Improving access to culturally-appropriate services and enhancing responses to the needs of older people from black and minority ethnic backgrounds were among the aims of the National Service Framework for Older People (NSFOP) that was introduced in England in 2001. Progress in meeting the aims of the NSFOP was evaluated by a mid-term independent review led by the Healthcare Commission, the body responsible for regulating health-care services in England. This paper reports the consultation with older people that underpinned the evaluation. It focuses on the views and experiences of older people from black and minority ethnic (BME) groups and of the staff that work in BME voluntary organisations. A rapid appraisal approach was used in 10 purposively selected local councils, and plural methods were used, including public listening events, nominal groups and individual interviews. In total 1,839 older people participated in the consultations and 1,280 (70%) completed a monitoring form. Some 30 per cent defined themselves as of a minority ethnic background. The concerns were more about the low recognition of culturally-specific and language needs than for the development of services exclusively for BME older people.

Contemporary popular culture proposes new ideological associations between time, ageing, the body and personal identity projects. In a range of magazine texts, television shows and associated websites, several commercialised discourses equate ageing, and women's ageing in particular, with the ‘look’ of ageing. They project a version of personal ageing that is reversible and repairable, on the presumption that looking younger is universally a desirable goal and one that can be reached through regimes of control operating on skin, body shape and weight, hair and clothing. Different moral stances are established in these discourses. One set offers magazine readers putative control over acknowledged risks and threats deemed inherent to ageing. Such texts invoke personal responsibility for maintaining and indeed for re-claiming a youthful appearance in middle and old age. Another set shames and vilifies people who ‘look older than they should’. In those cases, visible ageing needs to be urgently dealt with, on the gerontophobic assumption that the look of ageing renders the individual progressively less socially desirable or even less acceptable. Different frames of mediation, such as the keying of personal censure and humiliation as play, complicate the moral critique of these discourses, even though their ageist orientations are often stark. The decade is constructed as an important unit of bodily ageing, when the target is to look or in some ways to be ‘ten years younger’.

This article analyses the strategies that older widowers used to assert their masculinity during in-depth research interviews by the author, a middle-aged woman. Twenty-six widowers living in Atlantic Canada and Florida in the United States and who were aged from 56 to 91 years participated in the study. The author analysed the interviews from a symbolic-interactionist perspective that looks at the world from the perspective of those being studied. The widowers used various strategies of impression management to reinforce their identity as ‘real men’ during the interviews. These strategies included taking charge of the interview, using personal diminutives and endearments to assert control, lecturing the interviewer about various topics including differences between men and women, and bringing attention to their heterosexuality by referring to themselves as bachelors and commenting on increased attention from women. The paper chronicles the process of discovery of the importance to the study participants of portraying themselves as men. It was found that older widowers' identity as ‘real men’ is precarious because they lack three essential components of masculinity: being in a heterosexual relationship, being employed, and being young. The article makes extensive use of the participants' quotations to demonstrate their attempts, through impression management, to maintain a masculine identity while discussing the very topics that threatened it.

This paper examines whether participation in social activities is associated with higher levels of wellbeing among post-retirement age people in England, and, if so, whether these relationships are explained by the reciprocal nature of these activities. Cross-sectional analysis of relationships between social activities (including paid work, caring and volunteering) and wellbeing (quality of life, life satisfaction and depression) was conducted among participants of one wave of the English Longitudinal Study of Ageing (ELSA) who were of state pension age or older. Participants in paid or voluntary work generally had more favourable wellbeing than those who did not participate in these activities. Caring was not associated with wellbeing, although female carers were less likely to be depressed than non-carers. Carers, volunteers and those in paid work who felt adequately rewarded for their activities had better wellbeing than those who were not participating in those activities, while those who did not feel rewarded did not differ from non-participants. These results point to the need to increase the rewards that older people receive from their productive activities, particularly in relation to caring work.

