Public policies that provide incentives for higher middle-income people to purchase private long-term care insurance (LTCI) have been proposed as a way to shield large numbers of middle-income people from the risk of needing costly long-term care. A proposal to promote purchases of private LTCI that has gained modest traction in the United States of America is the Partnership Program. The structure and public–private nature of the Partnership Programs are reviewed along with the trends in sales of both regular private LTCI policies and Partnership LTCI policies to show that both experienced low purchase rates. Implementation efforts for the Partnership Programs were very modest, in part because many were launched when the Affordable Care Act was passed. At the same time, several well-known insurers withdrew from selling private LTCI. Understanding why the Partnership Program is not a success provides lessons for other counties interested in creating similar public–private ventures.

Financial welfare in later life is of prime concern as the funding of pensions and care rises up policy agendas. In this context, work and family histories are well known to impact on late-life income, generally reducing state and private pensions for women. In a political context where benefits are under threat as part of the retrenchment of the welfare state, we consider two key questions. First, how do state pension and benefit transfers interact with work and family histories to reduce poverty risks in later life? Second, who is kept out of poverty by state benefits and transfers? Using data from the English Longitudinal Study of Ageing, we examine how work, family and health histories are associated with poverty in later life and estimate how far and in what ways state pensions, income support and disability benefits play a mediating role. We conclude that state support is key to maintaining incomes above official poverty lines for substantial numbers whose work, family and health histories would otherwise have led to their incomes falling below these lines. While disability benefits are designed to compensate for the additional costs of disability, it is likely that many in receipt experience poverty (even though they are not captured in official poverty statistics); even more so for those incurring the costs of disability but not in receipt of these benefits.

An increasing number of middle-aged and older Americans are using social network sites (SNSs), but little research has addressed how SNS use is associated with social wellbeing outcomes in this population. Using a nationally representative sample of 1,620 Americans older than 50 from the 2012 Health and Retirement Study (HRS), we examine the relationship between older adults’ SNS use and social wellbeing associated with non-kin and kin relations and explore how these associations vary by age. Results of ordinary least-squares regression analyses suggest that SNS use is positively associated with non-kin-related social wellbeing outcomes, including perceived support from friends (β = 0.13; p < 0.001; N = 460) and feelings of connectedness (β = 0.10; p < 0.001; N = 463). Regression models employing interaction terms of age and SNS use further reveal that SNS use contributes to feelings of connectedness to a greater extent as people age (β = 0.10; p < 0.001; N = 463). Of all kin-related social wellbeing outcomes, SNS use only predicts increased perceived support from children (β = 0.08; p < 0.05; N = 410), and age negatively shapes this relationship (β = −0.14; p < 0.001; N = 410). As older people engage with an increasingly smaller and narrower network with a greater proportion of kin contacts, our results suggest that SNS use may help older adults access differential social benefits throughout later life.

Active Ageing is conceptualised to measure the extent to which older people remain actively engaged with life. However, there is no evidence that the concept of Active Ageing is actually associated with the activity levels of older persons. Influences of age, ethnicity and spirituality on Active Ageing are also unexplored. Using the Active Ageing Index (AAI), this study examines whether the level of Active Ageing predicted the actual activity level of 120 Singaporeans of Chinese, Malay and Indians ethnicities, aged 55–64 years old or 65 years and above. Spirituality, measured by the Spirituality Index of Well-Being, was added to the AAI, to see if the predictive power of AAI improved. Hierarchical multiple regression showed that the AAI alone (controlling for age) did not significantly predict the activity level of older persons. The predictive power of the AAI improved significantly with spirituality included. Two-way between-groups Analysis of Variance revealed main effects of age and ethnicity, with higher AAI in those aged 55–64 and in Indian-Singaporeans. These findings suggest that the theoretical construct of Active Ageing needs further examination to identify the domains that distinguish it from chronological age, and support broadening the construct by including spirituality in Active Ageing.

This study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.

This study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main themes and build a framework of perceived value of supports. Participant views converged on supports that facilitate patient independence and ease care-giver burden. However, important differences in participant perceptions arose regarding these priorities. Physicians and care-givers valued supports that facilitate health and safety while patients prioritised supports that enable self-efficacy and independence. While formal supports which eased care-giver burden were viewed positively by all members of the triad, many patients also rejected formal supports, citing that informal support from their care-giver was available. Such conflicts between patient, care-giver and physician-perceived value of supports may have important implications for consumer and care-giver willingness to accept formal supports when supports are available. These findings contribute to the broader literature on community-based care by incorporating the perspectives of patients, informal care-givers and family physicians to understand better the barriers and facilitators of uptake of supportive services that contribute to successful ageing at home.

