In this paper we study if and how persons with dementia are orally positioned by others, and how they position themselves while participating in assessment meetings held in order to discuss access to supportive services. We analysed five assessment meetings where two older persons (one diagnosed with dementia and one without a dementia diagnosis) participated to investigate whether the person with dementia is positioned differently than the other old person. Interactional phenomena used to position the person with dementia were identified by interactional analysis. We identified six phenomena that positioned the person with dementia as an individual with less interactional competence than the other participants: ignoring the person with dementia; voicing the feelings, capacity or opinion of the person with dementia; posing questions implying lack of competence; others' use of diagnosis; self-(re)positioning; and elderspeak. Persons with dementia are often orally positioned as less competent, indicating that they suffer further from discrimination than other older persons. We suggest that this has an impact on the participation of people with dementia in negotiations regarding their future care. The results indicate that social workers should be made aware that negative positioning exists and how it may affect the ability of people with dementia to contribute to discussions about their everyday life. Social workers should be encouraged to find strategies to reduce negative positioning in interaction.

Although the factors that influence people's perception of happiness have long been a focus for scholars, research to date has not offered conclusive findings on the relationships between income, age and happiness. This study examined the relationship between money and happiness across age groups. Analysing data from United States General Social Surveys from 1972 to 2006, this study finds that even after controlling for all the major socio-demographic variables, income (whether household income or personal equivalised income) had a significant positive association with happiness for young and middle-age adults, but it was not the same case with older adults. After controlling for the major socio-demographic variables, there was no evidence of a significant relationship between income (whichever definition) and happiness for older adults. The results also showed that the effect of household income on happiness was significantly smaller for older adults than for young or middle-age adults in the model controlling for major socio-demographic variables. The relationship between household income and happiness no longer differed significantly across age groups after social comparison variables were included. The relationship between equivalised income and happiness did not vary significantly by age group after controlling for the major socio-demographic variables.

Within research on ageing in neighbourhoods, older adults are often positioned as impacted by neighbourhood features; their impact on neighbourhoods is less often considered. Drawing on a study exploring how person and place transact to shape older adults’ social connectedness, inclusion and engagement in neighbourhoods, this paper explores how older adults take action in efforts to create neighbourhoods that meet individual and collective needs and wants. We drew on ethnographic and community-based participatory approaches and employed qualitative and geospatial methods with 14 older adults in two neighbourhoods. Analysis identified three themes that described the ways that older adults enact agency at the neighbourhood level: being present and inviting casual social interaction, helping others and taking community action. The participants appeared to contribute to a collective sense of connectedness and creation of social spaces doing everyday neighbourhood activities and interacting with others. Shared territories in which others were present seemed to support such interactions. Participants also helped others in a variety of ways, often relating to gaps in services and support, becoming neighbourhood-based supports for other seniors. Finally, participants contributed to change at the community level, such as engaging politically, patronising local businesses and making improvements in public places. Study findings suggest the potential benefits of collaborating with older adults to create and maintain liveable neighbourhoods.

Understanding how psychosocial factors can promote better cognition in mid- and later life is important for making recommendations regarding policies and intervention programmes. This study focuses on two psychosocial aspects (social connectedness and social engagement) in order to assess their independent contribution to explaining cognition, but also how their interrelationship acts on cognition. We hypothesised that each of the factors is positively associated with cognition, but also that a combination of both factors contributes more to cognition than each of the factors independently. Our sample comprises 66,504 individuals who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE). Multilevel linear regression analyses were performed. The results show that higher levels of social engagement and social connectedness are associated with improved cognition. When studying the interaction of social engagement and social connectedness and its association with cognitive function, the analysis shows that better cognitive scores are found in individuals having high levels of both social engagement and social connectedness. Moreover, when one of these aspects is lacking, the other plays a role in cognition protection. This study indicates the importance of social connectedness and social engagement for preserving/developing cognition, which greatly contributes to the quality of life of middle-aged and older adults.

