Understanding predictors of successful ageing is essential to policy development promoting quality-of-life of an ageing population. Initial models precluded successful ageing in the presence of chronic disease/functional disability; however, this is discrepant with self-reported successful ageing. Indicators of social, psychological and physical health in 1,735 people aged 65–74, living in Canada, Columbia, Brazil or Albania, were analysed in the International Mobility in Ageing Study. Multiple logistic regression analysis was performed to estimate the change in self-rated successful ageing in relation to physical health, depression, social connectedness, resilience and site, while controlling for age, gender and income sufficiency. Sixty-five per cent of participants self-rated as ageing successfully; however, this was significantly different across sites (p < 0.0005, range 17–85%) and gender (p = 0.019). Using objective measures, 6 per cent were classified as ‘successful’, with significant variability amongst sites (p < 0.0005, range 0–12%). Subjective successful ageing was associated with fewer (not absence of) chronic diseases, absence of depression and less dysfunction in activities of daily living, but not with objective measures of physical dysfunction. Social connectedness and resilience also aligned with self-rated successful ageing. Traditional definitions of objective successful ageing are likely too restrictive, and thus, do not approximate self-rated successful ageing. International differences suggest that site could be a surrogate for variables other than physical/mental health and social engagement.

With the predicted growth in the number of people with dementia living at home across the globe, the need for home-based care is expected to increase. As such, it will be primarily family carers who will provide this crucial support to family members. Designing appropriate support for family carers is thus essential to minimise risks to their health, to prevent premature institutionalisation or poor care for persons with dementia, as well as to sustain the effective functioning of health and social care systems. To date, the high volume of research related to care at home and acknowledged low impact of interventions suggests that a re-examination of the nature of care at home, and how we come to know about it, is necessary if we are to advance strategies that will contribute to better outcomes for families. This paper describes findings from an ethnographic study that was designed to support an analysis of the complexity and materiality of family care arrangements – that is, the significance of the actual physical, technological and institutional elements shaping care-giving situations. In this paper, we describe the arrangements made by one family to show the necessary collectivity of these arrangements, and the consequences of the formal care system's failure to respond to these.

In the transition to democracy and a market economy, the Central and Eastern European countries experienced rapid and fundamental changes. Large-scale emigration flows and pronounced reductions in previously universal welfare systems increased the phenomenon of ‘left behind’ older adults. We examine this phenomenon in the case of Poland, a rather family-oriented society which in recent years sent most emigrants to Western Europe in absolute terms. Employing a support system framework and representative survey data, we enquire into older adults’ support patterns. Our results suggest that older adults in Poland rely predominantly on family support, although this varies greatly across living arrangements. We also find a positive association between distance separating parents and their closest child, and support from at least one non-kin. Yet, our findings reveal differences between practical and emotional support, with the latter being more likely to be provided by non-kin, but with distance mattering to a lesser degree. Parents with very distant child(ren) are few and differ only from parents with very proximate child(ren), a finding prompting the question as to what is the difference between being ‘left behind’ by international and by internal migration. We conclude that the phenomenon of ‘left behind’ in Poland, at least in terms of support, is less a matter of children's migration and more an issue of household and regional context.

To cope with an increased proportion of older workers, organisations develop old-age adaptation policies. Two strategies underlie these policies: phasing out and activating. Although the existence of these strategies is widely recognised, the reasons for their presence have rarely been explored. We identify three arguments that explain the extent to which these strategies are present: profit, principles and pressures. We hypothesise that the intensity of the phasing out strategy is higher when it is profitable and easy to replace older workers, when employer's age norms support the principle of treating older workers differently, and when external pressures are high. We also hypothesise that the intensity of the activating strategy is higher when it is profitable but hard to replace older workers, when the employer's age norms reject the principle of treating older workers differently, and when external pressures are high. We use pooled regression analysis to study imputed managerial data from 5,410 organisations in seven European countries. Results confirm the importance of external pressures for the adaptation of both strategies, and of principles for activating. Although policy feasibility is important for the adaption of both strategies, the other profit variables showed mixed results. Net benefits of older workers to the organisation are only important for phasing out, and substitutability only for activating. This paper discusses the wider implications of the study.

Understanding the nature and extent of unmet need for social care among older people is a critical policy priority in the United Kingdom and beyond, as national governments juggle the provision of adequate social care for a growing older population with competing funding priorities. Several factors can heighten the experience of unmet need among older people, for instance their family environment, and their health and socio-economic status. This paper contributes empirical evidence on the patterns of unmet need for social care among older people in England today, focusing on the individual characteristics associated with experiencing unmet need in relation to mobility tasks, activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The results show that about 55 per cent of older individuals with an ADL difficulty had unmet need, compared to 24 per cent of those with an IADL difficulty and 80 per cent of those with a mobility difficulty. Characteristics reflecting greater vulnerability were more strongly associated with the risk of experiencing unmet need for ADLs, and such vulnerability was greater for particular ADLs (e.g. bathing), and for a higher number of ADLs. The findings reaffirm the complexity of conceptualising and empirically investigating unmet need in later life, and add to our understanding of the challenges of providing adequate and appropriate social care to older people.