This study investigates the changes in social network types among older adults in South Korea, and it examines whether, and to what extent, these changes influence their health and psychological wellbeing. Data were obtained from the Korean Longitudinal Study of Ageing. The sample was restricted to respondents over 65 years of age who participated in both the 2006 and 2008 surveys (N = 3,501). The social network types for both years were derived by Latent Class Analysis. Changes in network types over time were then identified. A series of multivariate regression analyses were conducted to examine the effects of social network changes on self-rated health, depressive symptoms and life satisfaction. Restricted, Family, Friend and Diverse network types were derived in each wave of the study. Although the direction of social network changes was not always towards the Restricted type, the Restricted network was the most prevalent and stable type among older Koreans. Older adults who remained in or transitioned to restricted types of social networks were more likely to have poor self-rated health, higher levels of depressive symptoms and lower levels of life satisfaction. This study adds to the limited body of literature on longitudinal network typology, and it expands the knowledge of social network types among older adults in diverse social and cultural contexts.

Population ageing is a global trend that affects individual life plans, family arrangements, market structures, care provisions and pension schemes. We combine insights from demography and lifecourse research to understand better the causes of population ageing. Demography explains population ageing by describing changes in fertility, mortality and migration rates. Lifecourse research argues that these rates are interconnected because they are embedded in the lifecourses of individuals. An individual's experiences at an early age can influence behaviours at a later age, thereby creating continuity throughout the lifecourse. Additionally, lifecourse research underlines that social networks – such as families – and countries influence lifecourse. Thus, historical events and past experiences have already set the course for today's demographic changes. Moreover, the effects of policies that strive to influence population ageing will not be evident for years or even decades to come. This paper introduces a conceptual framework that explains how the lifecourse perspective can be applied to the phenomenon of population ageing and illustrates the framework through a case study of Germany. The case study highlights that insights from the micro-, meso- and macro-levels need to be combined to achieve a deeper understanding of population ageing. Scholars can use the framework presented in this paper as a guideline for merging arguments from demography and lifecourse research in future studies.

Loneliness is a debilitating condition with particular negative health effects, including psychological distress. While the vast majority of older people do not experience significant degrees of loneliness, a minority do and there are some reports that this is even greater among lesbian, gay, bisexual, transgender and intersex (LGBTI) seniors. This article examines the experience of loneliness and social support among LGBTI people aged 50 and over living in New South Wales, Australia. It also explores their interest in participating in social and health-promoting activities. Findings from an online survey delivered to 312 people are reported. Loneliness was associated with living alone, not being in a relationship, higher psychological distress and lower mental health. Nonetheless, most respondents reported that they are able to gain support from both biological family and friends if they need it in a crisis. The social and health-promoting activities that were most preferred among all respondents were fitness groups, walking groups, swimming and meditation. Those who experienced the greatest degree of loneliness were much more likely than those who were less lonely to want to participate in social and health-promoting activities with other LGBTI people. The findings indicate scope for community organisations to develop targeted interventions, such as those social and health-promoting activities most preferred by the participants of this study.

Optimal mobility is fundamental for healthy ageing and quality of life. This study is part of a cross-sectional population-based study of 85-year-old people residing in Linköping municipality, Sweden. The purpose was to describe 85-year-old peoples' health-related quality of life (HRQoL) in relation to mobility and fall risk while adjusting for gender and body mass index. Data collection included a postal questionnaire, a home visit and a reception visit. HRQoL was assessed with EQ-5D-3L, mobility with the Timed Up and Go test (TUG) and fall risk with the Downton Fall Risk Index (DFRI). All those who completed the DFRI, TUG and EQ-5D-3L were included in the present study (N = 327). Lower HRQoL was associated with longer time taken to complete TUG and higher fall risk in both genders but not with body mass index. Women had higher risk of falling, took a longer time to complete TUG and reported less physical activity compared with men. Health-care professionals should address mobility capacity and fall risk in order to maintain quality of life in elderly people. This is of utmost importance, especially for elderly women because impaired mobility, high risk of falling and occurrence of pain are common among women, and related to lower HRQoL.