The COVID-19 global pandemic had a major impact on older people's mental health and resulted in changes in alcohol use, with more older adults increasing than decreasing consumption levels among the general population. So far, no studies have focused on older people who were already experiencing problem alcohol use. This qualitative research is the first to provide a nuanced understanding of changes to drinking patterns among older adults engaged in alcohol treatment during the COVID-19 pandemic, and the implications of these for practice. We conducted 30 semi-structured interviews with people in alcohol treatment aged 55+ living in urban and rural areas across the UK. Data were analysed using thematic analysis. We found that changes in alcohol use varied depending on the social, economic and health impacts of the pandemic on older adults. Boredom, lack of adequate medical or emotional support, and key life changes experienced during the pandemic (such as bereavement or retirement) increased the risk of increased drinking. Moreover, some people in longer-term alcohol treatment were struggling to maintain abstinence due to lack of face-to-face peer support. For others, decreased drinking levels were a side-effect of lockdown policies and restrictions, such as alcohol-related hospitalisations, closure of social spaces or inability to source alcohol; these also supported those who decided to cut down on drinking shortly before the pandemic. Generally, older adults who developed home-based interests and self-care practices managed lockdown best, maintaining abstinence or lower risk drinking levels. Based on these results, we argue that multilevel interventions aimed at strengthening resilience are required to reduce drinking or maintain abstinence among older adults. Such interventions should address three domains: individual (coping strategies and mindset), social (support networks), and structural (access to resources). In preparation for supporting older alcohol users through prospective future pandemics, building digital literacy and inclusion are essential.

Although older people who live alone might be in a vulnerable situation, they have often managed their everyday life for a long time, frequently with health challenges. In this article, we explore how nine older persons who live alone, who receive home care and are identified by home care professionals as being frail, manage their everyday lives by inquiring into their stories about living alone and receiving home care. We conducted three qualitative interviews with each of the nine participants over a period of eight months and analysed the data using thematic analysis and a narrative positioning analysis. Using the concept of resilience as our analytic lens, we identified three thematic threads: continuity, adaptation and resistance. In the narrative positioning analysis of three participants' stories, we identified that the participants used the processes of continuity, adaptation and resistance strategically and interchangeably. The study thus provides insight into how older people who live alone and use home care services narrate their balancing of strengths and vulnerabilities, and engage in the construction and maintenance of a sense of self through positioning in relation to master narratives. Older people's narrations are nuanced and complex, and this study indicates that encouraging storytelling and engaging with older people's narrations might support how older people enact resilience and thus their management of everyday life when living alone and ageing in place.

Ageing-in-place has become an internationally favoured policy and practice response to population ageing. However, limited literature has sought to understand this concept from Chinese older adults' perspectives, especially in rural China. The purpose of this study is to explore how older adults in rural China conceptualise ageing-in-place. This study took a qualitative approach by carrying out in-depth interviews with snowball-sampled older adults from a rural village in Shandong Province, China (N = 30). Participants conceptualised their ageing-in-place as consisting of two phases: first, when they felt self-reliant, these older adults preferred to live independently in the village; and second, when their capability declined, they would expect care-giving from their children. Autonomy was essential to participants' decision to age in place. The village offered both a physical and social environment in which participants could sustain their self-identity. This decision to age in place independently also related to participants' proactive adaptation to their children's evolving practices of filial piety. Still, had their capabilities declined, they reported they would expect their children's care-giving and move in with their children. Our findings suggest that older adults in rural China conceptualise ageing-in-place as a dynamic process that evolves as they age and experience changes in their needs and capabilities. This perception expands critical notions of ageing-in-place by highlighting rural older adults' flexible conceptualisation of the ‘place’ in which they plan to age. This study sheds light on socioculturally nuanced understandings of ageing-in-place while providing evidence to inform tailored policy and practice development in rural China.

