Drawing from theory and research on the role of social networks in promoting or undermining preventative public health measures, this article considers how structural, compositional and functional aspects of older adults’ close social networks are associated with HIV testing in the context of rural South Africa. Analyses use data from the population-based Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) – a sample of rural adults age 40+ (N = 4,660). Results from multiple logistic regression show older South African adults with larger, more heavily non-kin and more literate networks were most likely to report testing for HIV. People whose network members provided frequent information were also most likely to be tested, though interaction effects indicate that this pattern is primarily found among those with highly literate networks. Taken together, the findings reinforce a key insight from social capital perspectives: network resourcefulness – literacy in particular – is crucial for promoting preventative health practice. The synergy between network literacy and informational support reveals the complex interplay between network characteristics in shaping health-seeking behaviour. Continued research is needed on the connection between networks and HIV testing among sub-Saharan older adults, as this population is not currently well served by many public health efforts in the region.

The decision of whether to grow old in one's home (also referred to as ageing in place (AIP)) or relocating to an institution is an ongoing negotiation process, which involves residential decisions and adaptation. This research aims to explore how childless older adults in rural China choose between AIP and institutionalisation. Through a qualitative study conducted in rural China among childless older adults, we explored the reasons why they make certain residential choices and how they adapted during the decision process. Twenty-five childless participants (aged 60–83) were interviewed. Findings suggested that they referred to the term ku (literally meaning ‘bitterness’; and a metaphor referring to ‘conducting farming and farm-related activities’) to explain their residential decisions. If a person could endure ku – sustain food and basic living through farming and farm-related activities, they tended to choose to age in place; otherwise, they chose to relocate to institutions. Ku represents a sense of mastery, encompassing the stressfulness and suffering aspect that requires adaptation. Three adaptive strategies were identified: (a) positive reappraising of the negative aspect of ku, (b) routinising ku, and (c) transcending the narrative of ku into a toughness identity. Our findings suggest that childless older adults struggled to achieve residential mastery while making residential decisions, even though a sense of mastery was shaped by the individual and structural constrictions.

The aim of this study was to explore the experience of family care-givers of people with dementia during the COVID-19 pandemic in the Veneto region of Italy to understand how and to what extent the emergency has affected care-givers’ lives and care routines. Twenty adult children of an ill person were interviewed via phone and video call, in adherence with the restrictions against COVID-19. Thematic analysis showed five main themes: the care-giver's experience, the care recipient's experience, relationships with care recipients, changes in the care routine and resources. Results pointed out that the time needed in the care routine and everyday activities increased during the pandemic, together with the need to find alternatives to physical activity at home. Depending on one's personal experience of COVID-19 and approach to preventive rules, the availability of resources, and formal and informal support, three main approaches to care were identified: apprehensive, mindful and fatalistic ones. The pandemic amplified the differences among these already-existing approaches to care as well as the typical challenges and difficulties experienced by family care-givers, and it resulted in an increased burden connected to practical difficulties, emotional stress and difficulties in reaching for help. These results underline the importance of strengthening the external support network for older people to help family care-givers, especially during emergencies.

Seniors are a population of concern due to exposure to both increasing gambling venues and powerful age-specific risk factors. There has been only limited research on this population so far, but studies conducted among younger adults suggest that the illusion of control is a key factor, leading players to develop strategies that increase their risk-taking in gambling. Time perspective (TP) is a good indicator of risky behaviours in a number of different areas, including health and the environment. In the present study, we sought to identify the age-specific cognitive mechanisms underlying gambling behaviour in normal ageing. We asked 115 emerging adults (mean age = 20.86 years), 86 young adults (mean age = 30.59), 82 middle-aged adults (mean age = 44.57) and 108 seniors (mean age = 65.19) to play an online game. We rated their illusion of control, risk-taking and TP. Analysis revealed that seniors took more risks and had less illusion of control than younger adults. The fatalistic-present TP positively influenced the illusion of control, such that perceiving the present as being determined by uncontrollable forces increased the perceived level of control. Finally, we found an influence of age on TP. These results suggest that seniors constitute a specific population in terms of gambling-related cognitions and behaviours. Including TP in risky behaviour assessments would allow the development of tailor-made preventive measures.

