By the late 20th century, the plight of millions of older people in many developed countries was regarded as serious and was acknowledged to require concerted cross-national remedial action. Sociologists and social gerontologists only then were beginning to put together explanations rooted in the evolution of social policy and its corresponding institutions. One thesis that attracted support was that the dependency of the aged had been ‘structured’ by long-term economic and social policies. During the final decades of the 20th century, older people were perceived and treated, according to accumulating research evidence, as more dependent than they really were or needed to be. This had been fostered by the emerging institutions of retirement, income maintenance, and residential and domiciliary care. This development had been the responsibility primarily of the State, which tried to deliver welfare but also to accommodate the market. Forms of discrimination against older people had become, or continued to be, as deep as forms of discrimination against women and ethnic minorities. Such ‘institutionalised ageism’ had to be countered. Hopes were invested in anti-discriminatory policies that reflected good reciprocal relationships between the generations in many families and the rights of individuals of any age to human dignity and opportunities to practise their skills. The globalisation of the market and affiliation to neo-liberal policies, together with the simultaneous passage of various instruments of human rights, have changed the nature of the problem, and therefore the debate, during the early 21st century. This paper argues that the release and implementation during and after the Second World War of collective liberal egalitarian values, expressed in many countries in international statements on human rights, as will be shown, had a big impact on the design of public services, including those for older people. If the claims for the elderly in the welfare states of 50 years ago were exaggerated, as we can now safely conclude, the claims for older people today are even more exaggerated – at a time of heightened emphasis on individual rights and individual market powers. The various problems of ‘structured’ dependency persist, and seem set to grow in many parts of the world. Human rights offer a framework of rigorous analysis and anti-discriminatory work. Success depends on good operational measurement, and the incorporation of international and national institutions and policies that reflect those rights.

Retirement is undergoing structural and discursive transformations that have implications for the individual and social experience and management of later life. Although discourses about retirement do not determine how individuals will prepare for and act as ‘retirees’, they provide morally-laden messages that shape people's possibilities for being and acting. Using Canadian newspaper articles published in 1999 and 2000, and drawing upon the governmentality perspective, this study explores the interconnections between neo-liberal political rationality and discursive constructions of ‘retiree’ subjectivities. The analysis demonstrates the ways in which certain subjectivities, and their associated technologies and practices of the self that are consistent with neo-liberal political rationality, are being shaped as ideal for ‘retirees’. The paper critically examines this process and its implications, and argues that the personal ‘freedom’ promised with the idealised life practices is ultimately illusory, because they oblige older people to resist or defy ageing through relentless projects of self-reflection and improvement, self-marketing, risk management, lifestyle maximisation and body optimisation. The implications of the neo-liberal discourse about old age and ‘retirees’ for future social policies and older people's services are critically examined.

The article aims to answer three questions: How strong are the bonds of obligations and expectations between generations? To what extent are different types of support exchanged between generations? What are the impacts of filial norms, opportunity structures and emotional bonds on the exchange of inter-generational support between adult children and older parents across societies? It reports findings from the five-country (Norway, England, Germany, Spain and Israel) OASIS study, which collected data from representative, age-stratified, urban-community samples of about 1,200 respondents in each country. The findings indicate that solidarity is general and considerable although the strengths of its dimensions vary by country. Most respondents acknowledged some degree of filial obligation, although the proportions were higher in Spain and Israel than in the northern countries, and there was greater variation in the tangible forms than in the expressed norms. Adult children were net providers of support, but older parents provided emotional support and financial help. Most support was provided to unmarried older parents with physical-function limitations. The effect of filial norms on help provision by adult children was moderate but significant and variable across the five countries, appearing more prescriptive in the south than in the north, where inter-generational exchanges were more open to negotiation. The findings demonstrate that cross-national analyses provide insights into both country-specific factors and the sometimes unexpected similarities among them.

