Age-related macular degeneration (AMD) is a chronic, progressive eye condition that can affect individuals in later life and lead to loss of central visual function. In this analysis, we aimed to explore the discursive landscape of talk about AMD, drawing on extracts published in peer-reviewed qualitative studies on AMD. Drawing on procedures of qualitative meta-synthesis, we compiled a corpus of raw data extracts from 25 qualitative studies on AMD published in English, largely carried out in high-income countries. Extracts were analysed to identify dominant discourses and key interpretative repertoires (such as recurring metaphors, tropes and figures of speech). We adopted a Foucauldian discourse analytic approach, to consider the implications of dominant discourses, and their associated subject positions, for the subjective experience of living with AMD. Our analysis identified five distinct ways in which AMD was constructed in research participants' talk about experiences of AMD. They included: AMD as a mysterious affliction, linked to biological ageing; AMD as a total loss of independence; AMD as grievous loss; AMD as a condition to be stoically accepted; and – to a more limited extent – AMD as an opportunity for discovery. Drawing on theory from critical disability studies and gerontology, we suggest that the constructions identified are underpinned by broader societal discourses which construct ageing and disability in largely negative, medicalised and individualistic terms. Taking up subject positions within such discourses may compound feelings of isolation, hopelessness and powerlessness. We suggest there may be value in exploring talk about experiences of living with AMD within a broader range of everyday social, relational and environmental contexts.

In the United Kingdom, people living with dementia admitted to National Health Service (NHS) psychiatric/mental health inpatient dementia assessment wards (dementia assessment wards) are nearly always compulsorily detained under a section of the Mental Health Act 1983 owing to the risk and complexity of the presenting condition. As such, dementia assessment wards admit some of the most vulnerable patients in society, yet these environments of care are under-researched and under-reported in the literature. Using care aesthetics as an overarching explanatory lens, this article focuses on the care of one patient (Charlotte – not her real name) resident on a dementia assessment ward and uses a range of qualitative methods to illuminate that experience, including ethnographic observations and a care record review. To further develop the reach of the case study, interviews were also conducted with Charlotte's husband as her main family carer and key ward staff involved in Charlotte's care. Data were analysed using a sensory and narrative-based method to provide a sequential, embodied, individually positioned and storied account of Charlotte's care and interpreted experience on the ward. The analysis revealed that Charlotte's presentation of dementia was complex insofar as she resisted any attempt by the ward staff to offer her food or drink or to help with washing and dressing. Charlotte also swore frequently and loudly and spent time actively ‘watching’ and ‘looking’ at people and the environment in which she was now living. The findings contribute to the fields of critical dementia studies, dementia education, health-care practice and policy making, and may be used to highlight the value of sensory and embodied approaches to capturing a caring dynamic.

Against the backdrop of demographic change and the pluralisation of living arrangements, the article focuses on repartnering after widowhood, divorce and separation in older age in Germany. While theoretically framing repartnering as a lifecourse transition, the question arises of how later-life relationships form in relation to gender- and ageing-specific as well as structural and processual dimensions. Since previous research indicates that there are gender-specific patterns when repartnering in older age which differ from repartnering in middle age, the article explicitly accounts for gendered ageing and attitudes towards ageing. Using data from the German Ageing Survey (1996–2017), longitudinal hybrid panel regressions are modelled for 3,653 respondents, 11,628 observations and 179 new relationships. I propose to understand within-effects as processual and between-effects as structural dimensions of repartnering. The results for the structural dimensions show that the likelihood of repartnering is higher for men and for individuals with more negative attitudes towards ageing. The results for the processual dimensions show how repartnering becomes less likely the older one gets and the more positive one's attitudes towards ageing become. The interaction term for gender and ageing shows that ageing has a stronger influence on the likelihood to repartner for women than for men. Additionally, the findings reveal a difference between forms of singlehood: in the short term, repartnering is less likely for divorced or separated individuals than for widowed individuals, whereas the opposite effect shows in the long term. In sensitising the lifecourse perspective with gender- and ageing-specific concepts and analytically separating processual and structural dimensions, this article demonstrates the importance of gendered ageing and of the linkage between relationship transitions. Applying hybrid panel models to lifecourse transitions in older age reveals the processual dynamic and structural embeddedness of repartnering in older age.