Efforts in the United States to encourage divisiveness within the working class have been widely recognised as a key strategy in the war on welfare. This paper examines one aspect of this overall strategy, namely the creation of an ideology based on generational equity and ‘age/race wars’ thinking, which blames the old for poverty and economic hardship in the young. Attempts to frame problem analysis and policy deliberations within such an ideological framework are seen to be based on spurious assumptions concerning the relative financial well-being of the old, the role of elderly entitlements as a cause of poverty in minority children, and growing resentment of programmes for the old among minorities and youth.

This paper examines recent attempts to de-legitimate the claims of the elderly through the advancement of an ideology of age/race wars. The assumptions underlying this approach to policy are critiqued, and a case is made for developing an alternative framework which would stress the interdependence of generations, rather than age/race group competition.

Within the framework of an international research project aimed at studying the impact of different cultural settings on gerotranscendent development, six groups of older people distinguished by religiosity and cultural origin were studied. A life history approach, followed by thematic semi-structured interviews, was applied. One of the objectives was to inquire about the possible impact of religion, conceived of as a cultural setting, on development towards gerotranscendence. The findings of this inquiry gave rise to two hypotheses as to the relationship between gerotranscendence and religiosity. The first hypothesis is that the internalisation of mystical-type ideas in individuals' ways of thinking is probably a factor involved in the development of a gerotranscendent view of life. In other words, whether individuals practice their ‘religion’ in a spiritual, nonorganisational way, or in an organisational way, may play a role for development towards gerotranscendence. The second hypothesis is that certain characteristics, such as the secular and individualistic features of modern societies, may delay development towards gerotranscendence.

Second couplehood in old age is a growing phenomenon alongside increases in life expectancy. Lately, a shift has occurred in that individual diversity of ageing is perceived to depend on the physical and social contexts in which older persons experience change. Thus, the purpose of the study on which this paper reports was to examine second couplehood in the context of old age and old age in the context of second couplehood using an existential-phenomenological theoretical orientation. Twenty couples were recruited using criterion-sampling: men aged 65+ and women aged 60+, with children and grandchildren from a lifelong marriage that had ended in widowhood or divorce, living in second couplehood – married or not – in separate houses or co-habitating. Forty individual semi-structured interviews were tape-recorded, transcribed verbatim and analysed according to phenomenological tradition. Five sub-themes emerged, demonstrating couplehood and old age intertwining: (a) enjoying life while still possible; (b) living with health-related issues; (c) relationships with adult children: autonomy versus dependency; (d) loneliness: living as a couple is better than living alone; (e) self-image: feeling young–feeling old. Findings support the existence of positive and negative aspects of old age. Our discussion suggests the need to replace perceptions of old age as either a negative burden or a positive asset towards a period of balancing between gains and losses. Furthermore, we acknowledge the role of second couplehood in older peoples’ wellbeing on the personal–micro level through love, the familial–mezzo level through care-giving and the social–macro level by reducing prejudice.

Family relationships play a major role in individuals' lives and can be a source of comfort, support and protection during the entire lifecourse. Particularly in the context of life events, such as widowhood, family relationships may be salient for (older) adults in coping with feelings of grief, loss and loneliness. Using Dutch survey data and 18 in-depth interviews from a sub-sample, this study examines the role of family relationships through the lifespan in reducing loneliness among ever-widowed older adults (i.e. persons who have at some time during their life experienced the death of a spouse). Particular attention was paid to childhood memories, family ties and support from siblings. Quantitative analyses examined associations between loneliness and childhood experiences of relationships with parents, family ties and sibling support. Qualitative data elucidated how ever-widowed adults recall relations with parents and siblings and experience current family relations. Quantitative and qualitative data showed that emotional support from siblings reduced loneliness. Additionally, positive memories of childhood relationships and current family ties were negatively related to loneliness. In times of ever-increasing longevity, work detailing how family relationships across the lifecourse are supportive in alleviating loneliness is a key issue on the social research and policy agenda.

