This paper examines the prevalence, inter-relationships and correlates of various forms of self, informal and formal care. Analyses of data drawn from a random sample of 743 non-institutionalised elderly individuals living in Winnipeg, Manitoba reveal similarities as well as differences among the three types of care. Self- and formal care are somewhat similar, being positively related and having similar correlates. Nevertheless, substitutability as a consequence of medical scepticism is also evident. Both are unrelated to informal care. It is poor health in the form of functional disability and the availability of support through the marital relationship which are the strongest correlates of informal care. In contrast, health (chronic conditions and perceived health status) as well as beliefs in the efficacy of both preventative health behaviours and medical services are among the strongest correlates of self- and formal care.

Based on data from the Bangor Longitudinal Study of Ageing (BLSA) 1979–1999, this paper examines changes over time in the intergenerational relationships of older people (aged 65+ in 1979). The analysis uses quantitative and qualitative data to discuss changes from 1979–1999 for those respondents who survived in the community to 1999. It looks at mothers’ and fathers’ relationships with their adult children, grandmother and grandfather relationships with grandchildren and relationships between aunts and uncles with nieces and nephews. It identifies four different patterns of intergenerational relationships showing how the rural employment structure impacts on family structure, migration and support patterns.

Britain along with other western European countries has seen a marked decrease in allegiance to traditional forms of Christianity during the latter part of the 20th century. Although church attendance remains relatively high among older people compared with younger age groups, there has been little or no investigation into the stability or change of people's religious belief and practice with increasing age. This paper present findings on these issues from the Southampton Ageing Project, which from 1977–78 to 2002 followed 342 people almost all of whom had had an entirely Christian religious education and all of whom at the outset were aged 65 or more years. Although religion has continued to have considerable meaning in the lives of up to one-half of the participants, approximately one-quarter of the sample expressed a declining commitment to a religious faith and to church membership. The participants' accounts of their recent life experiences, for example following bereavement, give instances of disappointment with the support that they received from institutional religion and show that this was a factor in their declining adherence. They also provide suggestions for further investigation into the origin of this decline. The conclusion argues that the study of older people's religious and spiritual beliefs and practice should be integrated with the investigation of self and identity and of sources of existential meaning in later life.

Older care home residents are excluded from the sexual imaginary. Based on a consultative study involving interviews with three residents, three female spouses of residents and two focus groups of care home staff (N = 16), making an overall sample of 22 study participants, we address the neglected subject of older residents' sexuality and intimacy needs. Using thematic analysis, we highlight how residents’ and spouses’ accounts of sexuality and intimacy can reflect an ageist erotophobia occurring within conditions of panoptical control that help construct residents as post-sexual. However, not all accounts contributed to making older residents’ sexuality appear invisible or pathological. Some stories indicated recuperation of identities and the normalisation of relationships with radically changed individuals, e.g. because of a dementia. We also examine care home staff accounts of the discursive obstacles that frustrate meeting residents’ needs connected with sexuality and intimacy. Simultaneously, we explore staffs’ creative responses to dilemmas which indicate approaches to sexuality driven more by observed needs than erotophobic anxiety and governance, as well as panoptical surveillance.

Centres for seniors offering leisure-time activities currently represent significant actors that translate the idea of active ageing into a particular approach to seniors. Despite the fact that active ageing is now represented by the state and providers of social services as the universally desirable way of ageing, the significantly smaller numbers of male clients was identified as a marked feature of such organisations. A three-year ethnographic study was conducted at two centres in the Czech Republic which offer seniors-only leisure-time activities strongly grounded in the idea of active ageing. The method of participant observation was used, and 47 in-depth interviews were conducted with the centres' clients and employees. The higher participation by women in the centres and the role they attribute to such organisations in their lives is analysed in the context of their previous gendered biographies. Gender patterns embedded in the way daily activities at the senior centres are organised, as well as in the idea of active ageing itself, are highlighted. Despite the seeming invisibility of gender as a principle that structures the way these centres are run, they are in fact gendered organisations, where gender emerges as a basic principle affecting the chances of participating in active ageing as presented by the centres.

The philosophy concerning long-term care for frail seniors has shifted from a provider-driven, medical model toward a more client-centred, social model. While this philosophy emphasises the decision-making abilities of clients and respect for their values and preferences, evidence suggests that there are difficulties in understanding and implementing the philosophy. Qualitative in-depth interviews were conducted with residents of adult family living and assisted living programmes in western Canada to better understand the elements that residents themselves felt were integral to client-centred care.

Three main themes emerged from the data analysis: (1) the physical setting, people within the setting, and the community were important areas of expression of residents' values and preferences; (2) the decision about where to live influenced whether the residential care environment was congruent with residents' values and preferences; (3) contentment resulted when there was a good fit between preferences and experiences, reflecting the essence of residents' perspective of client-centred care. Choices among models of care, appropriate staffing levels and training, and recognition of family contributions may improve the practice of client-centred care.

This article explores experiences of relational intimacy (including sexual intimacy) in long-term relationships when one partner has dementia. An emerging body of research focuses on living with dementia, but work on relationships between people with dementia and their family and loved ones tends to focus on understanding the experience of caring, and on constructs like ‘care burden’. Research concerned with the lived experience of relationships themselves is less frequent, and very little published work focuses on experiences of sex and intimacy. This qualitative study explores how six participants experience their intimate relationships with their partners with dementia. Semi-structured interviews provided a rich source of data which were analysed using Interpretive Phenomenological Analysis. Three master themes emerged from our analysis: ‘everydayness’, ‘absent presence’ and ‘I don't know if you want to know this…’. Participants explored how living with dementia constructed specific, everyday relational challenges, and disrupted everyday intimacies. Intimacy, including sexual intimacy, remains an important element of older couple relationships. Relational experiences present specific and difficult to articulate experiences for the partners of people living with dementia – particularly experiences related to sex and sexuality. Representations of older adults (particularly older adults with a long-term illness) as relatively asexual beings can make elements of these relational challenges particularly difficult to express.

This paper reports a study of the associations between social relations, language and cognition among people aged 85 or more years (hereafter the ‘oldest old’). Although the links between cognition and both social relations and language ability are well-established, less is known about the relationship between social relations and language skills, especially among the oldest old. With a sample of 20 adults aged 85–93 years living independently in two retirement communities (a seniors' apartment complex and independent apartments in a continuum-of-care setting), we used the approach of the Rochester Interaction Record to assess the frequency, purpose and quality of their social interactions over one week. It was hypothesised that aspects of social relations, as well as the type of residential setting, would associate with both cognitive skills (measured using the Composite Cognistat) and language skills (measured using the Boston Naming Test). It was found that participants who had a low proportion of interactions with family members, or a high proportion with friends, as well as those with diverse relationships, performed better on the cognitive and language tasks. Furthermore, those from the setting with more programmed activities performed better on the language task. The conclusion critically examines the findings about the influence of family relationships and the importance of residential setting.

The extent of social isolation experienced by people living with dementia who reside in the community has been well acknowledged, yet little is known about how people living alone with dementia maintain neighbourhood-based connections. The purpose of this study is to examine the experiences of people with dementia who live alone, focusing upon how they establish social networks and relationships in a neighbourhood context, and how they are supported to maintain this social context within everyday life. Multiple data collection methods were used including, semi-structured interviews, walking interviews, guided home tours and social network mapping, which were conducted with 14 community-dwelling people living alone with dementia (11 women and three men) situated across the three international study sites in England, Scotland and Sweden. Data were analysed using thematic analysis. The analysis revealed four main themes: (a) making the effort to stay connected; (b) befriending by organisations and facilitated friendships; (c) the quiet neighbourhood atmosphere; and (d) changing social connections. The analysis suggests that people with dementia who live alone were active agents who took control to find and maintain relationships and social networks in the neighbourhood. Our findings indicate the need to raise awareness about this specific group in both policy and practice, and to find creative ways to help people connect through everyday activities and by spontaneous encounters in the neighbourhood.

The term ‘in the moment’ has received growing interest in the context of music programmes for people living with dementia, with music therapists, family carers, health-care professionals and people living with dementia themselves reporting the value of framing musical experiences in the ‘here and now’. Although this term is being used more frequently within the literature, there has yet to be a formal examination of such ‘in the moment’ musical experiences and how they might benefit a person living with dementia. We used a multiple-case study approach to develop a thematic framework of ‘in the moment’ musical experiences within the context of a music-making programme for people living with dementia. The research followed six people living with dementia and four family carers, and used video-observation and video-elicitation interviews to capture and analyse ‘in the moment’ experiences. Four thematic observations were developed which captured ‘in the moment’ musical experiences: Sharing a life story through music, Musical agency ‘in the moment’, Feeling connected ‘in the moment’ and Musical ripples into everyday life. These findings showcase the creativity and musical abilities of people living with dementia whilst affirming music as a medium to connect people living with dementia with their own life story, other people and the environments in which music-making takes place.

Domestic Homicide Reviews (DHRs) are conducted when an individual aged 16 or over appears to have died from violence, abuse or neglect by a person to whom they are related or with whom they are in an intimate relationship or who is a member of the same household. DHRs aim to identify lessons to be learned, to improve service responses to domestic abuse and to contribute to prevention of domestic abuse/homicide. We submitted Freedom of Information requests to English Local Authorities to identify DHRs where victim, perpetrator or both were aged over 60. Collected Reports and/or Executive Summaries were thematically analysed. Analysis identified four key themes in the context of the key relationship and caring: major mental illness of the perpetrator; drug and/or alcohol abuse; financial issues; and a history of domestic abuse in key or family relationships. We analysed 14 adult family homicides, 16 intimate partner homicides and five homicide–suicides. Age per se did not emerge as a significant factor in our analysis. Terminology needs to be standardised, and training/education regarding risk assessment needs to be improved in relation to age, myths around ageing/dementia and stresses of caring. Management of mental illness is a key factor. A central repository of DHR Reports accessible for research and subject to regular review would contribute to maximising learning and improving practice.

A survey of relatives, friends and others who knew the deceased in a random national sample of adult deaths in England forms the basis of this report. Comparisons of this 1987 sample are made with a similar study carried out in 1969. The sample of deaths was largely one of elderly people, and changes in the family and household compositions of these people reflect changes in the wider population of elderly people. More lived alone, or in smaller family units, and fewer sources of help during their final illness were available from relatives. Women were particularly disadvantaged, both as dependants and carers, who were then bereaved, often themselves left to live alone. The stress and the mixed feelings of carers are described. Nevertheless, a substantial minority were free of serious levels of dependency in their last year of life. Those dying of cancer formed a somewhat younger group, with shorter periods of dependency and greater availability of relatives to look after them. Many of the medical and nursing innovations in the care of the dying have focused exclusively on cancer. This study demonstrates the value of a broader perspective on death and dying that emphasises the needs of older people.

This paper is concerned with the interlinked issues of citizenship and the structured dependency of older people within Social Gerontology. It argues that implicit in much British Social Gerontology is a strategy of advancing the wellbeing of elderly people through the extension of citizenship rights. Absence of these rights leads to poverty, exclusion and ageism being commonplace experiences of large sections of the older population. This approach draws heavily on the ideas regarding social citizenship of T. H. Marshall who has influenced much mainstream social policy in Britain since 1945. Changes to the Welfare State since 1979 have seriously questioned the validity of this approach and many of these criticisms apply to the structured dependency approach. Recent work on citizenship can help us to see how the relationship between old age and citizenship has changed and how far theory in social gerontology needs to change to take account of these new circumstances.

Older people experiencing dementia are twice as likely to fall with consequences of serious injury, reduction in everyday activity, admission to long-term care and mortality. Carers of people with dementia are themselves at greater risk of physical and mental ill health, which increases as the dementia progresses. Unsurprisingly, carer burden also increases when a care-recipient falls. The aim of this study was to explore the experiences of falling of community-living older people with dementia and their carers. A qualitative approach was taken using interpretative phenomenological analysis. Nine older people with predominantly Alzheimer's disease and their ten carers were recruited from a large mental health National Health Service trust and participated in one-to-one and joint in-depth interviews. Three dyads participated in repeat interviews. Three focus groups were also carried out, with nine older people experiencing memory problems and 12 carers from a local Alzheimer's Society branch. The antecedents, falls events and consequences of falls were discussed. This paper reports specifically on the impact of falls on the caring relationship. Three themes emerged: ‘learning as you go’, ‘we're always together’, ‘nobody was interested’. The findings demonstrate how falling accentuates the impact of dementia on the dyad. Spouse-carers' discussion of their own falls emphasise the need for joint assessment of health and wellbeing to reduce carer burden and preserve the couplehood of the dyad.

Over the last fifty years, the pattern of family life in Turkey has been seriously affected by migration. Despite this, there remains a high degree of solidarity typified by transfers of income, material goods and cultural mores between and within family generations. This article is based on the life histories of fifteen migrant families living in Ankara, the capital city of Turkey. In-depth interviews were used to collect information about at least three generations in each family. Information was collected about occupational, educational and migration histories, property ownership, care of dependents, and parent-child relations covering three generations.

This paper examines the risk factors that influence physical activity levels among a representative sample of older people in England and their awareness of the Chief Medical Officer's recommended level of physical activity. The paper analyses data from the cross-sectional, nationally-representative Health Surveys for England (HSfE) in 2006 and 2007. In HSfE2006, 1,550 adults aged 60–69 years responded to a physical activity participation questionnaire, and in HSfE2007, 561 adults aged 60–64 years were asked about their knowledge of the physical activity requirement and their attitudes to participation. Very few respondents knew the recommended physical activity target, but more than one-half thought they had enough physical activity in their daily life, and over three-quarters thought they were ‘very’ or ‘fairly’ physically active compared with age peers. The perceived barriers to physical activity included work commitments, lack of leisure time and poor health. It was found that obesity, not being in work and having a limiting long-term illness associated with a lower likelihood of physical activity. Participation in sports and exercise, walking, heavy housework and gardening were all lower in non-working than working adults. Older adults had unrealistic views of their activity levels, and of work and lack of time as barriers to physical activity. It is concluded that more attention needs to be paid to health promotion and education among the over-sixties, especially those not in paid work.

Mobility or physical movement contributes to health and wellbeing in later life. Most studies have focused on the contribution of outdoor mobility to active ageing, but physical and cognitive impairments restrict the mobility of many older adults. This article aims to explore the gaps in the current literature on mobility in later life, and identify required innovations in the field through laying out key areas for future research. It discusses two, largely separate, areas of research, namely on mobility patterns and mobility experiences. The first focuses on quantitative and spatial research on outdoor mobility patterns in terms of routes, timing and transport modes. The second mainly concerns qualitative research on how older adults perceive mobility in their everyday lives. This article identifies three areas for future research on mobility in later life: (a) beyond outdoor movement; (b) diversity in mobility; and (c) the role of time in mobility. To conclude, addressing these areas jointly will contribute to further unpacking the concept of mobility as meaningful practice and to integrating quantitative and qualitative methods when studying mobility in later life. This will result in policy inputs on the mobility and wellbeing of our ageing population.

This study is an attempt to explore the dynamics in a group of family caregivers in a small rural setting in Sweden. Thirty-nine caregivers giving extensive help to elderly family members, who were all on the verge of institutionalisation, were interviewed. The results showed that the motives of caring were usually based on feelings of reciprocity and that the perceived burden of care was related to the proximity of the carer to the person cared for. Despite the existence of a rather well-developed system of formal care, these resources were poorly coordinated with the informal provision of care.

The Hughes Hall Project for Later Life screened all people aged 75 years and over on the lists of seven general practices in Cambridge in order to identify those who were suffering from dementia. Of those living at home, it was found that 40% were being cared for primarily by husbands or wives, most of whom were themselves over the age of 75. In this paper we describe a group of 34 married couples in which one partner was diagnosed as demented. We suggest that for the nondernenting partner, the experience of caring differs in important respects from that of the more typical carer – usually younger and female – described in much of the research literature.

This paper examines four specific themes relating to older carers' experience: care-giving in the context of particular roles and relationships embedded in biographical histories; care in the context of dementia; care involving skilled or complex health care-tasks; and care of an intimate/personal nature. In each case, we look at the nature of support provided by health care professionals. Analysis of the data suggests several conclusions. Older carers are carrying out a range of tasks including complex health care tasks, many of which were once part of a nurse's remit and role. Nurses approach older carers as a unique but not homogeneous group and acknowledge many of their distinct needs as well as their right to choice concerning the extent of their involvement in care-giving. However, this approach conceals several implicit assumptions and expectations about the role of older carers. In particular, professionals' emphasis on older people's individual choice jars with the latter's own experience of reciprocity existing within the context of lifetime relationships. The paper suggests that modifications have to be made in professionals' approach if older people are to be presented with choice and support in the care-giving they perform.