Older adults who have had a major depressive disorder (MDD) have a high risk of relapse. Although risk factors for depression have been researched extensively, less is known about protective factors, and what experiences might strengthen subsequent resilience and help to prevent relapse. Therefore, this qualitative study explored factors of resilience in older adults who recovered from MDD and did not relapse across at least six years. Twenty-five semi-structured interviews were held with older adults aged 73–85 years who participated in the Netherlands Study of Depression in Older Persons from 2008 to 2014 and were re-interviewed for the present study in 2020–2021. Participants were defined as resilient based on having an MDD diagnosis at baseline but not on two- and six-year follow-up. We used grounded theory coding techniques and thematic analysis to identify factors contributing to resilience. Factors contributing to resilience included: taking agency; receiving social support and engaging in social activities; doing activities individually; and managing thought processes. Resilience after late-life depression appeared to be a dynamic process involving internal and external factors, including finding a balance between rest and activity, between taking initiative and receiving support by others, and between accepting negative emotions and ignoring negative thoughts. Additionally, the ability to learn from depression shows that resilience is not only about avoiding psychopathology, but also about the recovery process and preventing relapse. These findings highlight the need for research and interventions to focus on understanding and influencing the dynamics underlying resilience.

The COVID-19 pandemic and ensuing restrictions/lockdowns have caused significant physical and psychological consequences for people with cognitive impairment who are heavily dependent on their care-givers. However, little is known about the impact on care-givers, the factors that exacerbate their situation and what supports they need. The aims of this paper are threefold: (a) to examine the impact of COVID-19 physical restrictions on both formal and informal care-givers of people with cognitive impairment; (b) to identify attributing factors influencing this impact; and (c) to recognise their support needs. Further, this paper informs future research, policy and practice. Guided by the Joanna Briggs Institute framework, a systematic review was conducted using a mixed-methods convergent integrated approach. Eight databases were searched using keywords related to COVID-19 restriction, dementia care-givers, impacts and care settings, followed by a manual search. The study was limited to primary research published in English between January 2020 and December 2021. Of the 840 records identified, 30 met the inclusion criteria. Service withdrawal and social distancing has effectively led to the reprivatisation of care to the family, particularly women. Care-givers experienced negative impacts including reduced psychological wellbeing and physical health, increased care burden and financial difficulties. A number of clinical attributes and socio-demographic factors influenced the COVID-19 impact on care-givers. Consequently, counselling services, assistance with care and financial support were identified as support needs. Implementation of new support and the strengthening of existing services are recommended to enhance resilience, build capacity to support care-givers in any given situation and mitigate the effects of future outbreaks.

Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70–85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises.

Previous research has highlighted the importance of past life experiences in the theoretical and conceptual understanding of loneliness. However, adding a lifecourse perspective to loneliness research remains underexplored. To comprehend the complexity of loneliness in old age, it is crucial to pay attention to the lifecourse perspective. This study addresses an important lifecourse perspective on loneliness through an in-depth, narrative approach. Building on the cognitive discrepancy theory, this study examines how precipitating events and coping strategies throughout the lifecourse may influence current feelings of loneliness in older adults. We qualitatively examined the experienced lifecourse of 20 lonely older adults living in Belgium by applying a modified version of the McAdams life-story interview scheme. Next, we conducted eight member-check interviews. A first finding provided insight into the importance of precipitating events during the lifecourse for current loneliness. The results pointed not only to the lifelong impact of events during childhood and adulthood, which may lead to vulnerability to loneliness later in life: unrealised life events (e.g. not being able to have children) as well as events with no impact earlier in life nevertheless turned out to be relevant in the emergence of loneliness later in life. Second, the narratives revealed that several older adults who experienced loneliness earlier and later in life continued to use the same coping strategies throughout the lifecourse, whereas by contrast some older adults adapted their coping strategies based on previous experiences and improved their loneliness-coping skills. It also appeared that changes in people's resources, such as the presence of physical limitations, may make it more difficult to cope with loneliness in later life. The discussion makes a plea for lifelong prevention of and attention to loneliness.

Laboratory-based experiments show ageing negatively impacts navigation abilities, yet a paucity of research explores lived experience. This exploratory study examined young-old adults' experiences of declining navigation abilities during 16 semi-structured telephone interviews. Findings reveal: (a) ‘Behavioural drivers’ that underpinned the participants' experiences and actions when engaging with their environments, (b) ‘Avoidance’ and (c) ‘Active’ strategies that were adopted by the participants. Declining cognitive function appeared to have a negative impact on participants' perceived abilities and confidence to navigate unfamiliar outdoor environments, which in turn influenced the strategies they chose to adopt. Future psychosocial interventions should draw on neuropsychological theory to ensure retention of navigation skills and confidence for as long as possible.