Baby boomers who rent are often overlooked as an important sub-group. We aimed to assess the chronic conditions, risk factors, socio-economic factors and other health-related factors associated with renting in private or public housing. Data from telephone interviews conducted each month in South Australia between 2010 and 2015 were combined. Prevalence estimates were assessed for each risk factor and chronic condition by housing status. The association between housing status and variables of interest were analysed using logistic regression models adjusting for multiple covariates (age, gender, income, smoking, physical activity, area and year of data collection). Overall, 17.4 per cent of the 16,687 baby boomers interviewed were renting, either privately or using government-subsided housing. The health profile of renters (both private and public) was poorer overall, with renters more likely to have all of the chronic conditions and ten risk factors assessed. For public renters the relationships were maintained even after controlling for socio-economic and risk factor variables for all chronic diseases except osteoporosis. This research has provided empirical evidence of the considerable differences in health, socio-economic indicators and risk factors between baby boomers who rent and those who own, or are buying, their own homes.

Innovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family care-givers, and health and social care professionals. Thematic analysis identified four themes: synchronicity between the physical and the psychological in frailty, living with frailty in the social world, the need for a new kind of care, and screening for and preventing frailty. Findings emphasised the need for a holistic approach to frailty care and early intervention. Integrated care services and advocacy were important in the organisation of care. Central to all stakeholders was the significance of the psychological and social alongside the physical elements of frailty and frailty prevention. Support and care for older adults and their family care-givers needs to be accessible and co-ordinated. Interventions to prevent frailty must encompass a social dimension to help older adults maintain a sense of self while building physical and psychological resilience.

This study investigates the relationship between the provision of informal care to older parents/parents-in-law and the employment status of adult children in mid-life. The study analyses unique panel data for a cohort of individuals born in 1958 in Britain, focusing on respondents at risk of providing care (i.e. with at least one surviving parent/parent-in-law) and in employment at 50. Logistic regression is used to investigate the impact of caring at 50 and 55 on employment status at 55, controlling for socio-demographic characteristics, the respondent's health status and their partner's employment status. Separate models examine (a) the likelihood of exiting the labour force versus continuing work, and (b) amongst those continuing in work, the likelihood of reducing hours of employment. Different types of care (personal, basic and instrumental support) are distinguished, along with hours of caring. The results highlight that providing care for more personal tasks, and for a higher number of hours, are associated with exiting employment for both men and women carers. In contrast, the negative impact of more intense care-giving on reducing working hours was significant only for men – suggesting that women may juggle intensive care commitments alongside work or leave work altogether. Facilitating women and men to combine paid work and parental care in mid-life will be increasingly important in the context of rising longevity.

Social exclusion is a dynamic multi-dimensional process that is interactive in nature. The complex interplay between domains, whereby each domain can act as a determinant, indicator and/or outcome of social exclusion, hinders understanding of the process and the mechanisms through which social exclusion exists. This article highlights the need to disentangle these pathways and move beyond descriptive accounts of social exclusion, presenting a new working framework that allows direct hypothesis testing of these between-domain relationships. Whilst this working framework can be applied to any population, this article focuses on older adults. Life events that can drive social exclusion such as bereavement and changes in health are more likely to occur in later life, and occur more frequently, increasing the risk of social exclusion for this population. Rooted in the new working framework, this article presents the construction of later life social exclusion measures for use with Understanding Society – the United Kingdom Household Longitudinal Study. The validity of these measures are considered by examining the characteristics of those aged 65 years and over who score the highest, and therefore experience the greatest level of exclusion. This new working framework and developed social exclusion measures provide a platform from which to explore the complex relationships between domains of social exclusion and ultimately provide a clearer understanding of this intricate multi-dimensional process.

This paper contributes to understanding housing adjustments in later life by investigating the role of four key lifecourse transitions experienced by older individuals and their households, namely changes in health, retirement, union transitions and adult children leaving the household. Using data from a representative sample of the Scottish population for the decade 2001–2011, the study examines who moves and, for movers, whether they adjust their housing size in response to changes in their personal and household circumstances. In particular, the study explores diversity in housing consumption at older ages by investigating whether the triggers of upsizing or downsizing differ across tenure groups. The majority of older adults in Scotland do not change their place of residence during the study decade. For the minority who do move, all four lifecourse transitions are significant triggers for residential relocation but there is considerable diversity across the two major tenure groups in the influence of household changes on their housing consumption adjustments. In both tenure groups, however, the presence of children in the household is associated with upsizing and is a significant impediment to downsizing. Given the relative rootedness of older parents with co-resident adult children and their propensity to upsize rather than downsize if they move, our findings raise concerns over the interdependencies between younger and older generations in the housing market.

