Social pension programmes play a key role in old-age support systems through their ability to reach vulnerable older persons. Pension income helps to sustain households affected by extreme poverty and vulnerability, by providing resources for spending that protects against vulnerability, and thereby they facilitate economic and social development. Under apartheid, South Africa's citizens were categorised according to race, and persons classified as Asian, black and coloured (mixed race) had less access to the opportunities and resources available to whites. Parity in the amount of social pension benefits paid to beneficiaries in the different ethnic categories was achieved only in 1993. The Non-Contributory Pensions and Poverty Study (NCPPS), conducted in Brazil and South Africa, has assessed the impact of social pension income on household poverty alleviation. This paper draws on the findings of the South African survey to analyse the differential effects of pension income on household poverty alleviation in three ethnic-geographic groups. Its data show a pervasive social and economic gradient of disadvantage among the groups, with rural-black households being most disadvantaged, urban-coloured households least disadvantaged, and urban-black households in between. The impact of pension income on household poverty alleviation has a similar pattern. The paper concludes with a discussion of the implications of the findings for the achievement of equity through informed policy interventions.

People in advanced old age with frailties and those who are resident in old-age institutions manage their identities within the constraints of stigmatised settings. This paper compares the processes of identity construction in an old-age home and in a sheltered housing project for older people in Israel. Applying a symbolic-interactionist perspective that sees old-age institutions as social arenas for the reconstruction of identity, the paper first distinguishes the residents' constructions of stigma and deviance. While the old-age home residents collectively turned their stigma into a source of positive labelling, the sheltered housing residents drew advantages from their previous roles and statuses. Gossip is shown to play a critical role in reproducing stigma, particularly in the old-age home. These findings are used to demonstrate the variability and potential for adaptation among the residents – who are often stereotyped as homogeneous and passive. The paper concludes with a discussion of the literal and metaphorical languages used by older people, and of stigma as a positive instrument that can introduce content into the definition of the self.

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.

This paper presents a new scale for the assessment of the salience of age in social interaction and of levels of agreement with four age stereotypical assertions, about the characteristics of people in the ‘third age’ and the ‘fourth age’, about older people's social roles and social participation, and about the problems for society produced by population ageing. The scale was constructed by testing the agreement of a national sample of 804 German respondents aged 41–84 years with over 60 item-statements in two pilot studies. The final scale has 24 items, and was tested using a stratified sample of 1,275 subjects aged 40–75 years. Five postulated subscales were confirmed using principal components analysis: ‘age salience’ in social interaction, old age as a time of ‘developmental gains and potentials of development’, old age as a time of ‘developmental losses and risks of development’, ‘the social downgrading of older people’, and believing that ‘older people are a burden on society’. For age stereotypes and age salience, no significant sex differences were found, but those aged 58–64 years held more optimistic views about old age and population ageing than both the younger and the older age groups (with no differences between the latter). Moreover, age stereotypes and age salience varied by several social-economic variables, particularly occupational status, the rate of unemployment in the region of residence, and being resident in the eastern or western part of Germany. No significant interactions between age group and sex were found for any of the five subscales.

Over the last few decades in Sweden, the proportion of older people living in the community who receive public home-help services has decreased, even amongst the oldest old. At the same time, the abilities of older people in the activities of daily living have on average improved. This paper reports a study of the changes between 1988/89 and 2002/03 in the allocation and utilisation of public home-help services and in the support and care needs of older people (aged 65 or more years). The aims were to analyse whether the reduction in the percentage of home-help recipients could be explained by a reduction in needs among the older population, whether public home-help services had been targeted at people with greater needs, and whether informal care had increased. It was confirmed that over the 15 years, even after taking needs factors into account, the likelihood of an older person being a recipient of public home care had declined. Home help had clearly been targeted at more needy individuals. Among older women (aged 80+ years) with limitations in the activities of daily living and who lived alone, the proportion that received home help declined and the proportion that received informal care increased, which suggests that informal care had substituted for formal care. The findings indicate that the Swedish welfare system had reduced its commitment to the support of older people who require less intensive care and that, in effect, the concept of need for public social care support had been redefined.

