This paper presents a structured literature review that focused on comprehensive case management by nurses for adults with long-term conditions living in the community. The emphases of the review are the implementation of case-management approaches, including its roles, core tasks and components, and the coverage and quality of the reported implementation data. Twenty-nine studies were included: the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. On the basis of the reviewed evidence, three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice, incorporating matters relating to the continuity of care, the intensity and breadth of involvement, and control over resources. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.

This article explores recent progress in theory, research and practical applications of reminiscence. It first describes the evidence for reminiscence as a naturally occurring process, and discusses the different functions of reminiscence and their relationships with mental health and lifespan processes. Three basic types of reminiscence that relate to mental health are specified: conversations about autobiographical memories and the use of personal recollections to teach and inform others have social functions; positive functions for the self include the integration of memories into identity, recollections of past problem-solving behaviours, and the use of memories to prepare for one's own death; negative functions for the self are the use of past memories to reduce boredom, to revive bitterness, or to maintain intimacy with deceased persons. It is proposed that in interventions the three types are addressed differently: simple reminiscence stimulates social reminiscence and bonding and promotes positive feelings; life review uses the positive functions to enhance personal wellbeing; and life-review therapy seeks to reduce the negative uses and thereby alleviate symptoms of mental illness. Studies of the effectiveness of interventions have provided some evidence that interventions are effective in relation to their goals. The review closes with recommended directions for future reminiscence research.

Over the past 50 years, self-neglect among older people has been conceptualised in both social policy and the academy as a social problem which is defined in relation to medical illness and requires professional intervention. Few authors, however, have analysed the concept of self-neglect in relation to critical sociological theory. This is problematic because professional judgements, which provide the impetus for intervention, are inherently influenced by the social and cultural context. The purpose of this article is to use critical theory as a framework for interpreting the findings from a qualitative study which explored judgements in relation to older people in situations of self-neglect made by professionals. Two types of data were collected. There were 125 hours of observations at meetings and home assessments conducted by professionals associated with the Community Options Programme in Sydney, Australia, and 18 professionals who worked with self-neglecting older people in the community gave in-depth qualitative interviews. The findings show that professional judgements of self-neglect focus on risk and capacity, and that these perceptions influence when and how interventions occur. The assumptions upon which professional judgements are based are then further analysed in relation to critical theory.

People with dementia are finding increasingly creative and diverse ways of making their voice heard in society and one such method is through the publication of autobiographical accounts. Following set inclusion criteria, this meta-ethnographic analysis compares and contrasts the contents of 12 books written by people with dementia and published between 1989 (the year of publication of the first text) and the end of 2007 (the selected cut-off point for inclusion). Of the 12 books, three authors were published twice, five were male, eight were from the United States of America, one was Australian and all nine had a professional background. Eight of the authors had Alzheimer's disease and one had fronto-temporal dementia. The average age of the narrator was 51.5 years (age range 38–61 years). Meta-ethnographic analysis of the 12 books inductively generated five themes that linked each story and these were: (a) awareness of change; (b) experiencing loss; (c) standing up and bearing witness; (d) sustaining continuity; and (e) liberation and death. The importance of reconstructing identity appeared a pivotal process in living with the onset and progression of dementia together with maintaining key social relationships and networks.

Making it possible for people with Alzheimer's disease to retain a sense of identity during the process of the disease poses a great challenge to care-givers, professionals and family carers. The aim of this study is to elucidate the role of the view of life of people with Alzheimer's in framing their sense of identity. Is their view of life a vital aspect of their sense of identity? ‘View of life’ was interpreted as a vital aspect of sense of identity, understood as the individual's beliefs about their life history and about the attributes that characterised them. Twenty-one people with mild to moderate stages of Alzheimer's disease were interviewed about their life story. The narratives were interpreted using a phenomenological hermeneutic method. By telling their life story, the participants also narrated their view of life, i.e. their conception of reality, their central system of values and their basic emotional attitudes. By their own accounts, the origins of the narrators' central values and basic emotional attitudes were established in early life. They also expressed a sense of meaningfulness and continuity when looking back on their lives. The findings suggest that for a care-giver or confidant, having knowledge of a person with dementia's view of life is valuable when seeking to confirm that person's sense of identity.

