Increased physical activity is widely promoted as beneficial for older people, but previous research indicates this may be difficult to implement in care homes, especially for people with dementia who form an increasing proportion of residents. Care home cultures can mitigate against physical activity for residents, but there is also scope for them to embed personalised physical activity. They are under-researched, but significant in terms of outcomes and quality of life for residents. This paper builds understanding of care home cultures of physical activity through qualitative, empirical research in five care homes. Key findings are that culturally framed views about physical activity, sometimes reflecting stereotypical views of dependency, can be seen in care homes. Managers, staff and residents may be invested in or resistant to physical activity and dominant managerial or societal views may be reflected or contested. The relatively closed boundaries of care homes reinforce sedentariness, and resident involvement in either chosen or enforced physical activity is varied. Interactions demonstrate potential to negotiate physical activity more or less effectively in any given care home. Rigid routines, external regulations and pressure on staffing can be negative, but management commitment has positive potential. In conclusion, the paper identifies that to increase physical activity in a sustainable manner, any intervention needs to address issues of culture change and individual needs and preferences.

Ageism is a widely used term that is not (yet) well understood. We propose a redefinition of ageism and to separate it from ableism. We believe this to be important as remedies may depend on whether someone is experiencing ageism or ableism. While focusing the discussion on older workers as a sub-group of older people who (can) experience ageism, we assess the usefulness of critical (feminist) disability studies for ageism research. We hope that redefining ageism and analytically separating it from ableism (without suggesting that both concepts should be studied independently from one another) will provide guidance for researchers who study ageism and will allow for more specific policy guidance on how to solve difficulties experienced by older workers.

Social isolation of older adults is difficult to break through, and interventions that focus on network development or enhanced social participation are hardly effective, especially when the older adults have been isolated for a long time and have problems in multiple life domains. This study aimed to investigate the needs and subjective experiences of this less-researched group and obtain a deeper understanding of their goals and priorities. The study involved a qualitative study with 25 socially isolated persons who receive assistance from a social worker in an individual guidance trajectory. Data were collected via repeated in-depth interviews with the older adults. By directing the focus towards their subjective experiences, the study gives insight into the ‘experiential effectivity’ of the intervention. It shows what their experienced problems were, and to what degree they benefited from the intervention in this respect. The experience of personal attention and involvement of the social workers represents the most relevant results for them. The participants have no need for network development or engagement in local communities. Yet, the help offered by the social workers produces other results for them, such as solved practical problems, emotional support, more self-sufficiency, a point of contact or a safety net that was not there before. This knowledge can help to improve the quality of intervention for this target group.

Fear of crime among older people has been a frequent topic in ageing research, criminology and urban studies. The ‘environmental docility hypothesis’ assumes that older people are more vulnerable to adverse neighbourhood conditions than younger age groups. Yet, few studies have tested this influential hypothesis using samples of respondents covering the complete adult lifespan. Looking at fear of crime, we investigated the person–environment interaction of age and neighbourhood disadvantage, using two independent surveys comprising 12,620 respondents aged 25–90 years residing in 435 neighbourhoods in four cities in Germany and Australia. We used multi-level analysis and cross-level interactions to model age-differential effects of neighbourhood disadvantage on fear. Contrary to the hypothesis, we found a weakening of neighbourhood effects on fear with age. The strong effect of neighbourhood disadvantage on fear of crime dropped by around half from the youngest (25 years) to the oldest age (90 years) in both countries. Younger people were almost as fearful as older people in the most disadvantaged neighbourhoods, but older people were considerably more fearful than younger ages in better-off neighbourhoods. We found limited empirical support for the assumption that this diminished association between neighbourhood disadvantage and fear can be explained by the stronger neighbourhood attachment of older people. The limitations of the analysis and potential future directions of research are discussed.

Self-ageism has a significant negative impact on older people's ageing experiences and health outcomes. Despite ample evidence on cross-cultural ageism, studies have rarely looked into the way cultural contexts affect self-ageism. In this article, we compare expressions of self-ageism and its possible predictors across four European countries based on two questionnaires in a study sample of 2,494 individuals aged 55 and older. We explore how predictors of self-ageism are moderated by cultural values in a comparative fixed-effects regression model. We empirically show that similarly to ageism, self-ageism is not present in the same way and to the same extent in every country. Moreover, the level to which cultures value hierarchy and intellectual autonomy significantly moderates the association between self-ageism and individual predictors of self-ageism. Our study adds to the small existing body of work on self-ageism by confirming empirically that certain expressions of self-ageism and individual predictors are susceptible to change in different cultural contexts. Our research results suggest that self-ageism interventions may benefit from a culturally sensitive approach and imply that more culturally diverse comparisons of self-ageism are necessary to figure out fitting ways to reduce self-ageism.

This study explored the coping strategies and social comparisons used by older adults on different loneliness trajectories (decreased loneliness, stable loneliness and degenerating loneliness). The adaptive consequences of social comparison in later life are recognised as an important strategy for preserving life satisfaction regardless of age-related losses. Coping strategies are also important in managing loneliness. Narrative interviews were conducted with lonely older adults (N = 11) who had participated in Wave One of the Maintaining Function and Well-being in Later Life Study Wales (CFAS Wales). The study found key differences in the coping strategies employed by older adults on different loneliness trajectories. Differences in coping styles between those who reported decreased loneliness and those who were chronically lonely stemmed from perceptions as to whether loneliness was modifiable or not. Different types of social comparison were also found to modulate the loneliness experience. The findings indicate that higher-order strategies (problem, emotional and meaning focused) are not distinct entities but are part of a dynamic process. The management of loneliness in later life may be dependent on several factors, including older adults’ interpretations of the cause of loneliness. These interpretations will have implications for interventions aimed at alleviating chronic loneliness, where the focus may have to be on changing older adult's perceptions of unmodifiable loneliness.

Inefficient health service utilisation puts pressure on health systems and may cause such negative individual consequences as over-medicalisation or exacerbation of health problems. While previous research has considered the key relevance of health literacy (HL) for efficient use of health services, the results of that research have been somewhat inconclusive. Possible reasons for diverging results of prior research may be grounded in different measurement concepts of HL and the disregarding of age-specific effects. This paper analyses the association between individuals’ HL typology based on a two-dimensional concept and indicators of health service utilisation measured by registered data covering the number of doctor visits and medication costs. Our results confirm a significant interaction effect between age and HL typology. The age-related increase in health service utilisation is strongest for individuals with the combination of high subjective HL but low health-related knowledge, while the smallest increase is for individuals with the constellation of high subjective HL combined with high health-related knowledge. Individuals with specific constellations of HL (that is, individuals with high subjective HL but low health-related knowledge) are associated with reduced service utilisation in younger ages but higher service utilisation in later stages of life, compared to other groups. These results are likely to be attributed to a higher external health-related locus of control and more traditional paternalistic role expectations in such groups.

Earlier studies show that experiencing life as meaningful in old age promotes holistic wellbeing and health among older people. As more and more people are living with reduced capacities in their own homes, there is an urgent need to find new ways of promoting holistic wellbeing of the ageing population. Analysing data gathered from existential discussion groups on Service TV (STV), we show how strongly relationality and meaning in life are intertwined for older people. Our findings indicate that respect and support for the autonomy of older people is very important: in order to continue living at home, and prepare for a future with reduced capacities, they need family members for support. Autonomy of ageing becomes relational as choices and wishes are negotiated with family members. Relationships also contribute to loss of meaning. When older people felt that they were not close enough to their family, longed for friends of the same age, were bereaved or widowed, the relational gap caused a violation of meaning. In contrast, participation and activities with peers brought deep joy and connectedness to the lives of the participants. STV provided a new channel for participants to find and form meaningful relationships. Therefore, it is concluded that relationality can be supported by technological means of care.

Participatory action research (PAR) advocates end-user involvement in various societal domains. This paper aims to identify and analyse impacts of PAR involving older persons as co-researchers, and how these impacts spread and are enhanced throughout the research process and after its completion. By impact we mean transformational change throughout and after a PAR study. We present a qualitative community-based research project involving older people who live in sparsely populated areas in the Netherlands, and explore three types of PAR impact: personal, interpersonal and community impacts. We demonstrate how these impacts unfold through expanding circles, from a personal to a community level, and how these circles enhance each other. The project was conducted by a PAR team consisting of one researcher and seven co-researchers. The data were collected from observations, interviews and minutes of meetings, which the team subsequently analysed. The results are presented as a narrative account, whereby four project stages are followed by reflection on the impact it made. The discussion addresses the circles of impact, and whether and how they can strengthen each other in community-based projects involving older people. The concluding remarks address the influence of group dynamics on PAR, whether frail older adults can be expected to take an active part in PAR projects and the extent to which the results from such community-based PAR projects can be generalised.

As there is currently no cure for dementia, providing psycho-social support is imperative. Counselling and psychotherapeutic interventions offer a way to provide individualised support for people with dementia and their families. However, to date, there has not been a systematic review examining the research evidence for these interventions. This review aimed to examine the following research questions: (1) Are counselling/psychotherapeutic interventions effective for people with dementia?, (2) Are counselling/psychotherapeutic interventions effective for care-givers of people with dementia? and (3) Which modes of delivery are most effective for people with dementia and care-givers of people with dementia? A systematic literature search was conducted in MEDLINE (via PubMed), PsycINFO and CINAHL in March 2019. Keyword searches were employed with the terms ‘dement*’, ‘counsel*’, ‘psychotherapy’, ‘therap*’, ‘care’ and ‘outcome’, for the years 2000–2019. Thirty-one papers were included in the review, from seven countries. Twenty studies were randomised controlled trials (RCTs) or adopted a quasi-experimental design. The remaining studies were qualitative or single-group repeated-measures design. The review identified variation in the counselling/psychotherapeutic approaches and mode of delivery. Most interventions adopted either a problem-solving or cognitive behavioural therapy approach. Mixed effectiveness was found on various outcomes. The importance of customised modifications for people with dementia was highlighted consistently. Understanding the dyadic relationships between people with dementia and their care-givers is essential to offering effective interventions and guidance for practitioners is needed. Information about the cognitive impairment experienced by participants with dementia was poorly reported and is essential in the development of this research area. Future studies should consider the impact of cognitive impairment in developing guidance for counselling/psychotherapeutic intervention delivery for people with dementia.

What explains ageism towards older people? Several answers exist in the literature, but it is still unclear whether the ageism people express has been altered by motivational forces (i.e. factors which carry or enact motivation, leading to action or thought) or whether an original, primal ageism can be expressed directly. Investigating populations of young adults (45 and younger), this article suggests that value systems are sources of internal and external motivational forces which work to either suppress or to justify both subtle and blatant forms of ageism. It was hypothesised that, at the individual level, values precede any threat perception and negative stereotypical beliefs associated with older people, leading to forms of ageism which match the motivational goals of a person's values. It was further expected that, at the cultural level, values represent the climate in which people express ageist beliefs. It was found that self-transcendence values can bypass the negative effects of threat perception and negative stereotypes, resulting in less-negative forms of ageism. A sample comprising a clear majority of hierarchical, non-Western cultures showed that self-enhancement values also contributed motivational strength for the suppression of blatant ageism. A practical implication of these findings is the possibility of further developing existing strategies of combating ageism by working to effect appropriate long-term changes in the values of young adults.

Person-centred care requires improved documentation of nursing home resident wellbeing, e.g. by nursing staff proxy assessments. Previous studies mainly focused on proxy self-report agreement of quality of life of people with dementia, using lengthy questionnaires. This is the first study to investigate how well nursing staff assess residents’ wellbeing after training, using a single-question assessment method of happiness and engagement. We conducted a cross-sectional mixed-method study, including proxy assessments from 49 nursing staff, and self-reports from 49 nursing home residents without dementia (mean age 85). We explored agreement between colleagues, and between proxy assessments and self-reports, and potential nursing staff characteristics associated to this (age, experience, hours worked per week). Brief written motivations were evaluated on nursing staffs’ understanding of the happiness and engagement concepts. The results showed low agreement between colleagues, and low agreement between proxy assessments and self-reports. Nursing staff assessed happiness and engagement substantially higher than residents’ self-reports. Hours worked per week was related to happiness proxy assessments, but none of the included nursing staff characteristics were related to proxy self-report agreement. Nursing staff interpreted the concepts in diverse ways. Overestimating resident wellbeing when using this single-assessment method may undermine subsequent efforts to improve wellbeing. We could not identify which nursing staff could best provide wellbeing assessments. For now, proxy wellbeing assessments should always be combined with regular self-reports whenever possible.

With an ageing society, the demand for health and social care is increasing. Traditionally, staff provide care for their clients rather than with them. In contrast, reablement aims to support people to maximise their competences to manage their everyday life as independently as possible. There is considerable variation between and within countries regarding the conceptual understanding of the approach. This variation affects the ability to evaluate reablement approaches systematically, compare and aggregate findings from different studies, and hinders the development of a robust evidence. Therefore, a Delphi study was conducted in 2018/9 with the aim of reaching agreement on the characteristics, components, aims and target groups of reablement, leading towards an internationally accepted definition of reablement. The study consisted of four Web-based survey rounds. In total, 82 reablement experts from 11 countries participated, reaching agreement on five characteristics (e.g. person-centred), seven components (e.g. goal-oriented treatment plan) and five aims (e.g. increase clients’ independency). Furthermore, most experts agreed that reablement is an inclusive approach irrespective of the person's age, capacity, diagnosis or setting. Based on these features, a definition of reablement was developed, which was accepted by 79 per cent of participating experts. This study is a significant step towards providing conceptual clarity about reablement. Future research should focus on evaluating the implementation of agreed reablement components to inform practice, education and policy.

