Conventional wisdom promotes gradual retirement rather than an abrupt end to the working life. This paper compares the outcomes of abrupt and gradual retirement one and three years after the transition to retirement began using data from an Australian panel study. The outcomes included changes in health, positive and negative affect, wellbeing and marital cohesion. For many outcomes there was no difference between gradual and abrupt retirements, but those who retired abruptly were more likely to rate their health as having deteriorated and more likely to report better adjustment to retirement. Control over retirement decisions was also explored; it emerged as a more important factor in retirement wellbeing than whether the transition was gradual or abrupt. The absence of interaction or additive effects between the retirement pathway and the level of control over the process confirmed this result. Thus there is no simple answer to the question in the title. Retiring gradually allows time for people to make changes to their lifestyle, but having control over the timing and manner of leaving work had a greater positive impact on psychological and social wellbeing, and this persisted three years after retirement. The findings suggest that policies and employment practices that promote employees' control of their retirement decisions will enhance wellbeing in later life and facilitate longer workforce participation.

Life expectancy has been increasing rapidly in many parts of the world, including Hong Kong. A longer life can be welcome as an opportunity to fulfil as yet unmet aspirations, or to take up new challenges and projects, but it may also be a burden, especially for individuals who are unprepared. A pressing question for longer-life societies is: how may older people live their longer lives to the full positively? This article reports a qualitative study of Hong Kong Chinese people's views about ‘positive ageing’, as expressed and discussed in 15 focus groups of middle-aged and older people. Two themes emerged: first, the participants considered that positive ageing should comprise good health, having a positive life attitude, active engagement with an activity or with society, feeling supported by their families and friends, being financially secure, and living in a place with emotional ties; and secondly, several key factors that enable positive ageing were identified, namely, adopting a healthy lifestyle, thinking positively, promoting family and inter-personal relationships, and building up financial resources. The views of the participants about ‘positive ageing’ are compared with those reported from western studies, and the policy implications are considered.

Self-reported altruistic activity and social capital were examined as predictors of perceived happiness and life satisfaction among a sample of 4,486 Canadians aged 65 or more years from the 2003 Canadian General Social Services Survey, Cycle 17. Altruistic behaviour was measured by number of volunteer hours per month and helping others (not including family and friends). Social capital was measured using dimensions of belonging to one's community, community and neighbour trust, and group activities. Drawing on generativity and role-identity theories, it was hypothesised that altruistic behaviour and social capital are positively associated with well-being (using perceived happiness and life satisfaction), and that social capital mediates the relationship. For both perceived happiness and life satisfaction, after controlling for demographic, health status, and social support variables, measures of altruistic behaviour demonstrated statistically significant associations. Once measures of social capital were entered into the analysis in the final block, however, the altruistic behaviour variables were no longer statistically significant. Robust associations were found for social capital and the two measures of well-being, particularly between sense of belonging, trust in neighbours, and perceived happiness and life satisfaction. The findings suggest that altruistic behaviour is mediated by social capital. The implications of these findings are discussed with respect to understanding the well-being of older Canadians.

Financial support and practical help between older parents and their middle-aged children vary greatly among the regions of Europe. Northern and Western Europe is characterised by a high likelihood of practical help to and financial transfers from parents, while in Southern and Eastern Europe these kinds of support are much less likely. Financial transfers to parents show an almost opposite distribution, with more children supporting a parent in Southern and Eastern welfare regimes. Using the second wave of the Survey of Health, Ageing and Retirement in Europe encompassing 14 European countries conducted in 2006–07, these country differences can be linked to different social policies. Controlling for different aspects of country composition in terms of individual characteristics and family structures impacting on intergenerational support, it was found that the more services and transfers provided publicly, the more people aged 50 or more years helped their older parents sporadically, and the less monetary support they provided. On the other hand, generous public transfers enabled parents aged 64 or more years to support their offspring financially. Thus, neither ‘crowding in’ nor ‘crowding out’, but a modification of private transfers depending on public transfers and vice versa is found, suggesting a specialisation of private and public support.

The ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

‘Promoting independence’ is a central theme of recent United Kindgdom health and social care policy development but is rarely defined. Instead it is generally assumed that we know what independence means. Based on a review of the literature on independence in older age, this paper examines the terms and meanings. While the most common conceptualisation equates independence with the absence of reliance on others, for older people themselves independence is a broader concept that encompasses not only self-reliance but also self-esteem, self-determination, purpose in life, personal growth and continuity of the self. Drawing on previous work in the field of health promotion, we therefore put forward a model that takes older people's views into account and that reconceptualises independence as two intersecting dimensions representing levels of dependence and levels of independence. While dependence equates with reliance on others, independence can be seen as subjectively self-assessed lived experience. Thus it becomes possible to combine high levels of dependence with high levels of experienced or felt independence, a particularly pertinent combination for service providers. Finally we examine the ways in which independence thus conceptualised can be promoted at the individual, institutional, community and societal levels.

Little sociological attention has been paid to the repartnering of older people after widowhood, and how age, gender and the meanings of marriage influence choices about new cross-gender relationships. This paper reports on in-depth, semi-structured interviews with 25 widows and 26 widowers over the age of 65, widowed for at least two years and who had not remarried. Respondents were asked about their current lifestyle and relationships and whether they had ever considered remarriage. The words ‘selfish’ and ‘freedom’ were often used by the widows when describing their present existence, which was associated with not having to look after someone all the time. Few of the widowers mentioned selfishness and this was more likely to be associated with feelings of anger at the loss of their spouse; none of the men associated widowhood with a sense of freedom. The paper argues that the desire for repartnering after widowhood is gender-specific: widows are more likely to choose to remain without a partner for intrinsic factors: the reluctance to relinquish a new-found freedom; while for widowers, extrinsic factors of older age and poor health are more salient issues in new partnership formation choices and constraints.

Research on older workers and retirement has yet to adjust fully to an environment influenced by a combination of demographic change, technological developments and economic recession. A key dimension to the changing relationship between ageing and work is the tension between policies to extend working life and the increasingly fragmented nature of late working life, with the emergence of varied transitions, including: bridge employment, second/third careers, part-time working, early retirement and other variations. These developments indicate both the challenge of conceptualising new forms of work-ending, and – in policy terms – the extent to which these can successfully accommodate longer working lives. The paper provides a critical perspective to the policy of extending working life and the narrative which underpins this approach. The paper argues that retirement has become a ‘contested’ institution in the 21st century, fragmented across different pathways and transitions affecting people in their fifties and sixties. The paper argues the case for improving work quality and security as a precondition for supporting policies for encouraging working in later life. An essential requirement for this will include linking debates on extending working life with technological developments and changes affecting the workplace, creating differentiated paths to retirement and labour force exit, enhancing the provision of training and continuing education, and re-thinking the idea of the ‘older worker’.

Most adults do not achieve the levels of physical activity currently recommended for a healthy lifestyle. Population surveys suggest that there is a linear decline of activity levels with age, yet physical activity has many health benefits for older adults. If these are to be more widely adopted among older people, health policy and promotion require an understanding of the factors that influence decreasing activity with age. This study examined the patterns of physical activity of 699 participants in the West of Scotland Twenty-07 Study who were aged 60 years when interviewed in 1991 and followed up four to five years later. It examined the factors that influenced whether or not the subjects achieved currently recommended levels of activity, by applying random effects models with a seasonal adjustment. It was found that higher levels of physical activity associated with a healthier lifestyle, and that socio-economic factors played a minor role in determining the level of physical activity. A substantial amount of physical activity occurred at work but was lost by those who had retired, for while those who were not working were more physically active at home or at leisure than those in work, the majority of the sample did too little physical activity outside work to compensate for the loss of work-based activity. One conclusion is that health promotion initiatives that encourage people to become more physically active should be targeted at those who are about to retire.

Person-centred provision of long-term care (LTC) requires information on how individuals value respective LTC services. The literature on LTC preferences has not been comprehensively reviewed, existing summaries are contradictory. An explorative, scoping review was conducted to provide a thorough methodological description and results synthesis of studies that empirically investigated LTC preference outcomes based on respondents’ statements. A wide search strategy, with 18 key terms relating to ‘LTC’ and 31 to ‘preferences’, was developed. Database searches in PubMed, Ovid and ScienceDirect were conducted in February 2016. The 59 studies meeting the inclusion criteria were grouped and methodically described based on preference elicitation techniques and methods. Despite substantial methodological heterogeneity between studies, certain findings consistently emerged for the investigated LTC preference outcomes. The large majority of respondents preferred to receive LTC in their known physical and social environment when care needs were moderate, but residential care when care needs were extensive. Preferences were found to depend on a variety of personal, environmental, social and cultural aspects. Dependent individuals aspired to preserve their personal and social identity, self-image, independence, autonomy, control and dignity, which suggests that LTC preferences are a function of the perceived ability of a specific LTC arrangement to satisfy peoples’ basic physiological and mental/social needs. Research on LTC preferences would greatly profit from a standardisation of respective concepts and methods.

