How do spouses' characteristics and activities affect the social participation of married older men and women? 2. Is the effect of husbands' characteristics and activities on wives equivalent or symmetrical to that of wives' characteristics and activities on husbands? The study is based on analyses of data collected in the Israel Survey of Persons Aged 60 and Over in Households, 1985, a national sample survey of households conducted by the Israel Central Bureau of Statistics which included approximately 4,500 persons age 60 and over. An innovation of our study has been the design of a data file which enables us to study the activities, role incumbency, and participation of the respondents in relation to the characteristics and activities of their spouses.

We study the performance by husbands and wives of social roles designated as ‘major commitment’ roles (MCRs), in that they are roles performed in social contexts invoving commitments over time to the activity and to the social units in which they are carried out: (a) employment, (b) continued parenting involving assistance to adult children, (c) full housekeeping, and (d) volunteer activity. Characteristics and roles of the wives of older married male respondents, and of the husbands of older married female respondents in Israel, are significantly associated with the respondents' performance of the MCRs which we have identified. However, the ‘marginal effects coefficients’ based on logistic regression equations show that the relative weight of spouses' characteristics and roles is small compared with that of the respondents' own characteristics and other competing or mutually supportive roles. There are both symmetries and assymmetries in the patterns of effects of husbands' and wives' characteristics and roles on prevalences of MCRs among the older married respondents.

Critical concern with infantilisation practices—i.e. the tendency to treat older people as if they are dependent children—has for the most part concentrated on the negative associations between infantilisation and dependency in later life. Infantilisation is usually defined as an unwelcome imposition on older men and women who are often portrayed as relatively powerless to resist. Whilst the negative consequences of enforced infantilisation must not be ignored there are also occasions when infantilisation may be regarded as a voluntary or chosen mode of resistance on the part of older people to the decrements and external impositions of later life. The concept of infantilisation may therefore be enlarged to include modes of resistance involving processes of mutual identification of the old with the young; in certain instances even as a form of conspiracy between these two age groups against the wider society. This paper therefore pursues fictional images of such rapport as they occur in a selection of the ‘William’ stories written by Richmal Crompton during the period from 1919 up to her death in 1969, and with an appeal which continues up to the present day. The argument is that these stories of alliances between boyhood and ‘elders’ may be regarded as vivid examples (a repository of positive images) of what may be described as ‘positive infantilisation’: that is to say, of consciousness of the independence of subjective selfhood from the ageing body in the face of the misperceptions and misleading stereotypes of the ‘mature’ adult world.

In most Organisation for Economic Co-operation and Development (OECD) countries, the government has to manage tension between growth in the need for long-term care (LTC) services for older people and significant public budget constraints. Not surprisingly, therefore, cost-containment policies are of increasing relevance. Nevertheless, despite the flourishing interest in the comparative literature in reforms and the sustainability of LTC policies, a scoping review of these measures has so far not been produced. This article aims to contribute to filling this gap. We present a typology of LTC cost-containment policies across the OECD. Cost-containment policies cluster in two areas according to their focus: demand-side policies, which reduce the actual chances of receiving LTC services and/or make them more expensive for users; and supply-side ones, which modify the provision of services. Furthermore, an indirect outcome of the review is that it allows an overview of potential negative implications of these policies. These negative implications can be grouped in two macro spheres relating to a worsening of the care arrangements for beneficiaries and to increased demand for individual/family resources, in both economic and time and effort terms. In the light of the expected profound impacts of the COVID-19 outbreak on all social security sectors in the medium and long term, this article provides a valuable tool for both academic and policy-making debate. It allows an analytical comprehension of cost-containment strategies adopted in LTC sectors linking them with the related impacts on beneficiaries and their families.