To date, support for independence in older people has been largely focused on achieving practice- and policy-orientated goals such as maintenance of function, remaining in one's own home and reducing the impact of receiving care. Uncertainty about what independence means to older people means that these goals may not align with what matters and should be considered for a more person-centred approach to independence. This study aimed to improve understanding of the meaning and facilitators of independence from older people's perspectives. Semi-structured interviews were conducted with 14 community-dwelling people aged 75+, purposively sampled for maximum variance in demographic characteristics. Interviews, conducted by phone or online, were recorded and transcribed. Analysis was conducted using a framework approach to organise, and facilitate comparison of, inductively and deductively generated codes. Patterns were identified and interpreted into themes. Transcripts and themes were reviewed with the research team. Disagreements in interpretations were resolved through discussion. Two themes were identified. The first theme, ‘Older people draw on personal values and experiences to develop unique interpretations of independence’, was underpinned by three concepts: participation, autonomy and control. The concepts reflected patterns identified within participants’ meanings of independence. The second theme, ‘It's not what you have, but how you think about it that creates independence’, represented participants’ shared prioritisation of psychological attributes over physical or environmental resources for maintaining independence. Participation, autonomy and control are shared concepts within older people's diverse interpretations of independence. This paper addresses uncertainty around what independence means to older people and contributes three key concepts that should be considered when operationalising person-centred support for independence.

The unstable employment trajectories and low wages of Chilean workers mean that the amount of savings accrued in pension funds are often insufficient to cope with the high costs of living in the country, compelling many older adults to remain in the labour market. Although financial need seems to be an important reason for post-retirement work in Chile, a national survey revealed that a majority of older workers would like to remain employed even if there were no economic need. Hence, this research aims at exploring the intrinsic work motivation of older Chilean adults beyond retirement age. This qualitative study is the second phase of mixed-methods research to analyse the factors influencing post-retirement work in Chile. A total of 32 in-depth face-to-face interviews were conducted with older workers in the formal labour market who were legally entitled to retire but continued being economically active in Santiago, Chile. The data are analysed using thematic analysis. We identify three main emerging themes, namely the meaning that work gives to life, future projects and post-retirement orientations, and work as the primary source of social interaction. The findings of this study provide valuable insight into intrinsic work motivation, highlighting important gender and occupational differences. It makes a significant contribution not only to the literature but also potentially to national policy makers as well as employers, indicating the need to adjust the labour market to the ageing workforce.

Sweden and West Germany have had persistently high divorce rates in recent decades, but these two welfare states were differently equipped to mitigate the economic consequences of divorce for individual security in old age: Sweden followed a gender-equal policy approach to enable women and men to achieve economic autonomy, while West Germany, following the male-breadwinner model, introduced the system of ‘divorce-splitting’ to account for differences in women's and men's income. Against this background, this study uses large-scale register data from the German Public Pension Fund and the Swedish population registers to examine how divorce is related to the monthly public old-age pension income of women and men. The main comparison groups are divorced and (re)married individuals who entered retirement between 2013 and 2018. We descriptively show annual income histories from ages 20 to 65, and calculate monthly public old-age pension income with respect to lifetime income and pension regulations, such as the supplements/deductions for ‘divorce-splitting’. Multiple ordinary least square regression models further examine how family status relates to monthly public old-age pension income by gender. The results reveal that women and men in Sweden experience similar working histories, although women's incomes are lower. This is also reflected in women still having lower pension incomes than men. However, divorced and married women show comparable pension incomes, while divorced men receive approximately 26 per cent less pension income than married men. In West Germany, divorced women have significantly higher pension incomes than married women. The system of ‘divorce-splitting’ increases women's and decreases men's pension incomes, which seems to equalise their pension incomes. However, both stay below a married man's pension income. The findings indicate economic inequality in public old-age pension income by family status in Sweden and West Germany.

Positively experienced relationships with family, partners and friends are the most important source of meaning in life for older persons. At the same time, Western countries are confronted with a growing number of socially isolated older adults who lack those relationships. This study aims to explore whether and how older adults who live in social isolation experience meaning in life. Data were collected via in-depth, semi-structured interviews with 24 socially isolated older adults, ranging in age from 62 to 94, all living in Rotterdam, The Netherlands. The criterion-based sampling of participants took place in close consultation with social workers of a mentoring project for socially isolated older adults. Follow-up interviews with 22 participants improved the credibility of findings and contributed to the breadth and depth of the researched casuistry. Data were analysed using an analytical framework based on seven needs of meaning identified by Baumeister (purpose, values, efficacy, self-worth) and Derkx (coherence, excitement, connectedness). The study demonstrates that isolated older adults may find anchors for meaning in life, although not all needs for meaning are satisfied, and there can also be tension between different needs. The needs-based model provides concrete distinctions for enabling care-givers to recognise elements of meaning.

Care home residents were vulnerable to severe effects from Covid-19 infection and experienced high mortality, especially early in the pandemic. In response, many countries introduced visiting restrictions to limit transmission. These often proved extensive and prolonged, drawing fresh attention to issues of autonomy and human rights in long-term care. We conducted in-depth interviews with 27 family carers in England with relatives living in a care home during the pandemic. Adopting a relational autonomy lens, conceptualised using the capability approach, we examined how family carers considered their relatives’ capabilities to have been impacted by visiting restrictions and how relational support could be strengthened. Family carers were concerned for their relative’s fundamental capabilities, including physical health, emotional well-being, and feeling connected to significant others. Capability deprivations were associated with family separation, ‘adapted’ visits that were inappropriate for their relative’s needs, and lack of opportunity for family carers’ to provide emotional support, help staff identify their relative’s emotional and physical needs, monitor care standards or advocate for their relative. Optimising relational support during a public health emergency requires effective collaboration between care homes and family carers. Specific measures include (1) ensuring there is clarity, a sense of shared purpose, clear accountability and confidence in visiting restrictions, (2) providing family carers regular, personalised updates about their relative using a range of digital communication tools, (3) allowing choice about visiting arrangements where possible, and ensuring visits are appropriate for residents with dementia and (4) ensuring that family carers feel welcomed, involved and enabled to resume in-person visits at the earliest opportunity. Consultation with care homes, families and residents, and workforce and digital readiness should be prioritised.

The COVID-19 pandemic in Australia has profoundly affected older adults, particularly in the state of Victoria, which experienced strict lockdown restrictions six times since the pandemic began in 2020; totalling 245 days over three years. This study explored the experiences of older adults living in retirement villages during the first three lockdowns in Victoria from March 2020 to February 2021. We draw on the concept of the ‘third age’ to explore how residents’ post-retirement social and lifestyle aspirations were disrupted by the pandemic and associated lockdowns. In-depth qualitative interviews were conducted with 14 residents during January and February 2021. All data were analysed using thematic mapping. Five key themes were identified: (1) benefits and frustrations of retirement village living during a pandemic; (2) the loss of amenities and activities; (3) heightened loneliness and social isolation; (4) reaching out to others; and (5) variable experiences of operators’ response. Although the COVID-19 pandemic has highlighted short-term and long-term issues around social isolation and the management of retirement villages, it has also demonstrated the resilience of residents and the strength of community ties and relationships. Retirement villages are promoted as age-friendly environments that enable an active and healthy post-retirement lifestyle. Yet our findings reveal heterogeneity within village populations. When services closed during lockdowns, this revealed a tension between the policy assumption that retirement villages are a housing consumption choice, and the unmet needs of those residents who depend on village services for day-to-day functioning.

Although older people who live alone might be in a vulnerable situation, they have often managed their everyday life for a long time, frequently with health challenges. In this article, we explore how nine older persons who live alone, who receive home care and are identified by home care professionals as being frail, manage their everyday lives by inquiring into their stories about living alone and receiving home care. We conducted three qualitative interviews with each of the nine participants over a period of eight months and analysed the data using thematic analysis and a narrative positioning analysis. Using the concept of resilience as our analytic lens, we identified three thematic threads: continuity, adaptation and resistance. In the narrative positioning analysis of three participants' stories, we identified that the participants used the processes of continuity, adaptation and resistance strategically and interchangeably. The study thus provides insight into how older people who live alone and use home care services narrate their balancing of strengths and vulnerabilities, and engage in the construction and maintenance of a sense of self through positioning in relation to master narratives. Older people's narrations are nuanced and complex, and this study indicates that encouraging storytelling and engaging with older people's narrations might support how older people enact resilience and thus their management of everyday life when living alone and ageing in place.

Older adults who have had a major depressive disorder (MDD) have a high risk of relapse. Although risk factors for depression have been researched extensively, less is known about protective factors, and what experiences might strengthen subsequent resilience and help to prevent relapse. Therefore, this qualitative study explored factors of resilience in older adults who recovered from MDD and did not relapse across at least six years. Twenty-five semi-structured interviews were held with older adults aged 73–85 years who participated in the Netherlands Study of Depression in Older Persons from 2008 to 2014 and were re-interviewed for the present study in 2020–2021. Participants were defined as resilient based on having an MDD diagnosis at baseline but not on two- and six-year follow-up. We used grounded theory coding techniques and thematic analysis to identify factors contributing to resilience. Factors contributing to resilience included: taking agency; receiving social support and engaging in social activities; doing activities individually; and managing thought processes. Resilience after late-life depression appeared to be a dynamic process involving internal and external factors, including finding a balance between rest and activity, between taking initiative and receiving support by others, and between accepting negative emotions and ignoring negative thoughts. Additionally, the ability to learn from depression shows that resilience is not only about avoiding psychopathology, but also about the recovery process and preventing relapse. These findings highlight the need for research and interventions to focus on understanding and influencing the dynamics underlying resilience.

The COVID-19 pandemic and ensuing restrictions/lockdowns have caused significant physical and psychological consequences for people with cognitive impairment who are heavily dependent on their care-givers. However, little is known about the impact on care-givers, the factors that exacerbate their situation and what supports they need. The aims of this paper are threefold: (a) to examine the impact of COVID-19 physical restrictions on both formal and informal care-givers of people with cognitive impairment; (b) to identify attributing factors influencing this impact; and (c) to recognise their support needs. Further, this paper informs future research, policy and practice. Guided by the Joanna Briggs Institute framework, a systematic review was conducted using a mixed-methods convergent integrated approach. Eight databases were searched using keywords related to COVID-19 restriction, dementia care-givers, impacts and care settings, followed by a manual search. The study was limited to primary research published in English between January 2020 and December 2021. Of the 840 records identified, 30 met the inclusion criteria. Service withdrawal and social distancing has effectively led to the reprivatisation of care to the family, particularly women. Care-givers experienced negative impacts including reduced psychological wellbeing and physical health, increased care burden and financial difficulties. A number of clinical attributes and socio-demographic factors influenced the COVID-19 impact on care-givers. Consequently, counselling services, assistance with care and financial support were identified as support needs. Implementation of new support and the strengthening of existing services are recommended to enhance resilience, build capacity to support care-givers in any given situation and mitigate the effects of future outbreaks.