Experiences of ageism are associated with poorer health outcomes. Sexual activity and interest are areas in life where the impact of ageism may also be evident as popular culture often depicts the older body as asexual, undesirable or sexually impotent. We explore the possible links between experiences of ageism and sexual activity/interest in later life using data from a study of Australians aged 60+. We explored characteristics of those who were more likely to have experienced ageism (measured using the Ageism Survey) and the relationships between experiences of ageism and measures of sexual interest/activity in later life (N = 1,817). Experiences of ageism were greater among those without a partner, unemployed participants, those with lower incomes and poorer self-rated health. Adjusting for these differences, experiences of ageism were more likely to be reported by those who had not had sex in the past two years and were not sure about their hopes/plans for sex in the future. Those who reported their sexual interest had increased or decreased since 60 also reported greater levels of ageism experience, as did those who wanted to have sex more frequently in the future. Ageism appears to impact sexual activity and interest in different ways. It is critical that social policy aims to reverse attitudes that reinforce the view of the ageist asexual and unattractive older body or person.

In recent years, increasing public attention has been paid to voluntary action, civic engagement and philanthropy. It is in this framework that the growing numbers of childless older people are regarded as a valuable source of charitable giving. In fact, by giving to philanthropic foundations – instead of consuming their wealth or leaving inheritances – childless donors may develop into pioneers in the field of post-familial civic engagement. The article explores the circumstances under which childless older people adopt this behaviour in both Germany and the United States of America. It is found that making large donations or setting up philanthropic foundations is still an elite phenomenon, but on the other hand that establishing a foundation is attractive for childless people, both as a means of ensuring that one's name lives on, and as a way of organising bequests. Educational level, ill-health, social capital and religiosity all positively reinforce the inclination of childless people to transfer resources to charities. It is also shown that the institutional framework or organised fundraising has a large role in fostering charitable giving among the childless. The framework of charity organisations and fund raising in the country of residence plays an important role in determining the expansion and democratisation of charitable giving.

Previous studies of East Asian welfare regimes focus on similarities between social security schemes. In contrast, this paper explores cross-national variations in public–private pension mixes in six welfare states: China, Hong Kong, Japan, Singapore, South Korea and Taiwan. Our research echoes the pension policy analysis of international organisations but takes a step forward with emphasis on the historical and institutional characteristics of the respective pension systems. The analysis identifies three institutional patterns. First, the statist pension system (Taiwan and China) primarily relies on public pensions to provide old-age security, with private pensions playing a rather minor role. Second, in the dualist pension system (Japan and Korea) both public and private pensions work in parallel to ensure retirement income, though a clear security gap exists between workers in the formal and informal economies. Finally, the individualist pension system (Hong Kong and Singapore) is characterised by genuine fully funded individual accounts, emphasising citizens’ own responsibilities for ensuring old-age security. These three types of pension systems demonstrate distinct institutional characteristics and policy outcomes, illustrated by the juxtaposition of their institutional structures as well as by the comparison of key indicators collected from government reports and Organisation for Economic Co-operation and Development statistics. The paper concludes with a theoretical reflection of East Asian pension policies and a diagnosis of the distinct challenges confronted by each of the various pension patterns.

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts’ suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore.

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.

This article examines three kinds of social relationship likely to be present when people with dementia are cared for at home by relatives or friends: custodial care, an intimate relationship, and home-life. Using Goffman's three defining aspects of custodial care – routinisation, surveillance and mortification of the self – the paper examines whether these characterised the care of people with dementia at home and, if so, whether they conflicted with the intimate relationship and with home-life. The study involved sustained observations and interviews with 20 people with dementia and their carers in and around London, and qualitative analysis of the data. It was found that all three aspects of custodial care were present although not fully realised, and that they led to difficulties, many of which were associated with the concurrent pursuit of an intimate relationship and home-life. In all cases, daily life was routinised partly to help accomplish care tasks but was found monotonous, while surveillance was usual but restrictive, and prevented both the carers and those with dementia from doing things that they wished to do. Those with dementia were distressed by the denial of their former identities, such as car-driver or home-maker, and by being treated like children. Both the carers and the people with dementia had various ways of balancing custodial care, their intimate relationships and home-life, such as combining routines with other activities, evading surveillance or carrying it out by indirect means, and there were many attempts to maintain some semblance of former identities.