Policies to extend working life (EWL) assume homogeneous workers face similar choices about working longer: this may be difficult for women, workers in physically onerous jobs or in low-paid precarious employment. Work-life trajectories are gendered; women interrupt employment and pension-building to provide care. There is occupational variation in capacities to prolong working lives: physically demanding jobs cause work-related health deficits. The precariously employed cannot contribute regularly to pensions and may face age discrimination. This research provides an inter-occupational and cross-national dimension to EWL research, comparing women teachers and health-care workers in the United States of America (USA) and Republic of Ireland. It documents intra-cohort distinctions that emerge among women when considering educational opportunities and occupational tracks expressed in lifecourse trajectories and accumulated capacities for extended work. Analysis draws on interview data from ten teachers and ten health-care workers in each country, comparing the implications of EWL policies for women workers: in precarious versus secure occupations and occupations with different physical demands. It reveals work-life trajectories leading to poorer financial and health outcomes for older health-care workers, especially in the USA. Most women (regardless of occupation or country) opposed extending working life, with concerns ranging from health status and ability to work to the desire to have healthy years in retirement. The most important distinctions are between the occupational categories considered, rather than cross-national differences. Implications for national and work-place policy and research are considered.

Ensuring distributive fairness in the long-term care sector is vitally important in the context of global population ageing and rising care needs. This study, part of the DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) programme, investigates socioeconomic inequality and inequity in the utilisation of long-term care for older people with and without dementia in England. The data come from three waves of the English Longitudinal Study of Ageing (ELSA, Waves 6–8, N = 16,458). We find that older people with dementia have higher levels of care needs and a lower socioeconomic status than those without dementia. The distribution of formal and informal care is strongly pro-poor. When care needs are controlled for, there is no significant inequality of formal or informal care among people with dementia, nor of informal care among people without dementia, but there is a significant pro-rich distribution of formal care among people without dementia. Unmet care needs are significantly concentrated among poorer people, both with and without dementia. We argue that the long-term care system in England plays a constructive role in promoting socioeconomic equality of long-term care for people with dementia, but support for older people with lower financial means and substantial care needs remains insufficient. Increased government support for older people is needed to break the circle between care inequality and health inequality.

Older adults benefit greatly from being physically active yet they are the least active generation. To appeal to older consumers, to reduce barriers older adults experience to becoming physically active and to increase the number of physically active older adults, the exercise market has been divided into mainstream fitness and age-segregated programming that specifically targets older adults. This research employed an institutional ethnography approach to understand better the social discourses and material practices that shape socially (in/ex)clusive physical cultures for older exercisers in both mainstream and older-adult group exercise classes. Textual analyses, interviews and field observations revealed that the material and discursive work practices intended to promote inclusivity in group exercise physical cultures actually engendered age-exclusive markets. Herein, we discuss how the guidelines and policies put forth by these certifying bodies, and the training curricula they publish, govern group exercise practices in a manner that tends to align with dominant ideological discourses conflating age and ability. We conclude by arguing that in order to create more inclusive physical cultures, mainstream fitness providers need to embrace options that appeal to potential group exercise consumers of all abilities, regardless of age.

Feelings of disconnectedness and social isolation among older adults are increasingly recognised as important challenges of our times. Interestingly, nature interaction can stimulate social connectedness and enhance perceived social support, indicating that nature can contribute to social wellbeing. However, nature may not always be around or accessible for older adults. In such cases, digital nature could provide an alternative means for enjoying nature's benefits. To identify limitations and restrictions that older adults experience with respect to nature interaction, and to explore preferences with respect to digital nature and their potential for influencing social wellbeing, two studies are reported: a qualitative study comprising focus groups with Dutch care centre residents (N = 26) and a subsequent quantitative study (N = 200) testing effects of digital landscapes on social wellbeing measures. Findings from the focus groups indicate that opportunities for nature interaction and preferences for digital nature vary with mobility restrictions, whereas findings from the quantitative study testify to the potential of digital nature for enhancing social wellbeing and related emotions. These findings extend research on how (digital) nature interventions can contribute to the social wellbeing of older adults and pinpoint essential nature characteristics important for doing so.

The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.