Oldest-old (age 80+) spousal care-givers of people with dementia experience unique challenges and concerns that they attribute to age and/or ageing, including difficulties providing care because of physical, cognitive or sensory decline; having fewer friends who can provide practical support; and having less energy for non-care-giving activities (e.g. leisure activities, self-care). Previous research on how older care-givers manage is not specific to oldest-old care-givers and may underrepresent their unique experiences managing age and ageing-related challenges. A limited understanding can compromise our ability to tailor services to ageing care-givers. The purpose of this research was to illuminate how oldest-old spousal care-givers of people with dementia manage ageing-related care-giving challenges and the barriers and facilitators to strategy use. The selective optimisation with compensation theory and the transactional theory of stress and coping informed our conceptualisation of management strategies. We used a narrative gerontology approach, with two or three semi-structured interviews with 11 care-givers aged 80–89 (25 interviews in total). Narrative data were analysed thematically. We identified four main themes that encompassed the strategies shared by care-givers: adjusting goals to lessen care-giving demands and to mitigate stress, using alternative means to reach goals and to mitigate stress, enhancing capacities to care and mitigate stress through engagement in non-care-giving activities, and choosing positive attitudes and perspectives to lessen emotional distress. We identified a myriad of facilitators and barriers to strategy utilisation in each theme. The study provides unique insight into care-givers' management strategies, especially in relation to relocation of self and spouse and participation in non-care-giving activities, as well as insight into age-related facilitators and barriers. This research can ultimately help inform the tailoring of age-sensitive health and social care services to meet the needs of this group of care-givers as they age.

The relationships that care home staff have with their co-workers are a key influence on the way they feel about their work and how they perform in their roles. This has a direct influence on quality of care and life as experienced by residents. However, care home providers face a challenge to promote co-worker relationships because: (a) the care home workforce often lack human resource oversight; (b) registered managers (and nurses), who often lack leadership training, are tasked with managing the working relationships of staff, the majority of whom are care workers of different ages, ethnicity and cultural beliefs; and (c) most (care workers) do not have any formal qualifications and are not routinely provided with the communication skills to facilitate collaborative working in dynamic and pressured climates. In this forum article, we consider these challenges and their implications for collaborative co-worker relationships, before highlighting opportunities for research, policy and practice. An important starting point is to focus on developing the leadership skills of staff at all levels and provide care workers with the skills they require to manage their working relationships and support them in their everyday work for the benefit of residents.

As the population ages and the prevalence of dementia increases, caring for a relative living at home with dementia has become a reality for many families worldwide. Studies have shown that families are confronted with diverse difficulties as they try to address the challenges involved in providing care. By understanding how they manage daily life, formal service providers become better equipped to meet the diverse needs of these families. Learning how families live with memory loss and cognitive changes calls for an understanding of the shared context surrounding the person, including the collective of people, and their connections. With the research method of ethnographic case study, we followed eight families living at home with dementia for two years. All participants had been placed on a waiting list for a specialised dementia day care programme. The analysis presented here is based on three cases which reflect widely different experiences and situations. We describe how these families dealt with their daily living at home, if and how they made use of the formal support available and what approaches they found helpful for improving their lives. The results show how the persons living with dementia and their care-givers drew on the collective of their backgrounds, surroundings and available support. With diverse arrangements, families tried to find ways to make their daily lives work out. But constant re-arrangement was necessary. This knowledge could be a central learning point for formal service to build on. While systematic or routine procedures in service provision can be helpful, time and space must be provided for professionals to understand families' different practices, so that they can provide family-centred support.