This study analyses gender inequalities in health among elderly people in Catalonia (Spain) by adopting a conceptual framework that globally considers three dimensions of health determinants: socio-economic position, family characteristics and social support. Data came from the 2006 Catalonian Health Survey. For the purposes of this study a sub-sample of people aged 65–85 years with no paid job was selected (1,113 men and 1,484 women). The health outcomes analysed were self-perceived health status, poor mental health status and long-standing limiting illness. Multiple logistic regression models separated by sex were fitted and a hierarchical model was fitted in three steps. Health status among elderly women was poorer than among the men for the three outcomes analysed. Whereas living with disabled people was positively related to the three health outcomes and confidant social support was negatively associated with all of them in both sexes, there were gender differences in other social determinants of health. Our results emphasise the importance of using an integrated approach for the analysis of health inequalities among elderly people, simultaneously considering socio-economic position, family characteristics and social support, as well as different health indicators, in order fully to understand the social determinants of the health status of older men and women.

In Britain, older people have lower average incomes and a higher risk of income poverty than the general population. Older pensioners are more likely to be in poverty than younger ones. Yet certain indicators of their living standards suggest that older people experience less hardship than expected, given their incomes. A possible explanation is that older people convert income into basic living standards at a higher rate than younger people, implying that as people age they need less income to achieve a given standard of living. Much existing evidence has been based on cross-sectional data and therefore may not be a good guide to the consequences of ageing. We use longitudinal data on people aged at least 50 years from the British Household Panel Survey to investigate the effects of ageing on the relationship between standard of living, as measured by various deprivation indices, and income. We find that for most indices, ageing increases deprivation when controlling for income and other factors. The exception is a subjective index of ‘financial strain’, which appears to fall as people age. We also find evidence of cohort effects. At any given age and income, more-recently-born older people in general experience more deprivation than those born longer ago. To some extent these ageing and cohort effects balance out, which suggests that pensions do not need to change with age.

In imagining how their lives might turn out, 100 young New Zealanders aged between 16 and 18 years wrote descriptions of their future lifecourse. Their descriptions of themselves at the nominal age of 80 years form the basis of the research reported in this paper. For these young people, ageing and old age are understood as accomplishments in the context of an imagined lifecourse. They see personal ageing as shaped by a common temporal ordering of life events that ensures material security, financial success, and an enduring intimate relationship. In imagining themselves aged 80 years, three key themes that constitute a discourse of ‘accomplished ageing’ were identified: the experience of old age would be contingent on achievements throughout the lifecourse; old age would be a time for harvest; and while people may look old they can continue to ‘be’ young. Although their images of bodily appearance included some negative stereotypes of old age, appearance and bodily function were understood as amenable to life-long self-management. The young people imagined themselves as life-long active agents, and framed a positive image and homogeneous social identity for older people. The ‘accomplished ageing’ discourse has implications for how ageing is understood by young people. In particular, the social identity that accomplished ageing implies may shape how they relate to those who do not accomplish ageing in the imagined optimistic and homogeneous way.

After the spouse, children are the most likely source of informal support for an older person when the frailties of advanced old age create the need for help. Childlessness may thus be seen as particularly a problem for older people. In general, to compensate for the lack of children, childless people develop closer relationships with available next-of-kin and non-kin. Despite this, in times of need they are likely to find themselves with inadequate informal support. Using data from the Bangor Longitudinal Study of Ageing, this article explores the consequences of childlessness among persons aged 85 years or more living in rural Wales. The results indicate that by the time they reach old age, childless people have adapted to their situation and developed expectations consistent with being childfree. They have closer relationships with collateral kin, friendships are important and a high value is placed on independence. Nevertheless, unless they die suddenly or after a short acute illness, almost all of them enter residential care or a long-stay hospital at the end of their lives. It is also shown that the situation of childless people varies greatly and depends on several factors, particularly marital status, gender, social and financial capital, and on the person's earlier investment in the strengthening of next-of-kin and non-kin networks.