This paper reports a study of the complex associations between older people's participation in activities and their wellbeing in later life using data from a national sample of 1,334 Jewish-Israeli retirees. Confirmatory factor analysis substantiated a division of the activities into solitary, formal and informal categories, as postulated by activity theory. The outcome measure, the latent construct wellbeing, was compiled from scores on the 12-item General Health Questionnaire (GHQ-12), a global measure of life satisfaction, and a measure of satisfaction with the use of time. The analysis also examined the influence of socio-economic status, health status and the quality of inter-personal relationships. ‘Social relationship quality’, also a latent construct, was a composite of measures of satisfaction with children, friends and neighbours and a self-rated loneliness scale. Path analysis using structural equation modelling was employed. The results showed that when the quality of social relationships was taken into account, the amount of activity had no independent effect on the respondents' wellbeing. Moreover, it was social relationship quality, a facet of informal activity that has generally been neglected in activity research, that emerged as the most influential variable in the association between activity and wellbeing. Thus, the findings provide empirical backing for the assertion that the quality of social ties matters more than activity participation per se as predictors of a good old age.

Life expectancy has been increasing rapidly in many parts of the world, including Hong Kong. A longer life can be welcome as an opportunity to fulfil as yet unmet aspirations, or to take up new challenges and projects, but it may also be a burden, especially for individuals who are unprepared. A pressing question for longer-life societies is: how may older people live their longer lives to the full positively? This article reports a qualitative study of Hong Kong Chinese people's views about ‘positive ageing’, as expressed and discussed in 15 focus groups of middle-aged and older people. Two themes emerged: first, the participants considered that positive ageing should comprise good health, having a positive life attitude, active engagement with an activity or with society, feeling supported by their families and friends, being financially secure, and living in a place with emotional ties; and secondly, several key factors that enable positive ageing were identified, namely, adopting a healthy lifestyle, thinking positively, promoting family and inter-personal relationships, and building up financial resources. The views of the participants about ‘positive ageing’ are compared with those reported from western studies, and the policy implications are considered.

The Senior Help Line in Ireland provides a confidential telephone listening service for socially-excluded older people and is operated by older volunteers. The service has grown rapidly in recent years and is highly regarded as an important service for older people in the country. This paper provides a systematic examination and assessment of the service, from the perspectives of costs, outcomes and best practice. The study uses personal interviews, focus groups and postal questionnaires to elicit information about the service and its impact on volunteers and callers. The Senior Help Line has made a significant contribution to the health and wellbeing of older people in Ireland at relatively low cost. The service demonstrates the positive effects of volunteering for older people, and the value and effectiveness of peer-to-peer communication for vulnerable callers. The help-line is a model project in terms of accountability and best practice, but requires additional resources, particularly for publicity and training. It needs to become a branded national service for vulnerable older people to meet the level of need for a service of this kind. The help-line also needs to be linked more formally to existing health and social care provision for older people, to become part of a holistic model of healthy ageing for older people. For the service to reach its manifest potential, the efforts of the volunteers need to be supported by higher and sustained levels of public spending, through more widespread and substantial public-voluntary partnership arrangements.

This paper reports findings from a European Commission funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom, and presents projections of future long-term care expenditure in the four countries under a number of assumptions about the future. Macro-simulation (or cell-based) models were used to make comparable projections based on a set of common assumptions. A central base-case served as a point of comparison by which to explore the sensitivity of the models to alternative scenarios for the key determinants. The sensitivity of the models to variant assumptions about the future numbers of older people, the prevalence of functional dependency and informal care, patterns of long-term provision, and macroeconomic conditions are examined. It was found that, under the base-case, the proportion of gross domestic product spent on long-term care is projected to more than double between 2000 and 2050 in each country. The projected future demand for long-term care services for older people is sensitive to assumptions about the future number of older people, the prevalence of dependency and the availability of informal care, and projected expenditure is sensitive to assumptions about rises in the real unit-costs of services and the structure of the models. It is important, for planning purposes, to recognise the considerable uncertainty about future levels of long-term care expenditure.

This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of ‘knowledge structures’ when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests.