Routinely-collected statistics show considerable variation between local authorities in Great Britain, in the proportions of supported residents placed in nursing and residential care. This raises the question of whether this is due to variations in demand (the type of resident approaching authorities), supply (the level and type of provision available for local authorities to purchase), or policy (in terms of eligibility criteria or interpretations of need at field level). Data were used from a national longitudinal survey of individuals admitted to publicly-funded residential and nursing home care. Information was collected from 18 local authorities on a cohort of 2,544 local authority supported residents who had been admitted to residential and nursing home care. The paper examines the pattern of admissions, the characteristics of people admitted and the relationship between these characteristics and admissions to residential or nursing home care. Characteristics of the individual explained the placement of over 80 per cent of admissions. Supply factors were statistically significant but did not improve the explanatory power of the model. Survival among those admitted to a type of care that was not predicted by the model, suggested that some unmeasured aspects of prognosis may account for some of the residual variation in placements. Overall, the results indicate a reasonably high level of consistency between authorities in nursing home placement decisions. This suggests that either there is considerable variation in the types of individual approaching local authorities or, more likely, that some authorities are more successful in maintaining people for longer at home than others. In addition to maintaining people at home to a higher level of dependency, prevention of admission to residential care is likely to be associated with: interventions that address carer support, safety issues among people who are deaf, and motivation.

Life satisfaction continues to be an important construct in the psychosocial study of ageing. It is one of the commonly-accepted subjective conditions of quality of life and seems to be one of the facets of successful ageing, both of which are key concepts in ageing. Research reports that life satisfaction is strongly related to socio-demographic and psychosocial variables. These, however, are mutually dependent interactive variables, and much more attention should be paid to the study of the relative contribution of these two types of factors to life satisfaction. The purpose of the research reported in this article was to discover which socio-demographic conditions and psychosocial factors are the most important, and to decide to what extent they contribute to life satisfaction. A sample of 507 individuals aged 65 and over and representative of the Spanish population in terms of age and gender, were interviewed at home. The results indicate that two socio-demographic characteristics (income and education) influence life satisfaction both directly and also indirectly, through psychosocial factors such as activity (physical activity level, satisfaction with leisure activities, and social contacts), perceived health and physical illness. Among psychosocial factors, activity and health both contribute to explaining life satisfaction. The results are discussed from the point of view of the activity theory of ageing.

As yet the determinants of the need for nursing homes and old age homes are not clearly understood. This may be due to the fact that care facilities providing different levels of care may yield different predictors of use. Moreover, the absence of theory and ignorance of the problems with ‘use‘ as the dependent variable, may be responsible for this. In this study these issues are addressed explicitly. The study focuses on the need for living in an old age home and a theoretical model predicts under what circumstances frail elderly people will express the need for living in such a home. Findings show that, as hypothesised, loss of comfort and affection are among the main predictors of a strong orientation towards living in an old age home. Resources to counter the loss of comfort and affection – a spouse, income, home adaptations, private help, informal and formal home care – were only partly effective in their hypothesised function of deterring orientation towards living in an old age home. Pressure from others to apply for an old age home had the strongest effect. The findings are discussed and some implications for policy are considered.

Two linked studies assess the feasibility of involving care staff in reducing the prevalence of depression in homes for older people. Mental health training was provided for care staff, delivered by members of a Community Mental Health Team for the Elderly. The research programme used quantitative and qualitative methods to evaluate the effects of a theoretical training for care staff, a system of mentoring care staff to reinforce the training; and a care-planning intervention for the management of depression which combined psychosocial and medical approaches. The training programme was positively evaluated by the recipients, the trainers and the researcher who observed it. The ability of care staff to detect depression improved significantly over time, and depression was reduced to below case-level in seven of the eight depressed residents who participated in the care-planning intervention. This research suggests that psychosocial interventions that involve collaboration between carers and residents, supported by a Community Mental Health Team, may have an important part to play in supplementing medical management of depression in residential care homes.

Health services research has been dominated by the biomedical paradigm and positivism, and the funding cultures of biomedicine have dictated the choice of method used by researchers. Social science paradigms, however, have been recognised as increasingly important within health services research and both quantitative and qualitative methods are accepted as appropriate. Older people with dementia have usually been excluded from or marginalised in studies about dementia because of traditional assumptions about the ability or appropriateness of people with dementia to act as participants or respondents. The choice of research method should be driven by theory and not by ideological or political prescription. Theory-driven pluralistic approaches to method will facilitate participation of people with dementia in research through the valuing of personhood. There are no unique methodological challenges in researching dementia. Rather, the complex nature of dementia and dementia care highlight the methodological challenges of investigating complex social phenomena.

Ageing in rural areas has received less attention in the literature than the proportions of older people living in rural areas might suggest. This paper looks at rural ageing in the United Kingdom based on the existing literature and on research in country areas in which the author has been involved. It examines some of the common myths about ageing in rural communities and explores these in terms of their accuracy when compared with the reality of the situation of older people in these areas. The realities of rural lifestyles, family and community networks, life satisfaction, health and access to services are briefly discussed. It is concluded that ageing in rural Britain has advantages and disadvantages but that it is conclusively neither better nor worse than ageing in urban areas. However, it is suggested that rural service provision demands a different approach from that which is appropriate in urban areas.

The beginning of the new millennium seems a good time to reflect upon issues in gerontology as many Western countries are experiencing population ageing and the challenges it entails. In comparison to Europe's 14 per cent average (Population Reference Bureau 2000), Canada is a relatively young country with only about 12 per cent of the population over age 65 (Statistics Canada 1999). Nonetheless, population ageing is a driving force in Canadian gerontology. In this paper we discuss current thinking in gerontology in Canada and how it reflects our approaches to research and development of public policy. We begin with an overview of national policy and research perspectives. We provide examples of research programmes addressing key issues: population ageing and the welfare state, rethinking independence, and quality of life issues from the Canadian perspective. Finally, we discuss the values that provide the context for the development of approaches to funding which affect the scope and direction of our research. Information sources include national policy documents, recent publications by Canadian gerontologists, and articles from the Canadian Journal on Aging 1998–2000.