Across the United Kingdom, new build and remodelled ‘extra care’ schemes are being developed in many areas on the assumption that they offer older people with care needs an alternative to residential care. This paper reports an evaluation by a multi-disciplinary team of 10 extra-care schemes remodelled from sheltered housing or residential care units. The evaluation audited buildings and identified social and architectural problems. No two schemes in the sample were alike; some aimed for a dependency balance and others set a dependency threshold for admission. The three criteria used for assessing eligibility were the number of paid care hours the older person had at home, their property status and the type of disability. This article focuses on the wide variation in assessing eligibility for an extra-care place and on some social consequences of remodelling. A number of tenants remained in situ during the remodelling process in six of the schemes. Building professionals were unanimous that retaining some tenants on site caused significant development delays and increased the remodelling costs. There was also a social price to pay. ‘Old’ tenants resented their scheme changing into extra care and were hostile towards ‘new’ tenants who had obvious needs for support. In some extra-care schemes, ‘old’ tenants were refusing to participate in meals and all social activities.

With the increase of childlessness in European societies, its consequences have become a matter of concern. Studies in this field, however, have concentrated on what childless people lack and need in terms of social, financial and moral support. In contrast, this article focuses on what childless people give to their families, friends, unrelated others and to society at large. Using 2004 data on social support and financial transfers given and received by people aged 50 or more years in ten European countries from the Survey of Health Ageing and Retirement in Europe (SHARE), the analyses show that the support networks of childless older people tend to be somewhat weaker than those of parents and that links with members of the younger generations in the family are stronger for parents than for those without children. The results also indicate, however, that the differences in transfer behaviour between parents and childless adults are small, and that the support networks of the childless are more diverse than those of parents, and characterised by stronger links with ascendants and lateral relatives and with non-relatives. Moreover, people without children tend to be more intensely involved in charities and comparable organisations.

The current study describes from an attachment-theoretical viewpoint how intergenerational support in adult child-parent relationships is associated with wellbeing in both generations. The attachment perspective and its focus on affective relationship characteristics is considered as an important theoretical framework for the investigation of special relationships across the life span. Data from the Netherlands Kinship Panel Study (N=1,456 dyads) were analysed to investigate if relationship quality moderated the association between providing intergenerational support to parents and wellbeing in adult children, on the one hand, and receiving intergenerational support from children and wellbeing of older parents on the other hand. The perspectives of both relationship partners were taken into account to allow for dependence within dyads. Intergenerational support, in terms of instrumental help provision, was negatively associated with the child's and parent's wellbeing. Being the stronger and wiser partner in adult-child parent relationships, as reflected by giving advice and being the initiator within the relationship, was beneficial for the wellbeing of both generations. Additionally, relationship quality was the strongest predictor of wellbeing in both generations. Parental wellbeing was benefited by filial support in high quality relationships. If an intergenerational relationships was of high quality, the challenges of intergenerational support provision and receipt were easier to deal with for both generations, parents and children.

Given global population ageing and the fact that Australia is experiencing a significant increase in the proportion of older adults in its population, research into ageing issues has become a national priority. Whilst body image and self-esteem have been empirically linked, the relationship among older adults has been neglected. This study investigated several body-image variables and their relationship to self-esteem in a sample of 148 men and women aged 65–85 years who were living independently in the Perth Metropolitan Area of Western Australia. They completed the ‘Rosenberg Self-Esteem Scale’ and the ‘Multidimensional Body-Self Relations Questionnaire’. The results indicated, contrary to a common misconception, that body-image concerns are significant to self-esteem in older adulthood, but that these vary by age and gender. Whilst women appear to develop various strategies to counter the effects of ageing, men seem to be more negatively affected, particularly in relation to body functioning. The findings shed light on the meaning of body image in older adulthood. A better understanding of the meaning of body image, of the factors that influence the meaning, and of how these relate to older adults' self-esteem may help older adults develop a positive body image that will contribute to psycho-social strengths and enhance their quality of life.

The associations between socio-economic position (SEP) and physical functioning have frequently been investigated but little is known about which measures of SEP are the best to use for older people. This study examined how different SEP indicators related to the physical functioning of men aged 50 or more years in England and Greece. The data derived from Wave 1 of the English Longitudinal Study of Ageing (ELSA) and from the Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported physical functioning limitations and mobility difficulties were combined and categorised into ‘no disability’, ‘mild disability’ and ‘severe disability’. The SEP indicators studied were: wealth, educational level and occupational class. The findings indicate that respondents with less wealth, fewer educational qualifications and lower occupational class were more likely to experience mild or severe physical disability than those of high SEP. When all three measures of SEP were adjusted for each other, in both samples wealth maintained a strong association with mild and severe disability, while education was associated with severe disability but only among English men. Occupational class was not strongly associated with physical disability in either case. Hence, among English and Greek older men, wealth was a more important predictor of physical functioning difficulties than either occupational class or education.

The purpose of this article is to investigate the relationship between spousal care-giving and declines in functioning and self-rated health among older care-givers. The authors used data from the 2000 and 2002 waves of the United States Health and Retirement Study, a biennial longitudinal survey of a nationally representative cohort of adults aged 50 or more years. Two outcomes were examined, declines in functioning and declines in self-rated health. Care-givers were classified into three groups: no care-giving, less than 14 hours of care-giving per week, and 14 or more hours care-giving per week. To assess declines in functioning, two summary scores were created of limitations in basic and instrumental Activities of Daily Living. To assess declines in self-rated health, we compared responses from 2000 and 2002. In the fully adjusted models, care-giving hours did not have an independent effect on declines in functioning or self-rated health. The relationship between care-giving hours and declines in functioning and self-rated health is probably attributable to socio-demographic characteristics, mainly age. The findings suggest that spousal care-giving does not of itself harm functional health or perceived health among older adult care-givers. Understanding the differential effects of these socio-economic characteristics with care-giving hours on health will be useful in promoting the health of older adult care-givers and treating their disorders.

Late-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data from both spouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction; concordance in emotional state or physical health; and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more diverse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States.

Much research on the impact of HIV and AIDS on older people fails to differentiate between age groups, and treats those aged from 50 years to the highest ages as homogeneous. The ‘oldest old’ or those aged over 75 years may be particularly vulnerable through declining health and independence as a result of the AIDS epidemic, which has forced some to take on roles that younger relatives would have performed had they lived. In this paper we describe the past and current experience of eight people in advanced old age living in rural Uganda who were informants for an ethnographic study of the impact of HIV and AIDS on households during 1991–92 and again in 2006–07. The aim of the study was to understand how they had coped with the impacts of the epidemic. From the eight case studies, it is concluded that family size, socio-economic status and some measure of good fortune in sustained good health enabled these people to live to an advanced age. While we recommend that targeted social protection is important in helping the poorest among the oldest, we suggest that sustaining respect for age and experience, and ensuring that older people do not feel discarded by family and society are as important as meeting their practical needs.

Inactivity has been identified as a major contributor to the burden of disease among older Australians, particularly those in culturally-diverse communities. This study assessed the facilitators and barriers to physical activity in older people from culturally-diverse communities, and investigated the predictors of physical activity participation by recruiting 333 older people from seven different communities in the western suburbs of Melbourne, Australia. A survey questionnaire that recorded physical activity and the barriers to and facilitators of activity was interviewer-administered in the participants' preferred language. The data were analysed using bivariate and multivariate inferential statistical methods. Personal barriers to physical activity, such as poor health, lacking the energy to exercise, being too tired and low motivation, were highly prevalent in all groups. Specific factors, such as ‘being self-conscious about my looks’, were more prevalent among the Vietnamese, as were concerns about the weather among Macedonians and Croatians. Across all groups, perceptions of health and safety strongly influenced physical activity behaviour, more so than the external environment. Some of the barriers can be addressed with a common approach, but others in some communities will require particular strategies.