Loneliness and social isolation are recognised, conceptually distinct threats to health and wellbeing in older age but limited evidence is available on their predictors in rural populations. This study performed logistical regression modelling to explore the predictors of loneliness, isolation from one's family and isolation from one's community in 884 British rural-living older adults (57.9% female; mean age = 71.5, standard deviation = 8.1 years) within the Grey and Pleasant Land data-set. While 13 per cent of participants reported feeling lonely, 49 per cent reported isolation from their family and 9 per cent reported isolation from their community. Minimal cross-over between groups was observed. Widowhood, financial difficulties, area deprivation, and self-reported impairments in physical and mental health predicted loneliness. Greater financial difficulty gave lower odds of isolation from one's family, and higher levels of community engagement gave lower odds of isolation from the community. Ageing in place (longer residency) was the only common predictor for all three dependent variables. Initiatives aimed at tackling loneliness and social isolation in rural-living older people must recognise that the two concepts are distinct, affecting different population sub-groups with mostly different risk factor profiles. Future interventions and policies should clearly identify whether their target is loneliness or social isolation and tailor their interventions appropriately.

The literature on caring and carers has tended to emphasise the care of aged parents by middle-aged daughters. A recent government survey, however, has drawn attention to the fact that a substantial proportion of all carers are themselves elderly. This paper focuses on elderly carers. It shows that at least a third of elderly people can expect to become carers during retirement. Elderly carers differ from younger carers in that they: care for shorter periods; are more likely to provide intimate personal care and heavy nursing tasks associated with terminal care; and to be caring for their most significant other, usually a spouse. It is suggested that elderly carers represent a sub-group of carers with special needs not necessarily met by present service provision. Some more appropriate interventions are suggested.

The preference of older people when it comes to ageing in place may be modified by levels of frailty. The aim of this research is to characterise the relationship between frailty and ageing in place, and to identify differences in neighbourhood characteristics supporting ageing in place missed by frail and non-frail older people. A concurrent nested mixed-methods approach was used. For quantitative evaluation, a sample of 945 independently living older adults residing in four districts of Rotterdam were asked to complete a questionnaire in 2013 (response rate = 62%; N = 558). In addition, 32 interviews were conducted with frail and non-frail older people. Results showed that gender, age and especially frailty were related to missed neighbourhood characteristics. People displayed awareness of their increasing frailty and often acknowledged that it increased the need for neighbourhood characteristics enabling them to age in place. We can conclude that dependence on neighbourhoods varies with frailty status. This relationship is dynamic; with frailty, older people become more dependent on their neighbourhood. However, expectations regarding neighbourhood characteristics seem to dissipate with advanced age and increasing frailty.

This article summarizes previous employment histories and studies associations between types of histories and quality of life in older ages. Retrospective information from the Survey of Health, Ageing and Retirement in Europe (SHARE) was used and the occupational situation for each age between 30 and 65 of 4,808 men and 4,907 women aged 65 or older in Europe was considered. Similar histories were regrouped using sequence analyses, and multi-level modelling was applied to study associations with quality of life. To avoid reverse causality, individuals with poor health prior to or during their working life were excluded. Men's employment histories were dominated by long periods of paid employment that ended in retirement (‘regular’ histories). Women's histories were more diverse and also involved domestic work, either preceding regular careers (‘mixed’ histories) or dominating working life (‘home-maker’ histories). The highest quality of life was found among women with mixed histories and among men with regular histories and late retirement. In contrast, retirement between 55 and 60 (but not earlier) and regular histories ending in unemployment or domestic work (for men only) were related to lower quality of life, as well as home-maker histories in the case of women. Findings remain significant after controlling for social position, partnership and parental history, as well as income in older ages. Results point to the importance of continuous employment for health and wellbeing, not only during the working life, but also after labour market exit.