Older adults who age at home independently are often celebrated as having anticipated and planned for their care needs in the later stages of life, whereas those who receive assistance from home support services are often stigmatised as dependent and characterised as a ‘drain on the system’. However, this thematic analysis of interview data from 12 home care clients in two Canadian provinces offers evidence that counters the assumption that home care clients are passive recipients of care. Extending Corbin and Strauss' theorisation of how individuals manage chronic conditions alongside Dorothy Smiths' conception of work, we explore how home care clients ‘work’ to receive care as they age in place. Specifically, home care clients not only engage in daily life work, illness work and biographical work, but also advocate for themselves and their workers, co-ordinate and negotiate with members of their caring convoys and networks, and adapt in various ways to navigate personal, relational, structural and policy-level challenges. We suggest that work done by older adults who are ageing in place be addressed, acknowledged and incorporated into care planning and operational policy development to challenge both the stigma of dependency and neoliberal narratives of self-sufficiency.

Previous literature attempted to gain insight into financial abuse involving people with dementia by analysing court cases, but these studies were limited in sample size or scope. This study collected 214 court rulings directly related to the financial decisions of people with dementia to identify characteristics of the financial abuse victim, perpetrators and the types of assets. The models of bystander intervention and routine activity theory were used as conceptual models to guide analysis regarding the role of bank staff as well as the court's decision in cases of financial abuse. The majority of financial abuse perpetrators were family members (73.8%), as opposed to outsiders (19.2%). Transfer of real estate was the most common legal issue, and land was the most common financial asset involved. Difficult intra-family relationships seem to pose a great risk of financial abuse involving people with dementia since adult children were found to be the most likely perpetrators (52.7%) but also plaintiffs accusing financial abuse (57.6%). In accordance with the bystander intervention model, bank staff were more likely to be suspicious of financial abuse when an outsider was regarded as the perpetrator. In accordance with the routine activity theory model, the court was more likely to acknowledge the case as an invalid financial decision when an outsider was regarded as the perpetrator in financial abuse cases. Since people with dementia suffer from greater losses due to their family members, future policies should establish guidelines for front-line bank staff to identify warning signs to reduce the risk of financial abuse involving people with dementia, not only to prevent fraud by outsiders but also exploitation by family members.

A growing number of organisations in residential care for older people are working towards safe and inclusive environments for LGBT residents. In the Netherlands, these efforts are supported by an LGBT inclusion scheme called ‘Pink Passkey’. Drawing on critical organisational diversity studies, the paper understands inclusion as ‘accomplished’ in interactions across difference, and as always inherently partial (i.e. exclusion-producing). Qualitative methods are used to study the implementation process of the Pink Passkey in two nursing homes during one year. In sum, the paper contributes evidence of positive change associated with the use of the Pink Passkey as an inclusion scheme characterised by a long-term, open-ended and comprehensive approach. Compared to fixed-term projects and stand-alone measures described in previous LGBT ageing literature, an inclusion scheme helps to gain sustained attention to sexual and gender diversity (despite gaps in the implementation process), to normalise it more and to overcome opposition (though this does not disappear). The inclusion accomplished is, indeed, partial: bisexual, transgender and other gender non-conforming identities are less represented than gay and lesbian identities. Also, there is an emphasis on residents' agency to disclose LGBT identities and preferences, which excludes involuntary same-sex sexual expressions caused by disinhibited behaviour. The paper ends by suggesting disinhibited behaviour in older LGBT adults as an issue of interest to the wider literature on LGBT ageing, given the increasing prevalence of dementia and Parkinson's disease. Here, the role of care professionals who are able to understand and respond to bodily cues that echo struggles with otherness merits further consideration.

The COVID-19 pandemic prompted concern about the wellbeing of older people, however, there have also been accounts of increased sense of community in response to the disruption of established routines. To explore how older people experienced lockdown in Aotearoa/New Zealand, we analysed 635 written comments on the 2020 wave of the Health, Work and Retirement longitudinal survey of people aged 55–85 years. Using narrative genre analysis, we discuss two narratives of lockdown: a narrative of lockdown as ‘idyllic’ and a ‘dystopian’ narrative of distrust. Using the idyllic narrative, people described pleasant activities and linked these stories to earlier times when community life was less time-pressured and people were more connected to one another. The dystopian narrative was used to describe politicians and the media as untrustworthy and to depict new vulnerabilities created by the rules of lockdown. These narrative genres provide different positions for older people. In the idyllic narrative, older people are treasured and supported by younger community members, whereas in the dystopian narrative older people feel abandoned and manipulated. These genres draw on possible late-life futures that are familiar to older people: either treasured or discarded. Identifying these narrative genres reveals the different vulnerabilities older people experience. This information can be used to support older people to experience security and to flourish in uncertain times.

