Increasing numbers of people with dementia reside in single-person households, yet little is known of their experiences and priorities. This exploratory Australian study elicited perceptions of seven people with dementia living alone, regarding their domestic environment and its surroundings. The general aim was to identify unmet service needs in this vulnerable population. Drawing upon the theoretical concepts of ‘the will to mobility’ and ‘life-space’, we identified four factors of particular salience to our respondents. These were access to public space, social distance and proximity, changing meanings of space and objects, and imaginative co-presence. Participants provided useful insights into a soon-to-be-common scenario in which increased numbers of people with dementia will be living without a resident carer. The findings have implications for the development of more personalised and targeted dementia care in the domestic setting, more inclusive public planning and more extensive public education programmes.

Driving cessation is a gradual process, where driver's self-regulation plays an important role. Age-based licence renewal may interfere with this process and trigger premature driving cessation. The present study compares Danish drivers (aged 69 years at the baseline) who either renewed or gave up their driving licence. Data were collected in 2009 (N=1,792) and in 2012 (N=863). The standardised interviews covered respondents' background information, health and wellbeing, and transportation patterns. Non-renewers had poorer health already at baseline but did become more dependent on others in their activities after giving up their licence. In travel frequency, neither the differences between renewers and non-renewers nor the changes over time within the groups were pronounced. The groups differed in their use of transport modes already at the baseline: the renewers drove, while non-renewers travelled as passengers, used public transport, walked or cycled. Not renewing the licence was a strong predictor of unmet mobility needs, especially in relation to leisure activities. The present study indicates that younger seniors' mobility is not likely to be affected by the strict renewal policies. However, given the positive economic and safety consequences of independent mobility in old age, society should try to prevent unwarranted mobility loss. Having restrictive, ageist policies that moreover fail as societal investments may work against this goal.

Falling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.

Second couplehood in old age is a growing phenomenon alongside increases in life expectancy. Lately, a shift has occurred in that individual diversity of ageing is perceived to depend on the physical and social contexts in which older persons experience change. Thus, the purpose of the study on which this paper reports was to examine second couplehood in the context of old age and old age in the context of second couplehood using an existential-phenomenological theoretical orientation. Twenty couples were recruited using criterion-sampling: men aged 65+ and women aged 60+, with children and grandchildren from a lifelong marriage that had ended in widowhood or divorce, living in second couplehood – married or not – in separate houses or co-habitating. Forty individual semi-structured interviews were tape-recorded, transcribed verbatim and analysed according to phenomenological tradition. Five sub-themes emerged, demonstrating couplehood and old age intertwining: (a) enjoying life while still possible; (b) living with health-related issues; (c) relationships with adult children: autonomy versus dependency; (d) loneliness: living as a couple is better than living alone; (e) self-image: feeling young–feeling old. Findings support the existence of positive and negative aspects of old age. Our discussion suggests the need to replace perceptions of old age as either a negative burden or a positive asset towards a period of balancing between gains and losses. Furthermore, we acknowledge the role of second couplehood in older peoples’ wellbeing on the personal–micro level through love, the familial–mezzo level through care-giving and the social–macro level by reducing prejudice.

Drinking motives may change as adults age, yet few studies in the United States of America have examined older adults' perspectives about their own drinking habits. The current study explored beliefs and attitudes of alcohol use of retired adults residing in a congregate care setting in the Baltimore/Washington DC metro area. Individual interviews were conducted with a sub-sample of 11 individuals who participated in a daily diary study on alcohol use among older adults. All participants in the study were identified as regular drinkers, meaning they had an alcoholic beverage on at least six of the eight days prior to screening. The participants' mean age was 81.5 years with a majority being women (54.5%). Older adults reported alcohol use as a long-term habit or routine. Participants also recognised that their alcohol use was influenced by peer drinking and by the availability of alcohol at the congregate care setting. Participants normalised their drinking as a form of routine socialisation carried from earlier life stages. Participants did not report reactive drinking, suggesting that older drinkers do not see their alcohol use as driven by specific reactions to life stresses or losses associated with ageing. The study also indicates that drinking may provide older adults in congregate care with a sense of continuity from before retirement and preserve their identity and autonomy.

The purpose of this study is to develop and extend our understanding of dementia care-giving by introducing a typology of informal care-giving across four different diseases. Care-giving factors were examined with respect to specific dementia presentation in mild cognitive impairment, Alzheimer's disease, dementia with Lewy bodies and Parkinson's disease-associated dementia. Informal care-giving literature in the four diseases was systematically searched to identify specific disease symptoms and resultant care-giving strains and outcomes. Key concepts were extracted and grouped thematically. The first classification, ‘role-shift’, reflects care-giving where cognitive deterioration results in changing roles, uncertainty and relational deprivation among married partners. The second classification, ‘consumed by care-giving’, refers to those caring for persons with dementia-motor decline that greatly increases worry and isolation. Finally, in the ‘service use’ classification, formal support is needed to help care-givers cope with daily responsibilities and behaviour changes. In each case, the dementia presentation uniquely impacts care-giver strains. A major conclusion is that the same support to all care-givers under the umbrella term ‘dementia’ is unwarranted; the development of targeted support is required.