This paper examines older people's contrasting images of older people as ‘those like us’ and as ‘others’. It draws on data from a qualitative study about the experience of ageing that was undertaken in partnership with two local groups of older people in England. Whilst the informants acknowledged their chronological age, changes in appearance and physical limitations, most did not describe themselves as old. They challenged the idea of older people as being ‘past it’. Older people who personified their own values of inter-dependence, reciprocity and keeping going were seen as ‘heroines’ of old age, but negative stereotypes were ascribed simultaneously to others, ‘the villains’. Aspects of behaviour which evoked censure were ‘giving up’; ‘refusal to be helped’ and ‘taking without putting back’, and were usually attributed to acquaintances known only at a distance. The victims of old age were primarily people with dementia, who were perceived as ‘needing to be looked after’ and objects of pity and concern. The paper explores the ways in which these various images of old age related to people's self-identity and management of the ageing process; especially in a society that has ambivalent conceptions of old age. The findings contribute to an understanding of how people's values underpin their conception of ‘a good old age’ and how they shape their interpretation of societal stereotypes. They also indicate the importance of considering whose voices are heard in the context of exploring the identity and contributions of older people to achieve a more inclusive society.

This paper is concerned with the emergence of consumerism as a dominant theme in the culture surrounding the organisation and provision of welfare in contemporary societies. In it we address the dilemmas produced by a consumerist discourse for older people's healthcare, dilemmas which may be seen as the conflicting representations of third age and fourth age reality. We begin by reviewing the appearance of consumerism in the recent history of the British healthcare system, relating it to the various reforms of healthcare over the last two decades and the more general development of consumerism as a cultural phenomenon of the post World War II era. The emergence of consumer culture, we argue, is both a central theme in post-modernist discourse and a key element in the political economy of the New Right. After examining criticisms of post-modernist representational politics, the limitations of consumerism and the privileged position given to choice and agency within consumerist society, we consider the relevance of such critical perspectives in judging the significance of the user/consumer movement in the lives of retired 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.

There is an assumption in western societies that death in old age is not only ‘natural’ but also ‘easy’. It is often characterised as death which occurs at the end of life with goals complete. By contrast death in youth is a traumatic and untimely end. This paper draws on interviews with people over the age of 75 to explore the nature of attitudes to death in old age. It focuses on the issues raised by elderly people themselves when given the opportunity to talk about death and dying. In so doing, attitudes to death and dying are separated into ‘death of self’ and ‘death of other’. Each of these categories is then divided thematically according to the issues raised by respondents.

Research attention has turned towards investigating the motivations and experiences of those who volunteer under conditions that benefit both giver and recipient. The purpose of this paper is to examine the motivation of 22 older volunteers as they embarked on training to become lay leaders of an arthritis self-management programme. Data were collected through semi-structured telephone interviews at two points in time, before training and six weeks after training. Volunteerism was motivated by three key needs: to fill the vocational void left by retirement, to feel a useful member of society by helping others and to find a peer group. These key motivations remained important throughout the six weeks of the study. The costs of volunteering were perceived as time, responsibility, invasion of social life, failure, anxiety, and the duration and intensity of training. Nonetheless, older volunteers valued finding a purpose, reported less pain and an increased desire to ‘get on with life'. Results suggest that volunteering in later life can help to offset losses associated with retirement and decline in health. Further research, incorporating standard measures of health status, is needed if the impact of volunteering on the health of this study population is to be more fully understood.

Social exclusion amongst rural-dwelling older adults and the role of the diversity of people and places in mediating the construction of that exclusion has not been adequately investigated or conceptualised in the international literature. Consequently, how ageing in a rural community can function to disadvantage or protect older people remains poorly understood. With the aim of advancing conceptual understanding on rural old-age social exclusion, this article explores how exclusion is manifest in the lifecourse experiences of rural-dwelling older adults and the role of mediating factors in the construction of exclusion in different kinds of rural places. The analysis draws on ten rural case-study sites across Ireland and Northern Ireland, encompassing five kinds of rural communities: dispersed rural; remote rural; island rural; village rural; and near-urban rural. Data come from 106 interviews with older people ranging in age from 59 to 93 years. Rural old-age social exclusion is confirmed as a multi-dimensional construct, involving: social relations; service infrastructure; transport and mobility; safety, security and crime; and financial and material resources. This analysis demonstrates that social exclusion for rural-dwelling older people is multi-layered, and its prevalence and form is shaped by four mediating factors: individual capacities; lifecourse trajectories; place; and macro-economic forces. The findings are used to present a conceptual framework that emphasises the role of mediating forces on rural old-age social exclusion.

