An understanding of ways in which older carers' perceptions of their marital relationship and duty to their spouse underlie adjustment to care-giving is required for the development of acceptable and efficacious services for spouse carers. With this aim we conducted qualitative interviews with 20 spouses of older people with a mental illness identified in a representative community study. While carers acknowledged distressing changes in their spouse, a history of reciprocity and intimacy emerged, comprising positive themes and perceived continuity which favourably influenced adjustment to care-giving. Those who still experience closeness in the relationship see themselves as coping and are reluctant to accept formal help. Others describe long-term unhappiness in marriage and experience feelings of entrapment in the role of carer. They require early and comprehensive services. Hypotheses regarding these themes are proposed.

The aim of this study was to explore older workers’ motivation for a full or extended working life. With particular focus on assistant nurses aged 55–64 years, working in the elderly care sector. Focus group interviews were conducted with five different groups of assistant nurses. Inductive thematic analysis was used to analyse the interviews and five main themes were developed from the data: ‘Organisational issues’, ‘Health-related problems’, ‘Private issues’, ‘Meaningfulness and appreciation’ and ‘Social support’. Several of the main themes concerned problems with too high work demands of the assistant nurses. These findings suggest that it is important to improve the working conditions of assistant nurses in order to create a more sustainable working life. Increasing the number of staff and improving recovery opportunities and work–life balance could be important steps to improving the working conditions for this group. Finally, upgrading the competency and professionalism of assistant nurses could help to increase the motivation for a full or extended working life.

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.

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.

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 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.

A grounded theory approach, consistent with the work of Strauss and Corbin, was used to undertake semi-structured interviews with 17 older people, to explore their experiences of living in a care home, during the four- to six-week period following the move. Purposive sampling was initially adopted, thereafter, theoretical sampling was employed to recruit individuals identified by care managers within older peoples’ community teams and care home managers within a large Health and Social Care Trust in the United Kingdom. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously. Constant comparative analysis underpinned data analysis and data management techniques. Data analysis revealed five distinct categories that captured these experiences. These were: (a) wanting to connect – ‘I am so lost here’, (b) wanting to adapt – ‘Well mentally you have to make the best of it’, (c) waiting for assistance – ‘it's a frustration for me’, (d) ‘waiting on the end’ – I am making no plans’ and (e) wanting to re-establish links with family and home – ‘I love getting home and I like getting out to the town’. Together these five categories formed the basis of the core category, ‘Waiting and Wanting’, which encapsulates the initial adaptation experiences of the men and women in the study. Findings indicate that individuals were dependent on others to create a sense of belonging, independence and wellbeing. Moreover, risk aversive practices were perceived as a threat to individuals’ independence and autonomy. Recommendations include the need to amend policy and practice for the development of a bespoke induction programme for each resident facilitated by a senior member of the care home staff working in partnership with individuals and families, in addition to the health and social care team, to support a more positive transition for new residents, relatives and care home staff.

Many older women reduce the amount of cooking and food preparation they do in later life. While cooking may be seen as traditionally associated with women's family roles, little is known about the impact of such reduced engagement with food on their lives. This paper presents the findings from a one-year qualitative study (Changes Around Food Experience, CAFE) of the impact of reduced contact with preparing and cooking meals from scratch for 40 women, aged 65–95 years, living in Norfolk, United Kingdom. Data were collected through semi-structured interviews, focus groups and observations. Women's reasons for reducing food-related activities included changes in health, loss of a partner or a caring role, and new patterns of socialising. Disengagement from cooking and shopping was not found to entail predominantly negative feelings, passive acceptance or searching for forms of support to re-enable more cooking from scratch. Accounts evidenced the dynamic adaptability of older women in actively managing changed relationships with food. In exploring new meal options, older women were not simply disengaging from their environments. CAFE findings linked women's engagement with their environments to how they were using formal services and, even more, to the value they placed on social engagement and being out and about. Through the connections they fostered with friends, family and community, older women actively enabled their continued involvement in their social, public and family spheres. Reduced contact with preparing and cooking meals from scratch, therefore, did not induce or imply passivity or debility in the CAFE cohort. By contrast, it involved their exploring new means of retaining what was important to them about food in the context of their lived situation and social connections with friends, family, the community and public spheres.

Care-giving research has focused on primary care-givers and relied on cross-sectional data. This approach neglects the dynamic and systemic character of care-giver networks. Our analyses address changes in care-givers and care networks over a two-year period using pooled data from the US Health and Retirement Study, 1992–2000. Based on a matrix of specific adult-child care-givers across two consecutive time-points, we assess changes in any adult-child care-giver and examine the predictors of change. A change in care-giver occurred in about two-fifths of care-giving networks. Ability to provide care based on geographical proximity, availability of alternative care-givers, and gender play primary roles in the stability of care networks. Results underline the need to shift care-giving research toward a dynamic and systemic perspective.

This article uses a comprehensive theoretical framework to explain why parents send money to particular children, and examines whether intergenerational solidarity is shaped by spending on various welfare domains or provisions as a percentage of gross domestic product. The theoretical model at the level of parents and children distinguishes parental resources and children's needs as the factors most likely to influence intergenerational money transfers. Differences in state spending on various welfare domains are then used to hypothesise in which countries children with specific needs are most likely to receive a transfer. For parents we hypothesise in which countries parents with specific available resources are most likely to send a transfer. We use data from the first wave of the Survey of Health and Retirement in Europe (SHARE) to analyse the influence of welfare-state provisions on the likelihood of intergenerational transfers in ten European countries. The results indicate that, in line with our expectations, the likelihood of a transfer being made is the outcome of an intricate resolution of the resources (ability) of the parents and the needs of a child. Rather large differences between countries in money transfers were found. The results suggest that, at least with reference to cross-generational money transfers, no consistent differences by welfare state regime were found.

In rapidly urbanising China, a high number of elderly people, the so-called ‘laopiao’, float to cities where their sons or daughters live to look after their children and grandchildren. Laopiao in urban China are thought to suffer poor mental health owing to their floating status. This study explores the inter-relationship among social capital, the built environment and mental health in urban China. Using a recent survey conducted in Nanjing (N = 591), structural equation modelling was performed to compare the local elderly people and the laopiao. Results showed that mental health determinants are dissimilar between the two groups of elderly people. Bonding social capital promotes mental health in both groups, while bridging and linking social capital only contributes to the mental health of the laopiao. Also, access to public transportation is positively correlated with mental health in both groups. Furthermore, lower street network density and better access to parks enhance the mental health of the local elderly people, while higher street network density and more open space within a community enhance the mental health of the laopiao. Our findings suggest that different policy measures should be implemented for different groups of elderly people in urban China to improve their mental health.

The rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.

The article reports on a study which explored the relationship female undergraduates and student nurses experienced with their maternal and paternal grandmothers. In addition, the article identifies some of the factors closely associated with the relationship, considers the role played by grandmothers with regard to their granddaughters and examines differences in granddaughters' perceptions of maternal and paternal grandmothers. The results highlight the intimate relationship between granddaughter and grandmother. When compared to paternal grandmothers, maternal grandmothers were perceived by granddaughters to be emotionally closer, provide a greater sense of security, be more influential in shaping their beliefs and were more likely to be preferred. They were also found to play a more active role in granddaughters' lives.

Resistances to empathy with older service users are outlined, drawn primarily from Jungian psychology. It is suggested that lack of a helper's personal experience of old age allows disproportionate influence to be played by archetypal intrapsychic processes. These are augmented by helpers perceptions of a negative personal future and a tendency either to ignore the age appropriate projects of older persons or replace them with those appropriate for the helper. Consequences for helper training are briefly explored.

This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of ‘knowledge structures’ when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests.

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.

Future increases in need of old-age care warrant research on receipt of informal care among older people in different policy and cultural contexts. Separating informal care into help provided by spouse and by children may shed more light on dynamics of informal help, important in alleviating the demands on the formal sector. Using nationally representative data from England and Finland, we performed logistic regression analyses to study receipt of help from spouse and children among community-dwelling persons aged 70+ years with functional limitations. In both countries, women and those with more functional limitations had higher odds of receiving spousal and filial help. In England – but not in Finland – those receiving formal public help had lower odds of receiving spousal help than those with no formal help. Those with low education received more filial help in England, but no association was found between formal and filial help. In Finland, the effect of education was not significant but those receiving formal help had higher odds of also receiving filial help. The results suggest that in a liberal market-led state, the role of children may be to help their parents living alone and with low financial resources. In the context of a generous welfare state, children may function more as active agents bridging the gap between their parents and formal services.

Although mobility in and out of intimate relationships has become more common in later life, it has been a neglected issue in social gerontology. In this article, we ask what characterises the formation of new intimate relationships in later life, and whether there are any specific conditions that separate these from relationships in earlier stages of the lifecourse. On the basis of qualitative interviews with 28 persons aged 63–91 who have established a new intimate heterosexual relationship after the age of 60 or who are dating singles, we argue that time constitutes such a central structuring condition. We discuss and theorise two aspects of time – post-(re)productive free time and remaining time – which have an important formative power on new late-in-life relationships. We argue that together these aspects form a central existential structure of ageing in many Western societies – the paradoxical condition of having lots of available free time but little time left in life – which, besides influencing new late-in-life relationships, might also be relevant to other aspects of and choices in later life.

This study investigated the determinants of Successful Ageing (SA) in a sample of 4,151 Peruvians aged between 65 and 80 years and living in poverty. A key contribution of this study is to combine the conceptual appeal of SA to measure wellbeing in old age with the multi-dimensional poverty counting approach developed in the economic literature. This setting allows for moving beyond the dichotomy of successful and usual ageing to take advantage of the full distribution of success along a set of dimensions of wellbeing. The data are drawn from the Encuesta de Salud y Bienestar del Adulto Mayor (ESBAM) survey, which is the baseline to evaluate the non-contributory public pension programme Pension 65. Nine indicators of SA have been used to assess the dimensions of physical health, functioning, cognition, emotional health and life satisfaction. The variables associated with a higher number of satisfied indicators were male gender, younger old age, literate, employed, low food insecurity, good nutritional status, normal blood pressure, absence of disabilities, non-smoker, empowerment, good self-esteem, absence of mental disability and less frequent contact with a social network. From a policy perspective, the results of this study report a remarkably stable effect of three variables affecting SA that can be relatively easy to measure, monitor and influence by public intervention. These variables are food security, nutrition quality and self-esteem.

Taking a life-cycle approach to marital power relations, the paper compares the attitudes of married men close to retirement with those who are retired. An integrative model based on Resource Theory was designed to analyse the effect of several variables on the husband's perceptions of power relations: perceived resources, attitudes toward gender roles, emotional commitment to his wife and anticipated dependence on her. The model was tested on a sample of 348 Israeli men – 137 pre-retired and 211 retirees. Contrary to expectations of a decline in the retired husband's perceived power, no differences were found between the two groups except for a reported increase in social power among the older group. Major differences were found, however, regarding the overall impact of variables: perceived economic resources had the strongest explanatory power for pre-retired respondents, whereas it was psycho-social factors (anticipated dependence on the wife for satisfaction of emotional needs, psychological resources, and emotional commitment to the wife) that best explained variance among retirees. The increased dependence of retired husbands on their wives' expressive resources seems to contradict their reports of greater social power, suggesting that their perceptions of marital power relations may be coloured by feelings of status anxiety.