Unnecessarily delayed discharges from hospital of older people living with frailty can have negative consequences for their health and add significant costs to health services. We report on an ethnographic study at two English hospitals and their respective health and social care systems where we followed 37 patient journeys. The study aim was to understand why delays occur. Our findings indicate that working practices in the study hospitals may have inadvertently contributed to delays. While many pieces of patients’ clinical and social information were collected, recorded and accessed in different ways by different professionals, to facilitate a discharge, these pieces needed to be re-found, integrated and re-constructed. A key component of this process was information related to patients’ social, family and functional background. This was often missing, not accessed or perceived to be of low value compared to other more readily available clinical information. Patients’ re-construction was thus often incomplete, or insufficient to reduce the clinical and prognostic uncertainty associated with frailty and to manage risks inherent in older people's discharge. Where this key component was present and integrated into decision-making in multi-disciplinary team working, uncertainty and risk were managed more constructively and sometimes avoided an escalation of care needs.

The purpose of this study is to assess the relationship between adult children's education and older parents’ cognitive health, and the extent to which this relationship is moderated by parents’ own socio-economic and marital statuses. Data using Waves 5 (2000) to 13 (2016) are drawn from the Health and Retirement Study (HRS), a nationally representative panel survey of individuals age 50 and above in the United States of America (USA). Older parents’ cognitive functioning is measured using episodic memory from Waves 5–13. Adult children's education is measured using years of schooling, on average, for all adult children of a respondent. Analyses based on multilevel linear growth curve modelling reveal that parents with well-educated adult children report higher memory score over time compared to their counterparts whose children are not as well-educated. We also find that the positive effect of children's education on parents’ cognitive health is moderated by parents’ own education, though not by their income, occupation or marital status. Our work contributes to the growing body of research on the ‘upward’ flow of resources model that assesses the ways in which personal and social assets of the younger generation shape the health and wellbeing of the older generation. Our findings are particularly relevant to the USA given the enduring linkage between socio-economic status and health, and the limited social and economic protection for those of lower social status.

Relations between grandmothers and their grandchildren following the loss of the son/father have not been studied to date. The present article focuses on this experience, as reflected in the stories of grandmothers (bereaved mothers) and spouses (widows) after the loss, and explores the perception of grandparenthood following the loss of the son/husband. Twenty semi-structured interviews were conducted with ten grandmothers (bereaved mothers) and spouses (widows) who were recruited as a convenience sample. Data were subjected to thematic analysis. The findings revealed three key patterns of the grandmother–grandchild relations, as perceived by the two groups of women. The patterns indicate complex relations between widows and bereaved mothers, which have implications for the access of the grandmothers to their grandchildren and for their perception of grandparenthood. The study sheds light on the patterns of relations in families that have lost the son/husband/father. The change in power balance between family members and the asymmetry in the family structure created by the absence of the son/husband affect grandparenthood relations. The study emphasises the role of the widows, as the middle generation, in shaping or mediating relationships following the loss. The findings stress the importance of clinical intervention with both the bereaved mothers and the widows.

As a result of the rapid ageing of societies, meeting the demands for long-term care has become increasingly difficult. In the Netherlands, informal care is recognised as a key element to compensate for cut-backs in formal care provision. Formal, informal and privately paid long-term care services, however, are not used equally across socio-economic status (SES) groups and whether these inequalities have been reduced or exacerbated over time has not been researched. This study investigates to what extent educational and income inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time: 1995 (N = 787), 2005 (N = 550) and 2015 (N = 473). Participants were between 75 and 85 years of age and living independently. The results indicate that lower SES groups are consistently more likely to use formal and informal care, and less likely to use privately paid care compared to higher SES groups. An increase in inequality was only found in the use of informal care; while informal care use is stable among lower SES groups, it decreases steeply among higher SES groups. These findings highlight the importance of education for explaining variation and changes over time in care use. Governmental efforts to mobilise informal care-givers might be outweighed by trends towards less long-term care.