The Consumer Choice Index – Six Dimension (CCI-6D) is a new instrument designed specifically to evaluate the quality of care received in long-term care from a consumer perspective. This study aims to demonstrate the construct validity of the CCI-6D. Older residents living in long-term care facilities and proxy family carers (where severely impaired cognition precluded resident consent) participated as consumers of long-term care. Data collected included the CCI-6D instrument, quality of life, physical function and characteristics of the care facility. Relationships between these variables and the CCI-6D dimensions were assessed and analysed through chi-squared and Kruskal–Wallis tests to assess the construct validity of each dimension. Of 430 eligible consumers, a total of 253 completed the questionnaire, of whom 68 (27%) were residents and 185 (73%) were informal carer proxy participants. There was strong evidence of construct validity of the dimensions relating to adequacy of individual care time, access to outside and gardens, access to meaningful activities and flexibility of care. There was more moderate evidence of validity of the home-like own room and shared spaces items, which may be in part due to difficulty in identifying strong discriminatory variables for comparison with these items. The results also indicate a strong association between ‘processes’ of care delivery (as measured by the CCI-6D) and quality of life of care recipients.

This paper has re-analysed and compared data between three studies conducted in the United Kingdom and in Sweden (the OPUS ‘Older People's Use of Unfamiliar Space’ study in the United Kingdom and the Swedish studies ‘Let's Go for a Walk’ and ‘Walking in Old Age’) to provide a comprehensive account of the issues facing older people in the outdoor environment. All three studies draw on the ‘fit’ between the person and their environment as a guiding conceptual base – capturing the dynamics of the relationship between older people's personal needs and their wider environmental context. This common conceptual base allowed us to test theory against practice, and to explore the utility of this concept across different geographical contexts. Participatory research was also applied, highlighting the importance of the voice of older people and involving older people in research. The studies also used a mixed-method approach involving both quantitative and qualitative methods. The paper highlights that although not generalisable, you can compare cross-locales and cross-nationally using different methodology; it investigates the challenges of cross-national comparative analysis and draws on findings from the three studies to illustrate the different challenges and solutions and finally looks at lessons that are transferable.

This longitudinal study evaluated the direct effects of providing/receiving family support on mortality in older adults with different living arrangements in Taiwan. All data analysed were obtained from the Taiwan Longitudinal Study on Aging, 1996–2007, of residents aged ⩾67 years (1,492 men and 1,177 women) and Taiwan's National Death Register. Living arrangements were divided into living alone, living only with spouse, living with family and living with others. Support was mainly defined as family support divided into two categories: providing and receiving. The effect of providing/receiving family support on the mortality of older adults was evaluated using Cox regression analysed by living arrangement. Participants living with their families had lower educational levels (illiterate or elementary school) and more disability in both activities of daily living and instrumental activities of daily living. However, they provided more family support than those in other living arrangements. After adjusting for several potentially confounding variables, including background characteristics, economic status and various health status measures, results showed that older adults living with their families and providing support had an 11 per cent lower mortality rate (Hazard ratio = 0.89; 95 per cent confidence interval = 0.83–0.96; p = 0.0018). In conclusion, we found that, when living with family, the lives of older adults can be extended by providing support, clearly supporting the old adage ‘it is more blessing to give than to receive’. Older adults wanting to extend their lives can be encouraged to provide more help to their families.

The European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions about intervention facilitators, moderators and barriers were coded into two themes: working with stakeholders and project management. We concluded that EIP-AHA partners are providing interventions addressing physical, cognitive and wellbeing elements of frailty. However, there needs to be an increase in the proportion of interventions that consistently apply valid methods of screening and/or measuring frailty and pre-frailty. Most, but not all projects are targeting pre-frail older adults, suggesting an appropriate balance of prevention in a useful ‘intervention window’ but also a growing understanding that frailty at later stages is amenable to intervention. Findings suggest design manipulations to improve outcomes and adherence to interventions, specifically inclusion of a perceived benefit/reward for older adults, e.g. a social aspect or health-care promotion.