This article summarizes previous employment histories and studies associations between types of histories and quality of life in older ages. Retrospective information from the Survey of Health, Ageing and Retirement in Europe (SHARE) was used and the occupational situation for each age between 30 and 65 of 4,808 men and 4,907 women aged 65 or older in Europe was considered. Similar histories were regrouped using sequence analyses, and multi-level modelling was applied to study associations with quality of life. To avoid reverse causality, individuals with poor health prior to or during their working life were excluded. Men's employment histories were dominated by long periods of paid employment that ended in retirement (‘regular’ histories). Women's histories were more diverse and also involved domestic work, either preceding regular careers (‘mixed’ histories) or dominating working life (‘home-maker’ histories). The highest quality of life was found among women with mixed histories and among men with regular histories and late retirement. In contrast, retirement between 55 and 60 (but not earlier) and regular histories ending in unemployment or domestic work (for men only) were related to lower quality of life, as well as home-maker histories in the case of women. Findings remain significant after controlling for social position, partnership and parental history, as well as income in older ages. Results point to the importance of continuous employment for health and wellbeing, not only during the working life, but also after labour market exit.

Recent surveys in Myanmar, Thailand and Vietnam reveal that substantial proportions of persons aged 60 and older co-reside with grandchildren and commonly provide grandparental care. Usually the grandchildren's parents are also present. Situations in which the grandchildren's parents are absent are considerably less frequent. Parents are commonly the main source of the grandchildren's financial support even if absent. Most grandparents that provide care do not consider it a serious burden even when the grandchild's parents are absent. Moreover, grandparental care is not always one-directional as grandchildren can also be of help to grandparents. These features of grandchild care reflect a regional cultural context that views acceptance of reciprocal intergenerational obligations as normal and in which co-residence of older persons and adult children is still common. Differences in economic development and past fertility trends account for much of the observed differences in grandparental care among the three countries by affecting grandchildren availability and migration of adult children. In addition, economic development and demographic trends will continue to shape grandparental care in the coming decades. Despite the lack of attention to development and demographic context in previous studies, these aspects of the changing societal context deserve a prominent place within conceptual frameworks guiding comparative research on grandparenting.

A number of professional disciplines employed internally and externally provide services in Residential Aged Care Facilities (RACFs). Literature has long highlighted numerous workplace issues in RACFs, yet little progress has been made in addressing these. As such there has been a call for greater understanding of shared issues among service providers. The aim of the current study is to explore and compare the perceptions of a cross-section of service providers regarding the challenges and motivators to working in RACFs. In-depth semi-structured interviews were conducted with 61 participants including: care managers, nurses, assistants in nursing, care, domestic and support staff, and speech pathologists. Analysis revealed few issues unique to any one service discipline, with four key themes identified: (a) working in RACFs is both personally rewarding and personally challenging; (b) relationships and philosophies of care directly impact service provision, staff morale and resident quality of life; (c) a perceived lack of service-specific education and professional support impacts service provision; and (d) service provision in RACFs should be seen as a specialist area. These data confirm there are key personal and professional issues common across providers. Providers must work collaboratively to address these issues and advocate for greater recognition of RACFs as a specialist service area. Acknowledging, accepting and communicating shared perceptions will reduce ongoing issues and enhance multi-disciplinary care.

Older prisoners are the fastest growing incarcerated sub-group. They have more complex health and social care needs than both younger prisoners and their age-matched peers living in the community. Prisoners who have been recently released are at enhanced risk in terms of their physical and mental health. Consequently, there is a need for timely, multi-disciplinary release planning. The aim of this study was to explore the health and social care needs of older male adults discharged from prison into the community. Qualitative interviews were carried out with prisoners with four weeks left to serve (N=62), with follow-up interviews conducted four weeks after release (N=45). Participants were selected from nine prisons in the North of England. The constant comparison method was used to analyse the data. Older prisoners perceived release planning to be non-existent. There was a reported lack of formal communication and continuity of care, causing high levels of anxiety. Older prisoners experienced high levels of anxiety about the prospect of living in probation-approved premises; however, those who did go on to live in probation-approved premises had their immediate health and social care needs better met than those who did not move into such accommodation. Release planning for older prisoners is generally inadequate and there is currently a missed opportunity to address the needs of this vulnerable group.