The lives of transgender older adults are rarely examined, and little is known about the critical life events and experiences of this population. Informed by the Iridescent Life Course, this study investigates how intersectionality, fluidity, context and power impact the life events and experiences of trans older adults by generation and gender. Utilising 2014 data from the National Health, Aging, and Sexuality/Gender Study: Aging with Pride (National Institutes of Health/National Institute on Aging funded), a national sample of LGBTQ+ individuals 50 years and older, living in the United States of America, were analysed to examine life events of 205 transgender older adults, including identity development, work, bias, kin relationships, social and community engagement, health and wellbeing. Ordinary least-squares regressions and logistics regressions are used to compare the life events between the generations then test the interaction effect of gender. Pride Generation more openly disclose their identities and are more likely to be employed and married compared to the Silenced Generation, who have more military service, higher rates of retirement, fewer same-sex marriages and more different-sex marriages. Invisible Generation, the oldest group, are more likely retired, have more children and are more likely engaged in the community compared to the Silenced Generation, who experienced more discrimination. Applying the Iridescent Life Course is instrumental in understanding older trans adults' lives through intersecting identities of both generation and gender. These insights have the potential to create a greater appreciation of how historical events shape differing generations of transgender people, creating an opportunity to link generations together.

Ageing and longevity have been central to the concerns of Western natural philosophy since their origins in Classical Greece. Greek medicine formulated the idea that the humours constituted the physiological basis of all living beings. Hippocrates identified these as blood, phlegm, black and yellow bile. Several hundred years later, Galen elaborated this Hippocratic doctrine, formulating the outlines of a theory of ageing and a regime to maintain health in old age. Formalised in Alexandria, the Galenic canon was later revised and expanded by physicians and philosophers from the Islamic world. The result was a theoretical superstructure linking together the humours, the elements (air, earth, fire and water) and the four qualities (heat, coldness, moisture and dryness) that constituted the basis of life, its development, decline and end. This ‘superstructure’ was further refined and revised during the Middle Ages, providing the theoretical basis for regimes for living well in later life that were written and published during the Renaissance. Although the ‘scientific revolution’ of the 17th century challenged Galenic medicine, many aspects of it survived into the modern period. This paper reviews the rise and demise of this tradition while also recognising that through much of this period other, more controversial approaches to the problems of ageing were espoused. In concluding, continuing points of contact with contemporary gerontological theory are emphasised.

This paper engages with a cultural politics of ‘older’. At the centre of this politics are essentialist discourses of corporeal ‘ageing’ that limit and stigmatise the subjective experience of ‘older’. Drawing together theoretical insights from Foucault's work on care of the self with data from in-depth interviews with ‘older’ people who have undergone cosmetic surgery and cosmetic surgery practitioners, this paper advances the proposition that cosmetic surgery can be re-imagined as an ethical practice of self-care. To critique the limitations imposed by ‘natural ageing’ through an ethic of ‘ageing gracefully’, the paper explores how older people who have undergone cosmetic surgery stylise the ethical experience of ‘older’ through active resistance of an ‘elderly’ identity. It argues that the practice of cosmetic surgery by ‘older’ people constitutes a cutting critique of the limits of ‘older’ and an experiment with the possibility of exceeding and ultimately transforming those limits.

As the number of older immigrants in Europe rises, dementia within minority ethnic populations warrants attention as a significant public health problem. Equitable health and care services constitute a prioritised health policy aim on both supranational and national levels in Europe and is formulated in the Norwegian health legislation. Through interviews and focus groups with older immigrants, relatives of immigrants with dementia and health personnel, we explored the perceptions of dementia among ethnically diverse groups in Norway. The findings show that many interpret symptoms such as memory loss and disorientation as a natural part of ageing. Others consider dementia symptoms to have a psycho-social origin, deriving from social isolation. Some describe symptoms as an expression of a potentially transient sign of madness, while others point to destiny and God's will, representing basic and unalterable causes. However, another pattern of perception includes viewing dementia as a potentially transient physical illness, including a belief in a medical cure. By investigating how people with dementia and their families understand and manage the condition, one may facilitate access to relevant and adapted information. Furthermore, by exploring how people relate to their illness, health personnel may challenge explanatory models that create unrealistic expectations of cure, as well as models that, due to stigma or normalisation of symptoms, prevent the use of public care.