Population ageing and discourses on healthy ageing have led to a growing interest in social dancing for seniors. While senior dance has been described as both common and contributing to good health, the fundamental connection between bodily and temporal dimensions has been fairly neglected. As a result, there is a risk of portraying dance among older adults as a general practice, while at the same time the senior dance's potential to shed light on relations between temporality and ageing is not utilised. Based on qualitative interviews with 25 women and eight men, aged 52–81, in Sweden, whose main leisure activity was dancing, this article sheds light on this knowledge gap by illustrating the pleasurable experiences of senior dance. The results illustrate that the pleasurable experiences of dancing can be understood as three different experiences of temporality: embodied experience of extended present, an interaction with synchronised transcending subjectivities and age identities with unbroken temporality. The results also highlight the central role that temporal aspects play in processes around subjectivities in later life, as well as the close connection between ageing embodiment and temporality. They also illustrate the ability of dance to create wellbeing, not only through its physical elements, but also through the sociality that constitutes the core of dancing. In light of these results, the article argues that the temporal processes relate to individuals’ diverse relationship with the world and that they therefore play a central role in subjective experiences of ageing.

Social media facilitates the sharing of ideas, thoughts and information about older people and later life through online networks and communities in contemporary society. Social media content about older people has become important for understanding media representations of older people, but it has not been sufficiently studied. Recent studies suggest that older people are predominantly represented as a disempowered, vulnerable and homogeneous group on social media sites, such as Facebook and Twitter. Because local authorities in many countries have begun using Facebook to reach out to and interact with citizens, they are seen as a significant producer of media content about older people and later life. The purpose of this study is to examine the ways in which Swedish local authorities have visually portrayed older people in their use of Facebook compared with other age groups. This research performed a visual content analysis of 1,000 Facebook posts posted by 33 Swedish local authorities, employing ten analytical aspects to describe and interpret the signs, activities and contexts associated with older people and other age groups (infants, children, adolescents and adults). The study found that the representations of older people on the Facebook pages of local authorities appeared to be not very diverse; specifically, older people (including those in residential care homes) were mainly portrayed as remaining socially engaged and moderately physically capable. This media representation destabilised the prevalent negative stereotypes of older people as being out of touch and dependent; however, it collided with the reality of older individuals with care needs. Additionally, this study argues that older people are represented as inferior to the young in terms of physical and technological competence, based on the connotations of the signs. Given that local authorities have progressively incorporated social media into their daily work, it is expected that this study will contribute to a greater understanding of the ways in which local authorities produce (non-)stereotypical representations of older people on social media.

Across literature on loneliness and ageing, little attention is given to the intersection of ageing, sexuality and masculinities, and how this shapes the social connections of older men. We report findings from a qualitative study of older men's experiences of loneliness and social participation, focusing on perspectives from two groups who are single and/or living alone: men identifying as (a) heterosexual and (b) gay (not bisexual). We present findings generated from semi-structured interviews with 72 men residing in England (65–95 years). We discuss three prominent themes: (a) loneliness, loss and social dislocation; (b) diverging life-events that trigger loneliness; and (c) variations in visibility and exclusion across social settings. Embedded within men's descriptions of loneliness is a running theme of social dislocation that speaks to a wider sense of social separation and estrangement. Unique to gay men's accounts are the ways in which experiences of loneliness and social isolation are compounded by living in heteronormative social environments and their encounters with ageism in gay social settings. Older men's accounts convey anxieties about visibility and anticipated exclusion across social settings shared with other men that vary according to sexual identity and context. We discuss how sexuality and being single and/or living alone impact on older men's social participation as we seek to move beyond a heterocentric understanding of loneliness.

For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, in this work, we aim at understanding the organisational implications of three types of interventions (labelled supportive care interventions – SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, our review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, we offer some considerations about the implications of SCIs for long-term care organisations and future research directions.

We studied older people's perceptions of how they organise their out-of-home mobility and independent living when they face mobility restrictions, based on seven focus groups with older people (N = 28) from a suburb in Finland. This article provides an everyday life view of how the ability to move outside the home evolves through interdependencies between older people and their neighbourhoods, social relations and societal arrangements. Our findings show that supportive socio-material surroundings can provide older people with new ways to move outside their home despite mobility restrictions and new ways to organise their daily life with decreased mobility. In contrast, restrictive socio-material surroundings can lead to situations in which older people forgo certain out-of-home journeys and activities. The findings contribute to an understanding that organising one's daily life and out-of-home mobility is an act of interdependence. Policies promoting independent living in old age should recognise these fundamental interdependencies and support versatile ways of living rather than overemphasise activity and self-reliance. Based on older people's everyday life perspectives, both sides of the coin need to be considered: how to enable the out-of-home mobility of older people facing mobility restrictions and how to support them in managing and enjoying daily life with decreased mobility.