The active ageing approach supports a set of roles or activities that are supposed to be beneficial for older adults. This paper reassesses the benefits of activities for the quality of life by (a) analysing many activities at the same time to control each other, (b) using panel data to detect the effects of activities over time, and (c) performing separate analyses for four European regions to test the context-specificity of the effects. The effects of roles in later life are tested on panel data from three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) project. The results of fixed-effects regression show that only some activities – volunteering, participating in a club and physical activity – increase the quality of life, and that care-giving within the household has the opposite effect. Moreover, the beneficial effects are much weaker and less stable than the other types of regression suggest; they are beneficial only in some regions, and their effect is much weaker than the effects of age, health and economic situation. Therefore, the active ageing approach and activity theory should reflect the diverse conditions and needs of older adults to formulate more-context-sensitive and less-normative policy recommendations.

Social resources – close relationships, support exchange and social engagement – can play an important role in successful adjustment to widowhood in later life. However, it is not clear whether access to, and the utilisation of, social resources are different for men and women during late-life widowhood. This study provides a qualitative exploration of the experience of social resources in the lives of older widowed men and women across the transition to widowhood (from pre-widowhood to later widowhood). Using a life course theory lens, in-depth interviews were conducted with 20 men and women who had been widowed in later life. The interview data were analysed using the framework approach. Four phases in the transition to widowhood were identified: ‘Illness and caring’, ‘Relocation and separation’, ‘Early bereavement’ and ‘Life goes on’. Widowhood brings great change to the accessibility and utilisation of social resources, and each of these transitional phases was associated with differential usage of these resources. Gender differences were observed in the availability of social resources across the transition to widowhood, with widowed men typically found to have smaller friendship networks, receive less support and be at increased risk of social isolation. Particular attention is required to ensure that all older widowed men and women have access to sufficient social support and contact following bereavement.

Whilst loneliness and social isolation amongst older care-givers are becoming increasingly recognised, little is known about how these concepts impact on specific sub-groups of care-givers, such as older males. In the current study, we aimed to gain a better understanding of the experiences of loneliness and social isolation amongst older spousal male care-givers. Semi-structured interviews were undertaken with 24 participants, caring for a spouse/partner with a long-term chronic condition. After thematic analysis of the data, three themes were identified: dwindling social interactions, loneliness in the spousal relationship, and living with loneliness and social isolation. Study findings suggest that opportunities for social interactions gradually ‘dwindled’ due to a reluctance by older male care-givers to leave their spouse/partner at home alone, to accept offers of help or respite, or to attend social events without their spouse/partner. Consequently, social isolation increased. Feelings of physical and emotional loneliness were evident, and the loss of spousal companionship (such as loss of conversation and shared interests) increased loneliness. Individualised coping strategies were adopted including focusing on moments of positivity, talking to others and using prescribed medication. Findings provide insight into the experience of loneliness and social isolation for many older male spousal care-givers. This may facilitate a better understanding of older male care-givers’ support needs in addressing loneliness and social isolation, and should help to inform the development of targeted support services for this population.

Previous studies have shown that family networks evolve over time. Nonetheless, little research has linked family expansion or shrinking to the levels of available family-based social capital in older adults’ family networks. To address this research gap, this paper explores the following question: to what extent are changes in family composition and family-related life events associated with current levels of family-based social capital in later years? We use the two waves of the longitudinal CIGEV-LIVES Vivre-Leben-Vivere study, a large survey addressing the family and health conditions of older people in Switzerland. We combine data on life events occurring during old age and family configurations. We find that family networks are indeed highly dynamic, with distinct patterns of losses and gains observed among respondents. Adding and omitting significant family members has distinct significant effects on social capital, while family-related life events only have marginal effects.