This paper presents a case study of the challenges and requirements associated with harmonising data from two independently-conceived datasets from The Netherlands and the United Kingdom: the Longitudinal Aging Study Amsterdam (LASA) and the Nottingham Longitudinal Study of Activity and Ageing (NLSAA). The objectives were to create equivalent samples and variables, and to identify the methodological differences that affect the comparability of the samples. Data are available from the two studies' 1992–93 surveys for respondents born during 1908–20, and the common data set had 1,768 records and enabled the creation of 26 harmonised variables in the following domains: demographic composition and personal finances, physical health, mental health and loneliness, contacts with health services, physical activity, religious attendance and pet ownership. The ways in which the methodological differences between the two studies and their different selective attrition might lead to sample differences were carefully considered. It was concluded that the challenges of conducting cross-national comparative research using independent datasets include differences in sampling, study design, measurement instruments, response rates and selective attrition. To reach conclusions from any comparative study about substantive socio-cultural differences, these challenges must first be identified and addressed.

Dementia is one of the greatest contemporary health and social care challenges, and novel approaches to the care of its sufferers are needed. New information and communication technologies (ICT) have the potential to assist those caring for people with dementia, through access to networked information and support, tracking and surveillance. This article reports the views about such new technologies of 34 carers of people with dementia. We also held a group discussion with nine carers for respondent validation. The carers' actual use of new ICT was limited, although they thought a gradual increase in the use of networked technology in dementia care was inevitable but would bypass some carers who saw themselves as too old. Carers expressed a general enthusiasm for the benefits of ICT, but usually not for themselves, and they identified several key challenges including: establishing an appropriate balance between, on the one hand, privacy and autonomy and, on the other: maximising safety; establishing responsibility for and ownership of the equipment and who bears the costs; the possibility that technological help would mean a loss of valued personal contact; and the possibility that technology would substitute for existing services rather than be complementary. For carers and dementia sufferers to be supported, the expanding use of these technologies should be accompanied by intensive debate of the associated issues.

Concerns about the economic impact of an ageing population have triggered many developed countries to advance policies that attempt to extend working lives and discourage early retirement. There is considerable evidence of a relationship between poor health and early retirement, but some researchers have suggested that there is a ‘justification bias’ in claims that ill-health is the cause of retirement. This paper reports a longitudinal qualitative study that interviewed 60 New Zealanders aged between 55 and 70 years on two occasions, and analysed their explanations of health-related retirement decisions. Although the participants' explanations included poor health as an important reason for retirement, two additional health-related retirement pathways were identified: the ‘maximisation of life’, being decisions to retire whilst healthy to fulfil other life goals; and ‘health protection’, being decisions motivated by health protection and promotion. These health pathways interacted with other factors such as financial security. An elucidation of these motivations pays particular attention to the social and discursive context of explanations of retirement, and considers the three identified health-retirement pathways in relation to the sickness justification bias and current government policies to extend working lives.

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

The British welfare state is over 60 years old. Those who were born, grew up and who are now growing old within its ambit are a distinctive generation. They have enjoyed healthier childhoods with better education than previous populations living in Britain. That they have done well under the welfare state is accepted, but some critics have argued that these advantages are at the expense of younger cohorts. The very success of this ‘welfare generation’ is perceived as undermining the future viability of the welfare state, and some argue that the current levels of income and wealth enjoyed by older cohorts can only be sustained by cutbacks in entitlements for younger cohorts. This will lead to a growing ‘generational fracture’ over welfare policy. This paper challenges this position, arguing that both younger and older groups find themselves working out their circumstances in conditions determined more by the contingencies of the market than by social policy.