This paper reports a systematic review of 28 evaluations of interventions that aimed to describe the benefits of the use of the life story for nursing-home residents with dementia, particularly with reference to their sense of identity. The 28 studies were published during 1990–2003. The review focuses on the methodology of the evaluations, and on how the studies contributed to our understanding of the value of using a resident's life story in care interactions. The studies were divided into three groups by the purpose of the intervention: to raise self-esteem and self-integration; to improve life quality; and to change behaviour. The features of the interventions that were associated with enhanced sense of identity were a thorough and encompassing treatment of the individual's life story, the translation of the life story into care interactions, and active encouragement of the residents' initiatives. Only one intervention had all of these features. The diverse aims and forms of the interventions were mirrored by the diverse methodologies of the evaluation studies. Recently the trend has been towards more rigorous designs that measure a few precisely-defined quantitative outcomes but at the cost of a narrower appreciation of the impacts. Given that there is still a great deal to learn about how best to deliver sensitive, individualised and effective support and care to people with dementia, it is argued that qualitative assessments have been too hastily discontinued.

This article describes and evaluates cash-for-care programmes for older people in four European countries, namely Home-Care Grants in Ireland, Direct Payments in the United Kingdom (England), Service Vouchers in Finland and Personal Budgets in The Netherlands. The purpose is to raise understanding of the background and reasons for the introduction of cash-for-care programmes and their impact on the countries' care regimes. It is argued that while the motives for introducing cash-for-care programmes in the four countries are similar, namely to promote choice and autonomy, to plug gaps in existing provision, to create jobs, and to promote efficiency, cost savings and domiciliary care, the relative importance of these goals varies. Current cash-for-care programmes have comparatively modest coverage as compared with direct service provision and provide no more than an optional, supplementary source of care in three of the studied countries. Cash-for-care schemes have not radically transformed the care regimes in Finland, The Netherlands or the United Kingdom. In Ireland, however, the restricted availability of alternative forms of formal service provision means that the expansion of cash-for-care might shift care provision significantly towards private provision and financing.

This article examines whether the different welfare states of the European Union member states engender different policy preferences and attitudes among the population. More specifically, it investigates variations in attitudes towards population ageing and pension reforms, and variations in people's retirement age preferences and expectations. It is shown that despite the different cultures and welfare traditions in the old and new member states, there are commonalities in people's value orientations and views about population ageing, not least that the vast majority are pessimistic about the consequences. In both Eastern and Western Europe, the most popular options for pensions reform are to raise taxes and to extend working life, and few favour reducing pension benefits. Despite these similarities, there are also marked attitudinal differences. Eastern Europeans rely more on their children for old-age care and are much more in favour of a pension structure in which benefits depend on the number of children. On personal expectations and preferences for retirement, it is shown that both Eastern and Western Europeans expect to retire from the labour market at an older age than the current actual retirement age.

The aims of this paper are to investigate both older people's views about ways in which to finance health-care costs and their willingness to pay for treatment themselves, along with variations in these views by age and gender. The data are from the Good Ageing in Skåne (GAS) prospective longitudinal cohort study in Sweden, which involved medical examinations and a survey of living arrangements and socio-economic conditions. For the analysis reported in this paper, 930 GAS respondents aged 60–93 years were invited to participate in an additional structured interview, and 902 (97%) accepted. The sample was divided into the ‘young-old’ (aged 60–72 years), ‘old-old’ (78–84 years) and ‘oldest-old’ (87–93 years). It was found that the participants recommended increasing health-care funding by higher taxes and that they were willing to pay themselves for specific treatments, e.g. cosmetic surgery and medication to combat impotence and obesity. Many were also willing to pay privately for cataract surgery, to shorten the wait, although the respondent's financial circumstances associated with this willingness. Significantly more men than women, and of the ‘young-old’ than of the other two age groups, would pay for cataract surgery. The views of people aged 85 or more years differed from those of the young-old, e.g. significantly fewer believed that older people's health care received too little resource. Views about how to finance health care thus differed among the age groups and between men and women.