Considering the important role that paid support workers play in care of older people with dementia, it is vital that researchers and relevant organisations understand the factors that lead to them feeling valued for the work that they do, and the consequences of such valuing (or lack thereof). The current study employed semi-structured interviews to understand the individual experiences of 15 support workers based both in residential care homes and private homes. The General Inductive Approach was used to analyse the interview transcriptions and to develop a conceptual model that describes the conditions that lead to support workers feeling valued for the work that they do. This model consists of organisational or individual strategies, the context in which support work takes place, and various interactions, actions and intervening conditions that facilitate or prevent support workers feeling valued. A significant finding in this research was the role of interpersonal relationships and interactions which underlie all other aspects of the conceptual model developed here. By understanding the importance of how employers, families of older adults with dementia and peers interact with support workers, we may promote not only the quality of work that support workers deliver, but also the wellbeing of the support workers themselves.

Older adults have more health-care needs and higher financial burdens but fewer income resources compared to other age groups in China. Meanwhile, substantial inequalities exist between rural and urban older adults in terms of welfare benefits level, access to health care, quality of care and financial resources to pay for health-care services. Using 2011–2013 panel data from the China Health and Retirement Longitudinal Study and a difference-in-differences methodology, this study examined the association between the incidence of catastrophic health expenditure (CHE) and health-related quality of life among older adults in China. To distinguish the dynamic of CHE and generate rigorous estimates, we categorised the older adults into four groups: CHE entry group, non-CHE group, CHE exit group and CHE persistent group. Overall, we found that entry into CHE was associated with poorer physical and mental health for both rural and urban older adults, but this association was more consistent and robust for physical than for mental health. Exiting CHE was found to have a weak and sporadic positive association with physical and mental health across rural and urban areas. The results suggest that financial resources and social services are needed in China to support older adults who experience CHE persistently or periodically to help improve their health outcomes.

Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants.

Older Black and Minority Ethnic (BME) people living in the United Kingdom (UK) are vulnerable to the experiences of social isolation and loneliness. Despite this, it is widely assumed that they adhere to traditional family practices and living arrangements that protect them from social isolation and loneliness. Such assumptions are problematic and can reify family networks as the main area of research for older BME people to the detriment of friendship networks which are also crucial. However, few researchers have explored this area. With the older BME population increasing at a faster rate than the older white population, further research is needed. Utilising data from Wave 6 of Understanding Society (N = 7,499, 4.3% of whom self-identified as BME), this study explores the ways in which the friendship networks of older BME people differ compared to older white people using logistic regression analyses. After controlling for potential confounding socio-demographic characteristics, older BME people were more likely to report having fewer close friends and fewer friends who live locally, suggesting that their friendship networks may be restricted in quantity and accessibility. Not only do these findings raise important questions about the varying needs of older minority ethnic people who have been largely overlooked in recent government policy, but they also highlight the continuing challenges of using large-scale surveys to research older BME people in the UK.

Centenarians worldwide are growing rapidly and thriving as they age. This growth reflects their desire to thrive beyond personal and societal obstacles, a hallmark sign of resilience. However, little research exists on centenarians’ perspectives about their lived experiences that reflect resilience. Therefore, the purpose of this secondary analysis was to capture the perspectives of Appalachian centenarians about (a) living through their childhood and early adulthood in an area known for poverty and isolation, and (b) exploring the resilient nature that emerged from their narratives. With a qualitative descriptive design, 21 community-dwelling Appalachian centenarians participated in face-to-face interviews. They resided in either their homes or assisted-living facilities. Transcripts were analysed with Neuendorf's method of content analysis. Within three themes, 11 sub-themes were identified: (a) working hard for the family, (b) loss of a loved one, (c) gender and race discrimination, (d) impact of isolation on health, (e) living a simple life, (f) using family/community support, (g) consuming and appreciating food from their farms, (h) spirituality, (i) generosity of spirit, (j) living a clean life, and (k) happy, good and loving life. Collectively, these themes and sub-themes reflected how the centenarians overcame and grew from challenges and adversities to become resilient. Consequently, these findings show that understanding resilience from centenarians’ perspectives can significantly contribute to the potential for longevity.

The article investigates the conditions of multiple engagement in the private and public realm in the second half of life. More specifically, I look at the relationship between informal care-giving and formal volunteering in a country-comparative way. Based on longitudinal data from the Survey of Health, Ageing and Retirement, 2004–2015, I investigate the 50+ population in 13 European countries. Controlling for unobserved heterogeneity by using conditional fixed-effect logistic regression models, I confirm earlier findings that care-givers are more likely to volunteer than non-care-givers; this effect is independent of care-giving intensity but only true for those who care outside their own household. As to macro-level influences, I find that both care-in-kind and cash-for-care expenditures increase the likelihood of volunteering among the 50+ population. The effect of cash-for-care expenditure is even stronger for the group of those who give intensive care outside their own households than for non-care-givers. Moreover, I find effects related to family's and women's role in society. First, I show a negative effect of a country's societal norm of family orientation on volunteering participation for those giving sporadic care outside their household but also among non-care-givers. Second, in countries with higher female labour market participation among the middle-aged, the volunteering likelihood is higher for sporadic female care-givers outside their own household but also among female non-care-givers.

The global population is ageing and the likelihood of living alone increases with age. Services are necessary to help older people living alone to optimise health and wellbeing. This systematic review aimed to summarise the effectiveness and accessibility of interventions to improve the health and wellbeing of older people living alone. Relevant electronic databases (CINAHL, MEDLINE, PsycINFO and Scopus) were searched for all years up to August 2018. Studies were included if they involved older people (aged ⩾55 years) living alone, and an intervention with measured health and wellbeing outcomes. All study types were included. The Theory of Access was used to assess interventions across dimensions of accessibility, availability, acceptability, affordability, adequacy and awareness. Twenty-eight studies met the eligibility criteria; 17 studies focused on ageing safely in place and 11 on psychological and social wellbeing. Studies comprised quantitative (N = 19), qualitative (N = 4) and mixed-methods (N = 5) approaches. Dimensions from the Theory of Access were poorly addressed in the studies, particularly those of higher-quality methodology. Studies were heterogeneous, preliminary in scope and lacked consistent study design, methodology or measurement. Services that do not address user accessibility in design or evaluation may be limited in their uptake and impact. It is recommended that dimensions of access and co-creation principles be integrated into service design processes and be evaluated alongside clinical effectiveness.

Transition to a care home often follows a hospital admission and can be distressing. Care home settings play an important role in the care of many people at the end of life. This longitudinal study employed a narrative approach, aiming to explore the perspectives of older care home residents on transitions to, and life and death within, care homes. Five participants, aged 85 years and over, were recruited from two privately owned care homes in the South-West of England. All participants had a diagnosis of an advanced progressive condition (excluding advanced dementia), or were thought to be frail. Longitudinal interviews (19 in total) were conducted over a ten-month period. A structural narrative analysis was performed and participants’ narratives are presented under three headings, with one participant's story chosen to illustrate each narrative type: ‘becoming a care home resident’, ‘living in a care home’ and ‘death and dying’. Findings revealed that care home residents experience a loss of autonomy and a lack of agency; they are often excluded from decision-making. Older care home residents have few choices with regard to care at the end of life. Further work is required to improve transition into care homes, including support and advocacy during decision-making, which often takes place in hospitals at a time of crisis.

In recent years there has been increasing policy focus on keeping mature-age people engaged in the labour market. At the same time, grandparents play an important role as regular child-care providers for many families. Yet, little research has explored how grandparents negotiate these dual, often competing demands of paid employment and intergenerational care. Drawing on focus groups with 23 grandparents and an online survey of 209 grandparents providing regular child care for their grandchildren in Australia, this paper addresses this gap in the literature by examining how Australian grandparents experience and negotiate competing responsibilities as older workers and intergenerational care providers. The paper draws on the concept of gendered moral rationalities to examine the way in which grandparents’ decisions about participation in paid work are deeply embedded in idealised forms of parenting and grandparenting that are highly gendered. The paper suggests that, as the rate of both maternal and mature-age participation in the paid labour market continues to rise, inadequate attention is being paid to how time spent undertaking unpaid care is compressed, reorganised and redistributed across genders and generations as a result.

Housing options for older people in the United Kingdom (UK) have been rather limited to remaining living ‘independently’ in one's own home and some variant of institutionally provided, pre-established and age-exclusive housing such as retirement communities, extra-care or sheltered housing. However, interest in alternative forms of housing and living which align more closely with the expectations of those currently entering later life is steadily growing. In this paper, we present some findings from original, mixed-methods research on the UK's only established example of senior co-housing, which also happens to be women only. Through thematic analysis, we explore two key questions about this important social experiment: (a) is this a model merely for the dedicated, activist and privileged few, as is often presumed; and (b) what might it tell us about post-traditional ageing. Is it merely a retirement lifestyle choice and identity project, grounded in logics of age denial, activity, choice, individualism and risk management? Our findings cannot be conclusive at this stage, but they do suggest a new model of later-life dwelling for the UK based on more collectivist values of inter-dependence, commitment, learning and, even, love.