This paper explores older women's evaluations of their weight as well as the perceived merits and detriments of weight gain and weight loss in later life. Using data from semi-structured interviews with 22 community-dwelling women aged 61 to 92 years, I examine the meanings that the women attribute to dieting, desired body weights and obesity. The women frequently offer unsolicited accounts for why they have gained or lost weight over time, and disclose their perceptions of and reasons for needing to alter their current body weights. I probe the tensions between weight loss for health concerns versus appearance goals. The women express dissatisfaction with their weight gain in terms of their physical appearance. However, they also tend to describe the need to lose weight in terms of health risks and benefits rather than in terms of approximating the beauty ideal or achieving a desired body size and shape. Health tends to be described as a valid justification for being concerned with one's weight, while an appearance orientation is deemed to be indicative of vanity. Many of the women suggest that while the health benefits of weight loss are often the stated reason for losing weight, the perceived appearance dividends are the key motivation behind altering one's body weight in later life.

An increasing number of middle-aged and older Americans are using social network sites (SNSs), but little research has addressed how SNS use is associated with social wellbeing outcomes in this population. Using a nationally representative sample of 1,620 Americans older than 50 from the 2012 Health and Retirement Study (HRS), we examine the relationship between older adults’ SNS use and social wellbeing associated with non-kin and kin relations and explore how these associations vary by age. Results of ordinary least-squares regression analyses suggest that SNS use is positively associated with non-kin-related social wellbeing outcomes, including perceived support from friends (β = 0.13; p < 0.001; N = 460) and feelings of connectedness (β = 0.10; p < 0.001; N = 463). Regression models employing interaction terms of age and SNS use further reveal that SNS use contributes to feelings of connectedness to a greater extent as people age (β = 0.10; p < 0.001; N = 463). Of all kin-related social wellbeing outcomes, SNS use only predicts increased perceived support from children (β = 0.08; p < 0.05; N = 410), and age negatively shapes this relationship (β = −0.14; p < 0.001; N = 410). As older people engage with an increasingly smaller and narrower network with a greater proportion of kin contacts, our results suggest that SNS use may help older adults access differential social benefits throughout later life.

Most published research on informal care for older people focuses on the support provided by relatives. The role of non-kin carers can, however, also be significant in supporting older people in their own homes. In this paper, we report the findings from an exploratory study of the support provided by friends and neighbours who are the main carers of frail older people. It draws on interviews with an opportunistic sample of friends, neighbours and older people, which explored their views about the support arrangements, the reasons why help was provided and any difficulties experienced. Several friends and neighbours provided intensive and frequent help, and some played a key role in co-ordinating other services. One of the main forms of direct support related to older people's quality of life, at a broader level than the practical help provided by statutory services. The flexibility of such support, and the friends' and neighbours' concern for older people as individuals, were particularly important to the people they helped. Nevertheless, such help was not provided without costs to the carers. The study highlights the need for policy-makers and practitioners not to take help from friends and neighbours for granted and, in line with the White Paper Modernising Social Services, to provide the support services they need.

The basis of an effective and satisfactory physician–patient relationship is found in the communication which occurs between these two individuals. By studying the interaction, we can learn much about the identities of the physician and patient, and how they view each other and the world. The interactional dynamics between physician and patient are unique. For example, even in initial medical encounters which involve the meeting of two strangers, patients and physicians deal with concerns as diverse as life and death as well as other intimate or personal issues. Researchers of physician–patient interaction seek to discover how communication evolves and how that communication reveals the multiple levels of meaning in the medical encounter.

The purpose of this article is to review, contrast and synthesise several major intellectual streams that have guided theoretical development and empirical research in the area of intergenerational family support to older people: (a) normative-integrative approaches that focus on cohesion between family members based on bonds of solidarity and norms of filial obligation, and (b) transactional approaches that are primarily concerned with identifying motives for resource transfers across generational lines. We propose the concept of moral capital – defined as the stock of internalised social norms that obligate children to care for and support their older parents – the transmission of which lies at the intersection of self-interest (for parents) and altruism (for children). Using data from a multigenerational family study, we present an empirical analysis showing that a strong positive correspondence in the filial obligations of adult children and their older mothers – arguably the result of intergenerational transmission – elevated the supportive behaviour of children. We suggest that moral capital may be a useful unifying concept that bridges disciplinary and theoretical divides in the study of intergenerational transfers to elderly people by helping resolve the paradox of how self-interest and selflessness can co-exist within families.

The end of the ‘Golden Age’ of welfare capitalism in the 1970s was the prelude to a period of greater individualisation within societies and was accompanied by an increase in the importance of consumption as a way of organising social relations. During the same period there was also an expansion in the discourses aimed at enhancing the government of the autonomous self. One such discourse operates around what has been termed the ‘will to health’: it suggests that health has become a required goal for individual behaviour and has become synonymous with health itself. The generational groups whose lifecourses were most exposed to these changes are now approaching later life. We explore the extent to which social transformations related to risk, consumption and individualisation are reflected in the construction of later-life identities around health and ageing. We examine how the growth in health-related ‘technologies of the self’ have fostered a distinction between natural and normal ageing, wherein the former is associated with coming to terms with physical decline and the latter associated with maintaining norms of self-care aimed at delaying such decline. Finally, we consider anti-ageing medicine as a developing arena for the construction of later-life identities and discuss the implications of the social changes for researching later life.

The aim of this study is to specify the concept of ‘healthy ageing’ from both western and non-western cultural perspectives, and to compare the views of academics and lay older people. Thirty-four published peer-reviewed full papers in English and Chinese (traditional characters) were identified using electronic database searches. The key components of their definitions of healthy ageing were extracted and categorised into 12 domains. The results show that, in general, lay definitions (as described in 11 studies) included more domains (independency, family, adaptation, financial security, personal growth, and spirituality) and more diversity in the healthy ageing concept than academic views (which tend to focus more on physical and mental health and social functioning in later life). Certain domains were valued differently across cultures. As shown in previous studies, the findings affirm that healthy ageing is a multi-dimensional and complex concept and that there are substantial differences in different cultures. Moreover, we found that there are pronounced variations in the conceptualisation of healthy ageing as between academic and older lay people. Generally, older lay people perceive healthy ageing more broadly than the maintenance of physical, mental and social functioning. We suggest that academic researchers should integrate the more holistic perspectives of older lay people and cultural diversity into the classical ‘physical–mental–social’ healthy ageing concept.

This paper focuses on the circumstances of death and dying in old age. It considers the ways in which social policies and social gerontology reflect the values of independence, autonomy and citizenship, and it considers the implication of these values for older people who are dependent on others for care and support at the end-of-life. It discusses the complexity of the relationship between ageing and dying, by exploring recent research from the fields of social gerontology and the sociology of death and dying. Arguing that a long-term perspective is required to understand fully the circumstances of older people's deaths, it analyses the third age/fourth age dichotomy as a conceptual model. The task of developing knowledge about the links between ageing and dying requires consideration of moral and ethical principles. The article examines the conceptual frameworks developed by feminists who argue for an ethics of care as a central analytic referent in social policy. The feminist ethics-of-care approach provides a powerful critique of the moral framework of independence and autonomy as characterised in contemporary policies and practices. Feminist ethicists argue that the inter-relatedness of human beings and the importance of the social context have been overlooked in the preoccupation with individual rights – as reflected more generally in policies and social life. It is argued in the paper that the need for care at the end-of-life highlights these shortcomings. The feminist ethics of care has considerable potential to illuminate our understanding of dependency and care, and to generate both new approaches to policy and practice in health and social care and theoretical perspectives in gerontology.

Most studies of retirement migration in the United States focus at the national level, and there is comparatively little information about the retirees who cross international borders in their search for new homes. Retirement migrants are unusual in that many select destinations in less-developed countries, contrary to the general pattern of migration from poor to rich countries in search of jobs, higher incomes and a better standard of life. This study has examined the reasons for retirement migration from the United States (US) to the Lake Chapala area of the Mexican state of Jalisco. A non-random sample of 211 US retirees was surveyed using a self-completion, semi-structured questionnaire that included items about the decision to move to Mexico, the quality of life at the destination, cultural adaptation, and aspects of personal identity, financial security and health-care. Four major reasons for migrating to Mexico were identified: financial circumstances, the natural environment, a sense of community and friendship, and a better quality of life. While the migrations contradict much taken-for-granted and popular knowledge about migration patterns around the world, they have important implications for the ways of life, social relationships and welfare of the most recent cohort of older people. More in-depth multidisciplinary studies are needed to increase understanding of this evolving phenomenon.

This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care.