Dementia is a growing issue in the United Kingdom (UK) with over 800,000 people affected. Of these people, in excess of 40,000 are aged under 65 years. Thus, a significant number of individuals may be experiencing symptoms of dementia while in employment. In addition, as working lives extend, the potential impact of dementia on the workplace could be substantial. However, to date, there has been little research on experiences of dementia in the workplace. The research that exists highlights the lack of support for workers with dementia. Dementia may be considered to be a disability under the Equality Act 2010. Therefore, the legislation potentially provides a framework for individuals to request that their employer make reasonable adjustments to support their continued employment. International human rights law is potentially another tool that could be utilised to obtain necessary adjustments. This paper argues that in developing the evidence base on workplace experiences of dementia, it is important that the legal framework be considered. This paper reviews the existing literature on dementia in the workplace and embeds this in the legislative framework in order to establish a cross-disciplinary research agenda. While the paper focuses on the UK legal context, the argument presented in the paper is still relevant to other national contexts.

Uganda's population is ageing, which comes with increased and varied burdens of disease and health-care needs. At the same time, gerontological care in Uganda remains neglected. This paper examines the factors that cause older Ugandans to delay health-care access. We conduct a thematic analysis of data drawn from nine focus groups held with rural Ugandans aged 60-plus. Our analysis highlights the factors that delay older persons’ access to health care and how these align with the Three-Delay Model, which was originally developed to assess and improve obstetric care in low-resource settings. Our participants report delays in deciding to seek care related to mobility and financial limitations, disease aetiology, severity and stigma (Delay I); reaching care because of poor roads and limited transportation options (Delay II); and receiving appropriate care because of ageism among health-care workers, and poorly staffed and under-supplied facilities (Delay III). We find these delays to care are interrelated and impacted by factors at the individual, community and health-system levels. We conclude by arguing for multi-pronged interventions that will address these delays, improve access to care and ultimately enhance older Ugandans’ health and wellbeing.

The benefits of meaningful activity in later life are well documented. Studies show that being occupied contributes to both physical and mental health as well as quality of life. Research also suggests that activity may be beneficial to people residing in care homes, including people living with dementia. This paper presents findings from a study which used the Adult Social Care Outcomes Toolkit (ASCOT) to measure quality of life in six care homes located in the south-east of England. The study found, like previous ones, that care home residents’ days were characterised by a lack of activity. Drawing on observations, interviews and focus groups with residents and staff from these homes, this paper attempts to understand why care home residents do not engage in meaningful activities. We reject the idea that these low levels of activity are a natural part of the ageing process or that they can be explained by notions of resident choice. Instead, the findings point to both insufficient funding and working practices within care homes as more substantive explanations. These explanations inform a discussion of how the low levels of engagement in meaningful activity could be addressed and residents’ quality of life improved.

In health and chronic illness, satisfying marriages promote wellbeing and life satisfaction, yet stroke research has focused on either the stroke survivor as the patient or the spouse as a care-giver. Using Pope, Mays and Popay's framework for synthesising qualitative and quantitative methods, we conducted a systematic review and synthesis of 39 peer-reviewed studies to determine what happens to marital relationships after one partner has suffered a stroke. All the articles examined the impact of stroke. Three overarching themes characterise the evolution of marriage after stroke: chaos in the marriage, work to re-establish the marriage and evolution of the marriages. While both the stroke condition itself and the survivors’ need for care undermined the emotional qualities of the relationship for some couples, about two-thirds were able to retain or regain the relationship closeness. As in other chronic illnesses, the relationship closeness and a couple's ability to collaborate contributed to the survivor's recovery and to the satisfaction with life of the stroke survivor and the spouse. Our results underscore the need to consider the quality of, and the qualities of, the relationship between stroke survivors and their spouses. Future research could include a greater focus on qualitative or mixed-methods approaches to explore the interactions between stroke survivors and spouses that impact the wellbeing of both partners.

