Reciprocity is a powerful principle in social ties. The ethos of family reciprocity is especially strong in Asian societies. We study contemporaneous family exchanges, hypothesising that the more current help older Singaporeans receive from family, the more they give in return. Cross-sectional analyses were undertaken of data from two national Singapore surveys conducted in 1995 and 1999. The help received by older people is measured by income and cash support, payment of household expenses by others, having a companion for away-from-home activities, and having a principal carer. The help given by older people is measured by baby-sitting, doing household chores, giving financial help to children, and advising on family matters. Multivariate models are used to examine the factors that affect an older person's ability and willingness to give help. The results show that the more financial support Singapore seniors received from kin, the more baby-sitting and chores they provided. In their swiftly modernising society, Singapore seniors are maintaining family reciprocity by giving time in return for money. We discuss how during the coming decades, reciprocity in Southeast and East Asian societies may shift from instrumental to more affective behaviours.

Whether life is spent in good health or disability has a critical influence on the use of health-care services. It is also known that average healthy life expectancy differs by sex. This paper reports estimations of healthy and unhealthy life expectancy in old age using self-reported health assessments for the City of São Paulo, Brazil in 2000–01. The data derived from the Health, Well-being and Aging in Latin America and the Caribbean Project (SABE), and from population censuses and mortality statistics. Sullivan's estimation method was used. It combines the age-specific schedule of the current probabilities of death with the prevalence of self-perceived ‘poor’ and ‘good’ health. The paper also reports multivariate analyses of the factors associated with variations by age group and sex in self-perceived health. The findings revealed that, at all ages, women live longer than men and for more years in a healthy state. Among men, those aged 60, 65 and 70 years were expected to live a higher percentage of their remaining life than women in a healthy state, but among those aged 75, 80 and 85 years, the opposite held. Among women, the percentage of remaining years that were unhealthy did not increase as age increased, which differs from previous findings. The multivariate analyses showed that with increasing age, for women the number of chronic diseases decreased but dependency increased, and for men the opposite held. This finding indicated that the percentage of life spent in poor self-perceived health more accurately predicts mortality in men than women.

This paper presents a study of the perceptions of filial obligations among immigrant and Dutch older people in The Netherlands. It is first questioned how and to what extent these perceptions are determined by ethnic background or attributable to socio-demographic factors. Secondly, we study how filial obligations among immigrant older people differ by level of acculturation. Data from the main and migrant sample of the Netherlands Kinship Panel Study (2002–2003) for respondents aged 50–80 years in five ethnic groups are used. The analysis sample included 470 Dutch, 70 Turks, 73 Moroccans, 125 Surinamese and 59 Antilleans. Immigrant background was found to be an important determinant of the perception of a child's obligations towards parents. Immigrant elders generally expected more weekly visits and care from their children, and more facilitation of co-residence to parents than was the case for the Dutch. Among elderly people in all ethnic groups, including the Dutch, the attained level of education was related to perceptions of filial obligation, but marital status and current health status were not. Finally, it was found that different aspects of acculturation were related to the perception of filial obligations among older people with Mediterranean and Caribbean backgrounds.

Nursing homes in the United States have for over 40-years been riddled with evidence of poor performance. To combat problems in this industry, state and federal governments developed an elaborate monitoring and regulatory structure. At the same time, an important citizens' movement involving nursing-home consumer advocacy groups (CAGs) came to life. This paper presents the results of a postal survey of 47 active nursing-home consumer advocacy groups. They indicate that the majority of these organisations were started by an individual dissatisfied with the care provided to a family member. The political arena in which these organisations were most active was State legislatures. Though they varied considerably, the average CAG operated on a thin financial margin, largely supported by member contributions and donations. These organisations defined their success in terms of their ability to generate policy changes at the State level. Unfortunately, as they pursued these changes, they often failed to develop the organisational infrastructure necessary to assure the CAGs' continued operation. When CAGs ceased operations, it was in most cases the loss of the organisation's original leader or the cumulative effects of the constant struggle to maintain adequate financial resources.

The aims of this paper are to review the health status of British nationals living on the Costa Blanca in the Province of Alicante, Spain, and to examine their access to health-care services. A sample of 155 of those that spent over three months a year in the area was interviewed. The results for those aged 45 or more years have been compared with those of the Health Survey for England 2003, the British Household Panel Survey 2004, the National Health Survey for Spain 2003, and the Spanish Household Panel Survey 2000. British nationals resident on the Costa Blanca appear to have a similar health profile to the Spanish and the British populations, and score higher than Spaniards and the British home population on some indicators: they have, for example, fewer mobility problems and a more positive perception of their state of health. These findings are consistent with the ‘healthy migrant hypothesis’. The Valencia Region Health Service provides health-care services to 62 per cent of this population. The total number of British residents' visits to a general practitioner is approximately the same as that of their Spanish neighbours. As for admissions to hospital, British residents on the Costa Blanca show trends similar to the population of the United Kingdom. The use of private health-care is relatively high, compared to the Spanish and the British populations.

Over the past 15 years, a growing body of research has shown that people with Alzheimer's disease (AD) are affected not only by brain neuropathology but also by their reactions to its effects, by the environments in which they live, and by how they are treated by others. Nevertheless, three relatively neglected social influences on people with AD remain to be examined: negative stereotyping, negative self-stereotyping and stereotype threat. Numerous studies reviewed in this paper indicate that: (1) negative self-stereotypes at conscious and unconscious levels can have adverse effects on the performance of healthy elderly people on tasks demanding explicit memory (recall in particular), and (2) the mere threat of being stereotyped negatively can have adverse effects on the performance of healthy elderly people on tasks including those involving memory. In this paper, we discuss the relevance of these phenomena for our understanding and treatment of people with AD who are exposed to negative stereotypes about old age and about AD before and after they are diagnosed. There is evidence to suggest that these influences may have significant effects on people with AD. The paper concludes with recommendations for best practice in the treatment of people with AD in the light of the most apparent effects of negative self-stereotyping and stereotype threat. These include advocacy for an approach that involves aspects of counselling.