The aim of this paper is to review the social constructionist view of age and ageing that emerged in the late 1970s and early 1980s. It begins with a general consideration of social constructionism as an epistemological framing of the world, before turning to its use in social gerontology. It considers two distinct social constructionist approaches treating later life as a social reality: (a) as a structural consequence of the rise of the modern state and its organisation of the labour market and (b) as a consequence of shifting cultural and social representations. Arguing that the earlier more structuralist accounts have gradually become overshadowed by concerns over age as identity, socially constructivist approaches now place as much emphasis upon the social representation of age as on its social-structural organisation. The paper then reviews the costs and benefits of social constructionism in general and its becoming a key part in the study of ageing. Its benefits arise from drawing attention to the salience of the cultural and the social in fashioning age and ageing and thereby advancing the sociology of later life. At the same time, social constructionist approaches to old age risk neglecting an other personal and social reality arising from corporeal decline and fear of the body-to-come. The paper concludes by noting how, whether approaching ageing and old age as natural kinds or as human kinds, adopting biological or sociological methodologies, all such methods privilege the externality of age – whether as a social or a biological fact. What is not captured by either is the problematic internality of age. What might be called the subjectivity of age will remain a topic for cultural representation, beyond the methods of both biological and social science.

This paper considers how a diagnosis of dementia affects people's planning for future social care needs and associated costs. It addresses the gap in knowledge about how people recently diagnosed with dementia, and their family carers, engage with planning for social care needs that are uncertain in timing and scale. The paper also considers people's attitudes to planning for care that they may need to pay for privately, and what facilitates or hinders acting on such plans. We conducted and undertook thematic qualitative analysis of 39 in-depth interviews with 27 people newly diagnosed with dementia and/or their carers over a two-year period. Topics included current care and support, planning and co-ordinating care, paying for care, and expectations and planning for the future. The research took place in England. Our findings indicate that whilst people recognised they would have future care needs, with associated financial implications, this knowledge did not necessarily translate into actively planning for care or its cost. A key reason that recognition did not translate into action was uncertainty, manifested in three areas: the timescales and trajectory of their dementia and thus need for care; the potential for care needs to change and so negate care planning efforts; and uncertainty over their own capabilities to plan for and access paid-for care, given the perceived complexity of social care and associated financial arrangements. The paper discusses how anticipated regret may affect decision-making and contributes to debates about appropriate professional support for older self-funders with dementia. It suggests the task for those involved in the care of people with dementia is to identify the points and places in the care system where worries about future self-funded care can be addressed, and carers and the people they care for can be prompted and supported to act.

The significance of home is broadly recognised as representing selfhood, safety and autonomy. For older people, especially those with dementia, the ability to age in place at home can be threatened by a necessary move into a care home. Home has heightened importance for people with dementia. We know most people want to stay in their own homes, but there is limited research which explores what home means for people with dementia when they move into care homes. Based in a care home in regional New South Wales, Australia, this study used the arts-based method, body mapping, to explore what home meant to people with dementia and/or cognitive impairment. Seven body maps were co-created by current residents (four), family members and supporters (six) and researchers (three). The findings of the body-mapping process highlighted that home is much more than a physical location. Home meant having the ability to carry out practices and rituals, use objects, maintain relationships and experience sensations that are personally meaningful, and which differ from one person to the next. Their body maps revealed that in care homes, people could not ‘do home’ anymore because many of the practices, objects, people and places that mattered to them were no longer accessible. Body mapping was a useful method that facilitated the exploration of a holistic expression of home that would not have been possible with more traditional methods. For people with dementia, home was not only embodied and spatial, but also temporal, helping us to understand the ways in which care homes might facilitate a greater sense of home for people with dementia.