Older people living in long-term facilities (nursing and residential homes providing 24-hour care) spend the majority of their time inactive, despite the known health and wellbeing benefits of physical activity and reduced time spent sedentary. In order to successfully embed interventions that aim to increase physical activity or reduce sedentary behaviour, it is necessary to understand the features of the care environment that influence residents’ routine patterns of movement. Drawing on an organisational perspective, this paper explores the structures and mechanisms that shaped different care practices concerning residents’ movement in two contrasting care homes in the north of England. This study adopted an ethnographic approach, using a combination of qualitative observations, informal conversations and interviews. A grounded theory approach to data analysis was adopted. The findings illustrate the importance of translating espoused values of care into tangible and acceptable care practices, systems of management, staff training and development, and the use of care planning in residents’ routine patterns of movement. Understanding how organisational factors shape routine movement among care home residents will help inform the development of embedded and sustainable interventions that enhance physical activity and reduce sedentary behaviour. This study is part of a wider programme of research developing and testing a complex intervention, embedded within routine care, to reduce sedentary behaviour among care home residents.

The changing retirement landscape calls on employers to develop practices that respond to individuals’ retirement needs. Line managers are a key stakeholder in managing retirement and this study focuses on how they respond to employee retirement scenarios. This empirical work examines manager openness to involvement in retirement, focusing on three sets of explanatory variables: manager psycho-social characteristics (experience of managing older workers, intention to work past 65), their decision-making environment (influence, discretion and decision-making support) and older employee situational factors (performance, ease of replacement, retirement affect and attitude to work). Data were collected from 129 managers in the United Kingdom's university sector using survey items and a factorial vignette design. The multi-level analysis found support for each category of variables in predicting manager openness to involvement in employee retirement. Managers with more experience of managing older workers were more likely to be open to involvement although managers’ own retirement intentions were not significant as a predictor. Decision-making environment variables were significant predictors of manager openness to involvement. The only older employee situational factor that was associated with manager openness to involvement was employee performance. Practically, organisations need to recognise the potential influence that managers have on employee retirement decisions and this study's findings show that managers may need training to help them understand their own role in supporting older employee retirement.

Older persons with alcohol problems have today become an all too common part of everyday elder care, but research in this area is still scarce. This article has a Swedish context with the aim of describing and analysing home care workers’ narratives about older people who can be characterised as heavy drinkers, i.e. people with severe alcohol problems who need considerable care for extended periods. Limited knowledge is available concerning this age group. This article therefore fills a knowledge gap about home care workers’ perspective about body work and the abject, and breaches the myth that older individuals should be able to drink as they prefer and/or notions of drinking alcohol as a last enjoyment in life. The care workers talked about how they got drawn into the daily lives of the care recipients and how they ended up in situations where they, on the one hand, removed the consequences of drinking, and on the other, felt that they sustained the drinking by cleaning out dirt and washing the care recipients’ bodies.

The present study was undertaken in order to examine the differences between occupations in the Swedish labour market with respect to the risk for men and women of leaving working life prematurely. The project was carried out as a population study employing methodology used in demographics to predict life length at birth. Here, calculations of expected remaining work-life length were based on the exits from working life. The study was based on the Swedish national labour statistics, covering all employees who had an occupational definition in 2006 and who were in the age range 35–64 years during the study period 2007–2010. There was a clear socio-economic divide in exit patterns, comparing blue- and white-collar jobs. The differences between the highest and the lowest risk jobs exceeded 4.5 years among both men and women. In the blue-collar occupational groups there were 50 per cent or less ‘survivors’ still working at age 65; in many white-collar occupations there were more than 60 per cent. Men and women exited working life at the same age. Compared to a similar study carried out in 2006, the same socio-economic pattern prevails, but people now work longer in almost all occupations. Women exited working life 0.8 years earlier than men in 2006; this difference is now gone.

This article tests the fit of a social support network typology developed for collectivist cultures to six migrant populations living in England and Wales. We examine the predictive utility of the typology to identify networks most vulnerable to poor quality of life and loneliness. Variables representing network size, and the proportion of the network classified by gender, age, kin and proximity, were used in confirmatory and exploratory latent profile analysis to fit models to the data (N = 815; Black African, Black Caribbean, Indian, Pakistani, Bangladeshi and Chinese). Multinomial logistic regression examined associations between demographic variables and network types. Linear regression examined associations between network types and wellbeing outcomes. A four-profile model was selected. Multigenerational Household: Younger Family networks were most robust with lowest levels of loneliness and greatest quality of life. Restricted Non-kin networks were least robust. Multigenerational Household: Younger Family networks were most prevalent for all but the Black Caribbean migrants. The typology is able to differentiate between networks with multigenerational households and can help identify vulnerable networks. There are implications for forecasting formal services and variation in networks between cultures. The use of a culturally appropriate typology could impact on the credibility of gerontological research.

This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence.