There is a danger that the ‘missionary zeal’ exhibited by some social gerontologists in the interests of those members of society who are older than others, may endanger the subject's ‘scholarly stance’ and the potential contribution to social policy of research on old age. This paper discusses four facets of the matter: (1) the anticipated values underpinning policies of state welfare (2) personal feelings and values in the business of research (3) values and the kind of data we value and (4) the question of whose side we are on. The paper concludes with a theoretical model of the relationship between the social policy process and the social research process as framework for understanding exactly how values about ageing impact both research about ageing and the relationship between that research and relevant social policies.

A new theoretical framework for understanding and working with the dementing illnesses of old age is presented, and explicated with particular reference to senile dementia of the Alzheimer type. For several reasons the commonly accepted model, which assumes a simple linear causal relationship between neuropathology and dementia, is inadequate. A more comprehensive model, grounded in a monistic view of the mind-brain relationship, must take into account not only the psychological states that correspond to particular brain states, but also both developmental and pathological aspects of brain structure. Using this we can describe the dementing process, ‘normal’ psychological functioning in old age, pseudodementia and ‘benign senescent forgetfulness’. Further, the scope for some degree of ‘rementia’ is explored.

This paper describes the theoretical and methodological perspectives adopted by a multidisciplinary research group undertaking a government-funded evaluation of a United Kingdom innovation in the continuing care of elderly people. In 1983 three experimental National Health Service (NHS) nursing homes were set up to care for patients usually cared for in NHS geriatric hospitals. Drawing on different approaches to the evaluation of health-care innovations, this paper delineates an evaluation model which identifies four types of variables: structure, process, intermediate outcome and final outcome. The relationship of this model to the design of an evaluation comprising seven complementary research activities is described, emphasising the need for multiple perspectives and multiple methods in policy-oriented health-care evaluations.

This research examines the comparative perceived income adequacy among older Swedes and older Americans. The persisting issue of ‘poverty’ and income adequacy, and the use of monetary-unit income (dollars, kroner, etc.) as a basis for determining levels of poverty or of income adequacy has severe limitations. In an attempt to simplify the problem of developing standard measures for different monetary-unit systems, i.e. between nations, this study utilises a typology of perceived income adequacy to examine, among older persons in Sweden, the extent to which they believe their incomes support a satisfying standard of living. Additionally, the research examines differences in income adequacy between the U.S. and Sweden. Results from the 1981 NCOA/Harris survey data in the U.S. are compared with findings from a representative survey of older Swedes conducted by SIFO in 1986. Among other results, it is found that for older Swedes only 20% feel financially hard-strapped, compared to 35% of older Americans. Discussion of this and other findings is included. Income adequacy of the elderly in Sweden should be of particular interest to policymakers in the U.S. because of the widely held belief that Sweden has achieved a level of income security beyond the ‘safety net’.

An observational study was carried out in order to measure the quality of life of elderly people in two different types of long-stay care (two NHS nursing homes and a hospital ward). This formed part of a wider evaluation study of these two forms of institutional care. Qualitative techniques provided insights into the behaviours, moods, interactions and atmospheres in the settings, which were difficult to measure using traditional survey approaches. The observational study showed that it is.essential not to rely solely on interview material, and assessments of mental and physical functioning, when evaluating long-stay care. Characteristics of ‘total institutions’ clearly emerged from the analyses of the hospital ward, although the inclusion of the hospital patients' Club in the study revealed that these need not be inevitable, and that both the ward and the homes could be improved if modelled on the more autonomous and flexible philosophy of the Club.

One of the principal motives behind pension reform in Britain in the post-war era has been to reduce dependence on means-tested assistance. Alternating attempts have been made to attain this objective through State and occupational collectivism but with only partial success. The present Government has shifted the emphasis away from collective provision towards individual saving promoted in the form of portable pensions. However, recent research has underlined the importance of structural determinants of dependency on means-tested assistance in retirement and of other factors over which individuals have little if any control. In the light of these findings questions are raised about the potential effectiveness of portable and occupational pensions as mechanisms for reducing future dependency on means-tested supplementation.

A comparative analysis of the life circumstances of older people in Poland and Norway is presented. It examines differences and similarities in attitudes to both family- and state-provided care, for those living in their own homes. In more prosperous Norway, public services are more frequent, elderly people are more independent and play a more active role in the labour market. In Poland formal care is seen as the last resort, with the responsibility for supporting elderly people placed firmly with the family. State services are directed towards those without families. The Norwegian system places no legal obligation on families, which results in a higher proportion living in institutions.

Rapid economic growth in post-war Japan, has been accompanied by unprecedented population ageing. In this paper the impact of Japan's ageing population is analysed in respect of (i) health-care services (ii) allocation of resources to health care and (iii) the manpower requirements to support health in old age. These projections are based upon macroeconomic modelling techniques.

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 article compares treatment of the elderly today and in the mid-nineteenth century. The starting point is David Thomson's recent claim (Ageing and Society, 4, 1984) that welfare-state pension benefits are not as valuable, relative to the incomes of non-pensioners, as were the poor-law pensions of Dickensian England. Thomson's calculations of incomes and of the value and availability of pensions in the mid-nineteenth century are critically reassessed. It is argued that welfare-state pensions are superior to poor-law pensions not only in absolute terms but also as a proportion of average working-class incomes. The paper concludes with some comments on long-term trends in pensioners' living standards and the implications for pension policy.

The focus of this paper is on the beginnings of dementia – on the grey area where normal and abnormal ageing seem to overlap, but where a diagnosis can be established. We look at a group of elderly people diagnosed as suffering from mild dementia and at the relatives most closely involved with them and whom we had assumed to be their carers. Our principal interest is in the relatives' perception of the deterioration in intellectual function, and in their awareness of and response to problems associated with it. Contrary to expectation, these relatives did not see themselves as carers, or the elderly person as demented. Spouses often saw their partner as no more disabled than themselves; and, more generally, the relationship between them often showed a high degree of reciprocity. Sons and daughters were usually aware of changes in their parents' behaviour but tended to explain them in terms of normal ageing. Improvement in the process of early identification and the creation of more appropriate services are generally seen as desirable. Questions are raised about the usefulness and justification for intervention in a situation which is not yet recognised by those involved as requiring it.

This research extends the study of social network analysis and labelling theory into the context of adult residential care facilities (ARCFs). Network density, reciprocity, and intensity are hypothesized to explain who labels the frail elderly ‘out of place’ in their homes and refers them to an adult residential care facility. Using data from interviews with 81 new, elderly ARCF residents and 75 of their closest others, logistic regression analyses indicate that network intensity is related to the differential involvement of professionals and informal network members in the ARCF entry process. Findings suggest further research on the networks of the elderly's relatives may explain the role of density in ARCF labelling and referral. Practice implications incorporating a network strategy are addressed.

The availability of high technology designed to preserve human life, places medical practitioners in a set of ethical dilemmas. In particular the use of Intensive Care Units to sustain acutely seriously ill elderly people is a matter of widespread debate. An examination of the medical research literature suggests that such interventions are largely successful and wished for by the patient, but the quality of surviving life is for some, unacceptable. It is concluded that the maintance of life should remain the predominant rule, but that where patient and clinical judgement indicates it, death should be accepted as the natural course.

Using contributions from moral philosophy and sociology, this paper explores the decisions confronting care professionals when discharging frail elderly people from hospital. It is based on research into hospital discharge in South Glamorgan that has illuminated the nature of professional decision-making in multi-disciplinary ward meetings. Two key dilemmas are identified and examined in detail: first, the dilemma of discharging elderly people who, while thought by professionals to be incapable of looking after themselves and therefore ‘at risk’, nevertheless want to go home, and secondly, the dilemma of finding residential care for elderly people who are defined as being ‘partly sick and partly well’. Whilst the principle of autonomy may be used to support individual choice, it may also be interpreted as encouraging self-reliance, and as a way of denying a collective responsibility to elderly people's care needs. The dilemma of institutional care for the ‘partly sick and partly well’ is found to be a persisting problem, fraught with conceptual ambiguities and resource-boundary negotiations between ‘medical’ and ‘social’ care. An examination of both dilemmas serves to highlight the role of political ideology in discharge decisionmaking.

Violence to elderly people in residetial institutions is well documented. In this paper both violence and resulting death are examined in the German context. A thesis is put forward that is not lack of humanity but lack of professional routine which is the main cause.