Due to the growing elderly population, adult children care-givers (ACCs) are increasingly providing complex care for one or both elderly parents. Social support from similar peers can mitigate care-giving-related health declines. To date, ‘peer similarity’ amongst care-givers has been predominantly investigated in the context of peer-matching interventions. However, because peer similarity is especially influential in ‘naturally occurring’ support networks, care-givers' everyday peer support engagement warrants further attention. Our goal was to explore care-givers' everyday peer support engagement and the influence of peer similarity on support perceptions. We employed a mixed-method design using Web-based surveys and in-depth qualitative interviews. The quantitative data were analysed using a hierarchical multiple while qualitative data were thematically analysed. Seventy-one ACCs completed the online questionnaire and 15 participated in a telephone interview. Peer similarity was positively and significantly associated with perceived support (β = 0.469, p < 0.0005) and explained 18.5 per cent of the additional variance. ACCs' narratives suggested the most important aspect of similarity was ‘shared care-giving experience’ as it optimised the support received from peers, and also enhanced the quality of the relationship. In conclusion, both data-sets underscored that peer similarity importantly influences support perceptions. The importance of ‘shared care-giving experience’ suggests that a more comprehensive understanding of this concept is needed to optimise peer-matching endeavours. Peer similarity's influence on relationship quality should also be explored.

An overarching reason why carers do not utilise support services is that many people who perform care-giving do not necessarily self-identify as a carer. Understanding the development of carer identities is therefore crucial for the utilisation of different carer-focused health services. This study arose from the European Union-funded INNOVAGE project and aimed to describe how older carers conceptualise and understand their identity as carers on a Swedish online social forum. Theoretically the study adopts a constructionist approach and the method of netnography was applied. The findings reveal that a change in self-perception occurs in the process through which a carer role is acquired. The presence or absence of recognition for the older carers’ capacity, knowledge and life situation is seen as filtered through the needs of the care recipient, making the carer identity into an invisible self. This is not least the case when the identity is constructed in alliance with conceptual and moral obligations found within a marital discourse. Nevertheless, the opportunity for online communication may help to create a virtual space of social recognition through which different experiences attached to caring can be discussed. The significance of online communication is here understood as the possibility it presents for carers to be recognised by other carers. It is a process through which an invisible self can become visible.

Using data from the Cebu Longitudinal Health and Nutrition Survey (1994, 1998, 2002, 2005, 2007, 2012), we utilise latent class analysis to develop time-use class membership to characterise the degree to which women in Cebu are subject to the double burden of work and family responsibilities in mid- and later life. Results suggest that close to a third of the sample are engaged in high-intensity work for pay (either outside or home-based), while combining it with a substantial amount of household chores and with a low level of personal time in a span of 18 years. Our latent transition analysis also shows that, with the addition of grandchildren into the household, some women experience a shift in time-use class membership by becoming high-intensity care-givers or by completely transitioning out of the work arena, while others remain double-burdened with active involvement in both work and family responsibilities.

This study examined how financial strain, worry about having no care-giver and social engagement modify the association between widowhood and depressive symptoms among older adults in China. Using national representative data from older adults in China in 2006, we ran structural equation models and ordinary least square regressions to investigate the mediating and moderating effects of financial strain, worry about having no care-giver and social engagement on the association between widowhood and depressive symptoms. All three variables significantly mediated the association between widowhood and depressive symptoms. Compared to their married counterparts, widowed older adults showed more worry about having no care-giver, increased financial strain and lower social engagement, which were significantly associated with depressive symptoms. Higher level of worry about having no care-giver and lower social engagement significantly exacerbated the adverse effects of widowhood on depressive symptoms in the moderation analyses. Our finding of mediating effects suggests that widowhood is negatively related to psychological wellbeing via financial strain, social engagement and care resources. The results regarding moderating effects suggest that alleviating worry about having no care-giver and increasing social engagement may buffer the deleterious effect of widowhood on psychological wellbeing in later life.

Previous research has established significant positive associations between social trust and wellbeing among older adults. This study aimed to obtain a deeper understanding of the relationship between different sources of social trust and wellbeing by examining the mediational role of political interest. A sample of 4,406 Italian residents aged 65 years and over was extracted from a national cross-sectional survey during 2013 in Italy, representative of the non-institutionalised population. Measures included trust in people, trust in institutions, political interest, life satisfaction and self-perceived health. Mediation path analysis and structural equation modelling were used to test the mediation effects of political interest on the relationship between trust in people and trust in institutions with life satisfaction and self-perceived health. Associations between trust in people, life satisfaction and self-perceived health, and between trust in institutions and life satisfaction were partially mediated by political interest, while the association between trust in institutions and self-perceived health was fully mediated by political interest. Having high levels of political interest may thus enhance the relationship between social trust and wellbeing among older adults. These results suggest that interventions to enhance wellbeing in older adults may benefit from examining individuals’ levels of political interest.