Much research on the impact of HIV and AIDS on older people fails to differentiate between age groups, and treats those aged from 50 years to the highest ages as homogeneous. The ‘oldest old’ or those aged over 75 years may be particularly vulnerable through declining health and independence as a result of the AIDS epidemic, which has forced some to take on roles that younger relatives would have performed had they lived. In this paper we describe the past and current experience of eight people in advanced old age living in rural Uganda who were informants for an ethnographic study of the impact of HIV and AIDS on households during 1991–92 and again in 2006–07. The aim of the study was to understand how they had coped with the impacts of the epidemic. From the eight case studies, it is concluded that family size, socio-economic status and some measure of good fortune in sustained good health enabled these people to live to an advanced age. While we recommend that targeted social protection is important in helping the poorest among the oldest, we suggest that sustaining respect for age and experience, and ensuring that older people do not feel discarded by family and society are as important as meeting their practical needs.

Research on informal care-giving has largely neglected the contributions of non-kin carers. This paper investigated the characteristics and contributions of non-kin who care for older adults with a long-term health problem, and investigated friends and neighbours as distinct categories of care providers. Using data from 324 non-kin carers in the 1996 General Social Survey of Canada, this study compared individual and relationship characteristics, care tasks and amount of care provided for the two groups. Interpersonal and socio-demographic characteristics were investigated as mediators of potential differences between friends and neighbours in patterns of care. Results demonstrate that friend and neighbour carers differed on age, marital status, geographical proximity and relationship closeness. Friends were more likely than neighbours to assist with personal care, bills and banking, and transportation. Neighbours were more likely to assist with home maintenance. Friends provided assistance with a greater number of tasks and provided more hours of care per week, suggesting a more prominent role in the care of non-kin than neighbours. Age, income, a minor child in the household, proximity and relationship closeness significantly predicted amount of care provided, and relationship closeness largely explained differences between friends and neighbours. Future research on informal care-giving can build on the findings that distinguish friend and neighbour carers to further discriminate the dynamics of non-kin care.

Secure, full-time jobs that last until the statutory retirement age have dwindled. Meanwhile, flexible forms of work have grown and are increasingly promoted as promising solutions to the ‘problem’ of economic inactivity in later life. Government committees, campaigning groups and management authors have warmly embraced the possibilities of self-employment, contract work, freelancing, consultancy and part-time work for those who need or want to work beyond the age of 50 years. Portfolio-type jobs appear to offer choice, opportunity and control for individuals in the final stages of a career. Working for a range of clients, so the argument goes, allows older people to bypass age-discriminatory barriers to employment and negotiate their own transition into retirement, but very little research has examined the viability of portfolio work in later life. This paper draws on a three-year study of freelance employment in the British media industry. The aim was to understand the conflicts, barriers and opportunities involved in portfolio careers in later life. It applies a critical realist perspective. The study found that older individuals were vulnerable to job insecurity and financial risk because of their diminishing networks and skills. They experienced a reduced flow of commissions, which hampered their ability to exert choice and control in the labour market.

Retirement villages have been slow to emerge as a housing model for older people in the United Kingdom (UK) but the sector is now growing rapidly, with an increasing number of both private and not-for-profit developers entering the market. Research findings to date have indicated high levels of satisfaction among residents, but commentators have criticised this form of provision on the grounds that they are only an option for the better off. This paper reports a study of a retirement village that has attempted to address this issue by integrating residents from a range of socio-economic backgrounds and by making various tenures available in the same development. The paper begins with a brief history of retirement villages in the UK and an overview of the concept of community, including those of communities of place and interest and their role in social policy. The presented findings highlight a number of factors that impact on a resident's sense of community, including social interaction, the development of friendships, the built environment and the existence of common interests. The discussion focuses on the development of cross-tenure social networks and how residents' health and social status shapes community experience. It is concluded that the clustering model of mixed tenure is likely to emphasise differences in the socio-economic backgrounds of residents and that the success of retirement villages as communities depends on grasping the subtleties of the diversity of later life.

Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.

The epidemiological health transition in Indonesia has lead to a substantial ageing of its population and a rapid increase in the prevalence of chronic progressive illnesses in advanced age that, in most cases, require some sort of care. This shift from ‘cure’ to ‘care’ necessitates new paradigms in both health-care delivery and research on older people in less-developed countries. Care involves both attitudes and practice, and is a dynamic interaction between giver and recipient. The vulnerability of frail older people is strongly related to the resources, capability and willingness of kin and non-kin to act as care-givers for extended periods. Normative filial piety and kinship obligations are no longer undisputed. This paper reports a study of the care and support received by chronically ill older people in urban areas of North Sulawesi, Indonesia. The majority rely on close family members, most often a wife or a daughter (or both), to provide treatment, care and support. The main care activities are support with ‘activities of daily living’ and therapies for specific illnesses. Care-givers experience manifold burdens when providing care for frail older people, and tend to reduce their support as the severity and duration of their relative's illness increases. It is shown that an older person's vulnerability to inadequate care provision, or its withdrawal, is associated with marital status and gender (unmarried women and widows being most at risk), poverty, weak support networks, and having care-givers who are themselves vulnerable.

This paper reports a study of the relationships between shared and separate living arrangements and the life satisfaction of two generations of migrants from the former Soviet Union to Israel, adult children (the younger generation) and their elderly parents. An attempt was made to identify the social, familial and personal factors that affect life satisfaction, and special attention was devoted to inter-generational family solidarity and to informal and formal social support. Data were collected from a stratified random sample of 425 respondents – 248 in the older generation and 177 in the younger. The results show that for both generations, contrary to expectations, life satisfaction was higher when the two generations lived in separate rather than shared households. Affectual solidarity was positively associated with life satisfaction for both generations, but functional solidarity for the older generation only. Among the older generation, the subjective evaluation of health contributed most to the explained variance; while among the younger, standard of living and employment contributed most. For both generations, family solidarity and social support had little impact. The findings are discussed in relation to the structural and economic factors that influence co-residence and which differentially affect the two generations.

The high cultural valuation of youthfulness and fitness in the mass media and more generally in western consumer society is the contextual frame for this study. It examines older people's attitudes towards their own ageing and towards people who are older or frailer than themselves. Participant observation was conducted of the attitudes, actions and interactions of the users of a senior centre in Norway. The users held two sets of attitudes that led to quite different activities and actions at the centre. On the one hand, they saw the centre as helping them ‘thrive’, which was associated with involvement in the community and participation in the structured daily activities to promote the senses of belonging and being useful. On the other hand, some perceived the centre and particularly the other users as ‘threats’ – as reminding them that they were getting old and increasingly vulnerable to sickness and disability. To some, the centre was for old people with disabilities, and they used subtle strategies to distance themselves from this group. Some users' attitudes and behaviour were in tension: they wished to participate in the valued activities but also to distance themselves from frailer users, while not denying their own ageing. The distancing strategies and behaviour amounted to age discrimination in interpersonal relations and interactions at the centre. This behaviour accepts rather than challenges the cultural valuation of youthfulness and the negative representation of old age.

This paper considers the social symbolism of hair, how it is managed and styled in later life, and what attitudes to appearance in general and hairstyling in particular reveal about ageism in contemporary culture. The paper draws on findings from a two-year, nationwide, participative study of age discrimination in the United Kingdom, the Research on Age Discrimination (RoAD) project. Using data collected by qualitative methods, including participant diaries and interviews undertaken by older field-workers, the paper explores narratives of image and appearance related to hair and associated social responses. The paper focuses on older people's accounts of the dual processes of the production of an image and consumption of a service with reference to hairdressing – and the dilemmas these pose in later life. The findings are considered in the context of the emerging debate on the ageing body. The discussion underlines how the bodies of older people are central to their experience of discrimination and social marginalisation, and examines the relevance of the body and embodiment to the debate on discrimination. A case is made for further scrutiny of the significance of hairdressing to the lives of older people and for the need to challenge the assumption that everyday aspects of daily life are irrelevant to the policies and interventions that counter age discrimination and promote equality.

This qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.