Older adults were particularly vulnerable to the COVID-19 pandemic, necessitating significant efforts to avoid contamination. This extraordinary situation posed an increased risk of mental pressure, and the ability to handle stressful situations is affected by several aspects. Therefore, this study aims to explore the coping strategies employed by older adults during the early months of the COVID-19 pandemic. A sample of 41 Swedish older adults aged 70–85 participated in phone interviews regarding their experiences with social distancing due to COVID-19. The interviews were conducted between April and May 2020, with nine follow-up interviews conducted in November and December 2020. The findings revealed results that despite the challenging circumstances, the participants demonstrated a strong mindset and resilience. Strategies utilised to improve their wellbeing and manage the situation included following recommendations, accepting the situation and maintaining a positive outlook. The influence of previous experiences on their coping strategies was evident. Additionally, the participants expressed a longing for their relatives and a need to adopt new technologies to manage their everyday lives. The follow-up interviews indicated no significant changes in worry or behaviour; if anything, participants were less worried at the beginning of the pandemic. This study contributes to the ongoing discussion on vulnerability among older adults by highlighting the diverse range of coping strategies employed during a prolonged crisis such as the COVID-19 pandemic. It demonstrated that though they are medically vulnerable, they are situationally resilient and, in many ways, well set to handle a challenging situation. During crises, older adults might need practical assistance. On the other hand, they can be a resource regarding mental preparedness during crises. Further research should explore the possibilities of balancing the needs of older adults and, at the same time, viewing them as a resource during long-time crises.

Laboratory-based experiments show ageing negatively impacts navigation abilities, yet a paucity of research explores lived experience. This exploratory study examined young-old adults' experiences of declining navigation abilities during 16 semi-structured telephone interviews. Findings reveal: (a) ‘Behavioural drivers’ that underpinned the participants' experiences and actions when engaging with their environments, (b) ‘Avoidance’ and (c) ‘Active’ strategies that were adopted by the participants. Declining cognitive function appeared to have a negative impact on participants' perceived abilities and confidence to navigate unfamiliar outdoor environments, which in turn influenced the strategies they chose to adopt. Future psychosocial interventions should draw on neuropsychological theory to ensure retention of navigation skills and confidence for as long as possible.

Oldest-old (age 80+) spousal care-givers of people with dementia experience unique challenges and concerns that they attribute to age and/or ageing, including difficulties providing care because of physical, cognitive or sensory decline; having fewer friends who can provide practical support; and having less energy for non-care-giving activities (e.g. leisure activities, self-care). Previous research on how older care-givers manage is not specific to oldest-old care-givers and may underrepresent their unique experiences managing age and ageing-related challenges. A limited understanding can compromise our ability to tailor services to ageing care-givers. The purpose of this research was to illuminate how oldest-old spousal care-givers of people with dementia manage ageing-related care-giving challenges and the barriers and facilitators to strategy use. The selective optimisation with compensation theory and the transactional theory of stress and coping informed our conceptualisation of management strategies. We used a narrative gerontology approach, with two or three semi-structured interviews with 11 care-givers aged 80–89 (25 interviews in total). Narrative data were analysed thematically. We identified four main themes that encompassed the strategies shared by care-givers: adjusting goals to lessen care-giving demands and to mitigate stress, using alternative means to reach goals and to mitigate stress, enhancing capacities to care and mitigate stress through engagement in non-care-giving activities, and choosing positive attitudes and perspectives to lessen emotional distress. We identified a myriad of facilitators and barriers to strategy utilisation in each theme. The study provides unique insight into care-givers' management strategies, especially in relation to relocation of self and spouse and participation in non-care-giving activities, as well as insight into age-related facilitators and barriers. This research can ultimately help inform the tailoring of age-sensitive health and social care services to meet the needs of this group of care-givers as they age.

The relationships that care home staff have with their co-workers are a key influence on the way they feel about their work and how they perform in their roles. This has a direct influence on quality of care and life as experienced by residents. However, care home providers face a challenge to promote co-worker relationships because: (a) the care home workforce often lack human resource oversight; (b) registered managers (and nurses), who often lack leadership training, are tasked with managing the working relationships of staff, the majority of whom are care workers of different ages, ethnicity and cultural beliefs; and (c) most (care workers) do not have any formal qualifications and are not routinely provided with the communication skills to facilitate collaborative working in dynamic and pressured climates. In this forum article, we consider these challenges and their implications for collaborative co-worker relationships, before highlighting opportunities for research, policy and practice. An important starting point is to focus on developing the leadership skills of staff at all levels and provide care workers with the skills they require to manage their working relationships and support them in their everyday work for the benefit of residents.

As the population ages and the prevalence of dementia increases, caring for a relative living at home with dementia has become a reality for many families worldwide. Studies have shown that families are confronted with diverse difficulties as they try to address the challenges involved in providing care. By understanding how they manage daily life, formal service providers become better equipped to meet the diverse needs of these families. Learning how families live with memory loss and cognitive changes calls for an understanding of the shared context surrounding the person, including the collective of people, and their connections. With the research method of ethnographic case study, we followed eight families living at home with dementia for two years. All participants had been placed on a waiting list for a specialised dementia day care programme. The analysis presented here is based on three cases which reflect widely different experiences and situations. We describe how these families dealt with their daily living at home, if and how they made use of the formal support available and what approaches they found helpful for improving their lives. The results show how the persons living with dementia and their care-givers drew on the collective of their backgrounds, surroundings and available support. With diverse arrangements, families tried to find ways to make their daily lives work out. But constant re-arrangement was necessary. This knowledge could be a central learning point for formal service to build on. While systematic or routine procedures in service provision can be helpful, time and space must be provided for professionals to understand families' different practices, so that they can provide family-centred support.

Older adults who age at home independently are often celebrated as having anticipated and planned for their care needs in the later stages of life, whereas those who receive assistance from home support services are often stigmatised as dependent and characterised as a ‘drain on the system’. However, this thematic analysis of interview data from 12 home care clients in two Canadian provinces offers evidence that counters the assumption that home care clients are passive recipients of care. Extending Corbin and Strauss' theorisation of how individuals manage chronic conditions alongside Dorothy Smiths' conception of work, we explore how home care clients ‘work’ to receive care as they age in place. Specifically, home care clients not only engage in daily life work, illness work and biographical work, but also advocate for themselves and their workers, co-ordinate and negotiate with members of their caring convoys and networks, and adapt in various ways to navigate personal, relational, structural and policy-level challenges. We suggest that work done by older adults who are ageing in place be addressed, acknowledged and incorporated into care planning and operational policy development to challenge both the stigma of dependency and neoliberal narratives of self-sufficiency.

Previous literature attempted to gain insight into financial abuse involving people with dementia by analysing court cases, but these studies were limited in sample size or scope. This study collected 214 court rulings directly related to the financial decisions of people with dementia to identify characteristics of the financial abuse victim, perpetrators and the types of assets. The models of bystander intervention and routine activity theory were used as conceptual models to guide analysis regarding the role of bank staff as well as the court's decision in cases of financial abuse. The majority of financial abuse perpetrators were family members (73.8%), as opposed to outsiders (19.2%). Transfer of real estate was the most common legal issue, and land was the most common financial asset involved. Difficult intra-family relationships seem to pose a great risk of financial abuse involving people with dementia since adult children were found to be the most likely perpetrators (52.7%) but also plaintiffs accusing financial abuse (57.6%). In accordance with the bystander intervention model, bank staff were more likely to be suspicious of financial abuse when an outsider was regarded as the perpetrator. In accordance with the routine activity theory model, the court was more likely to acknowledge the case as an invalid financial decision when an outsider was regarded as the perpetrator in financial abuse cases. Since people with dementia suffer from greater losses due to their family members, future policies should establish guidelines for front-line bank staff to identify warning signs to reduce the risk of financial abuse involving people with dementia, not only to prevent fraud by outsiders but also exploitation by family members.