‘University programmes for older people’ (UPOP) have recently expanded rapidly in Europe and are now well established. This study examines the functions and achievements of the programmes and the characteristics of UPOP students in Spain. The evaluation is from a general sociological perspective, and uses data from a survey of a representative sample of the students and other sources. The main socio-demographic findings are that the students are relatively young older people, have a relatively high socio-economic level, and are predominantly women and retired. It is shown that beyond the education imparted, the programmes also fulfil important social roles. A critical analysis of the programmes as social policy highlights their socially selective reach and impacts, and compares their actual and potential functions. Some alternatives are discussed. If UPOP are to maintain their identity as programmes for older people, a different approach is required to reach all elderly people, including the ‘really old’. On the other hand, if the objectives emphasise the promotion of social integration and personal development (in matters other than employment skills), there is no reason why they should be addressed exclusively to people aged 50 or more years (or any arbitrary age). Rather, they should be open to adults of all ages. If this change were made, UPOP would give less reinforcement to a particular social construction of old age.

We report the findings of a survey of 104 Asian older people in Bradford. For a high proportion, their condition was characterised by poverty, limited entitlements, inadequate housing, low levels of knowledge of health and social services, and problems of access to welfare benefits, health and social care. The situation of women was of particular concern. The study also highlights the problems of divided families, caused by restrictive immigration rules, resulting in many elderly people having no family support in this country.

As people grow older in late life, their need for help with the activities of daily living increases. In Spain, those who need such help constitute about 20 per cent of the population aged 65 or more years. Support may be from formal care, informal care or both, and the type has different consequences for care receivers and their social networks. The aim of this paper is to examine the relationship between informal and formal care and the use of health services among older people in Spain. Using a sample of 1,148 respondents aged 65 or more years from the Spanish National Health Survey of 2003, we analysed the association between the sources of care (formal, informal, both, or no care) and the frequency of three types of health-care utilisation: hospitalisation, emergency services and medical consultations. After controlling for sex, age, level of difficulty in the activities of daily living, self-perceived health status, and social class, it was found that older people with disabilities who received neither informal nor formal care were more likely to consult physicians than those who received informal care, but that there were no significant relationships between the type of care and health-services utilisation. The findings provide new information about the consequences of the different types of care of older people with disabilities, and suggest specifically that informal care substitutes for some tasks usually done by health professionals.

This paper deals with ambivalence in the working generation's attitudes towards the elder generation in the German welfare state. Whereas most researchers focus on either norms or self-interest in intergenerational relationships, ambivalence is widely neglected. Ambivalence denotes a simultaneous positive and negative evaluation of the elder generation. The theoretical framework is developed by combining two common perspectives on intergenerational relationships in the welfare state. The first is age-based self-interest that is often discussed in the context of ageing societies with scarce welfare state resources. The second perspective concerns the norms that individuals internalise when growing up both in society and in the family. Drawing on survey data from the Population Policy Acceptance Study in Germany, the empirical analysis first presents evidence of intergenerational ambivalence and, second, investigates whether the structural contradictions that confront individuals in certain situations cause ambivalent attitudes towards the elder generation. The findings show that the higher the structural contradictions of being young and holding strong societal norms towards the elder generation the higher the ambivalent attitude towards this group in the context of the welfare state.

Statistics of the movement of elderly people through institutions of care have attracted little attention from present-day researchers, and none at all from historians. The intention in this paper is to indicate some of the analyses which the historian can make, to explore the changes and continuities in the inmate populations of institutions over 120 years, and to speculate upon the reasons for the higher and lower incidences of residential care amongst the old in specific periods. The questions of interest here are how many and which groups amongst the old have been in care in different periods; how many people would ever find their way into institutions in old age: at what ages would they enter; for how long would they stay in care; would they die in care or leave for other reasons; what are the reasons for taking the elderly in to care; and what does all this tell us about the society in question.

The extension of user involvement in different aspects of service delivery in health and social care has been a central element of care in the community policy. Purchasers and providers of such services for older people have been exploring ways of tailoring services to meet individual need and ensure that the quality of the service reflects user preference rather than service-provider requirements. This article describes a project involving residents from a random proportionate sample of nursing homes and residential homes for older people in the City of Manchester. The project was designed to bring user views about quality into the service contract specification for the purchase of residential and nursing home care. The process and the outcomes are described. Factors which appear to promote the movement of user involvement into the mainstream of service specification and service development are identified. The role of small-scale initiatives is discussed.