This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

The purposes of this study were to explore the self-rated and objectively measured quality of life of people with early-stage dementia and to describe their personal experiences and reactions to the negative public view of dementia. Information was collected from 23 participants who lived in a mid-western United States metropolitan area. Self-ratings were collected by semi-structured and structured interviews, and the objective measures were the Quality of Life Index (QLI) and the Single Item Quality of Life Scale (SIQLS). It was found that 21 of the participants perceived their current QOL as ‘good’ or better, and that the mean scores for the QLI and the SIQLS were 22.8 and 7.3 respectively. Triangulation of the subjective and objective data established their congruence. The QLI scores suggested that people with early-stage dementia often perceived their current life as good and that the participants were as satisfied with their life as the general population. Their accounts also revealed that many had experienced stigma and that this appreciably affected their psychosocial wellbeing. The findings of this study provide new insights into the ways in which health-care professionals and the general public can and should view and treat people with dementia.

Government policy in Sweden, as in other developed countries, pays increasing attention as to how best to support the family carers of older people. New and innovative means of support, such as information and communication technology, are emerging. This paper explores the perceived benefits of, and barriers to, information technology as a means of supporting family carers of older people. Following a brief overview of the care-giving literature, with particular reference to the Swedish context, interview and questionnaire data collected from 34 families who took part in the Swedish ACTION project are used to explore the role of user-friendly information and communication technology to inform and enable family carers of older people to exercise choice, to care more effectively and to work in partnership with professionals. Interview data from two groups of professionals that utilised ACTION are also examined to throw light on its potential benefits for both carers and professionals. Consideration is given to the barriers to using information technology, and to identifying those carers most likely to benefit. Areas for further development are the need for practitioners' education and a wider range of programmes to address carers' diverse needs. Clearly, lessons learned from the Swedish project have wider relevance, given that new forms of support are being developed in most technically advanced countries.

Preventing and alleviating social isolation and loneliness among older people is an important area for policy and practice, but the effectiveness of many interventions has been questioned because of the lack of evidence. A systematic review was conducted to determine the effectiveness of health promotion interventions that target social isolation and loneliness among older people. Quantitative outcome studies between 1970 and 2002 in any language were included. Articles were identified by searching electronic databases, journals and abstracts, and contacting key informants. Information was extracted and synthesised using a standard form. Thirty studies were identified and categorised as ‘group’ (n=17); ‘one-to-one’ (n=10); ‘service provision’ (n=3); and ‘community development’ (n=1). Most were conducted in the USA and Canada, and their design, methods, quality and transferability varied considerably. Nine of the 10 effective interventions were group activities with an educational or support input. Six of the eight ineffective interventions provided one-to-one social support, advice and information, or health-needs assessment. The review suggests that educational and social activity group interventions that target specific groups can alleviate social isolation and loneliness among older people. The effectiveness of home visiting and befriending schemes remains unclear.

This study has examined the flow of financial transfers between generations in Sweden, measured as financial support in the form of relatively large money transactions or gifts over 12 months. Two questions are considered: is there a net downward flow in the Swedish welfare state and, if so, are there differences according to gender and social class? The questions were tested using data from two linked and nationally representative large-scale surveys. The results show that almost all inter-generational transfers are downward, from older to younger generations. Unlike earlier studies of inter-generational transfers, the analysis focuses on inequality, and the results reveal clear class and income gradients. Both giving and receiving were more common among people in the higher social strata. A gender gradient among unmarried (single) recipients was also found, whereby unmarried women more often received financial support than unmarried men. The paper concludes with a discussion of the implications of the results for social stratification and inequality. From a static or cross-sectional perspective, the results suggest that financial transfers are neutral or even equality promoting, but a dynamic or lifecourse interpretation suggests that financial transfers transmit or even reinforce class inequalities over generations.

The increases in human longevity and early retirement in recent decades have posed new challenges for policy makers, and require a comprehensive understanding of the processes that influence the economic resources of older people. This paper examines the income mobility experienced by older people living in Britain and Germany during the 1990s, and identifies the influential personal attributes and lifecourse events. The analysis uses British Household Panel Survey (BHPS) and German Socio-Economic Panel (SOEP) panel data. The comparative perspective yields insights about the different income experiences of older people in the two markedly different welfare regimes. It is found that old-age income mobility has been more pronounced in Britain than in Germany, and that in both countries its occurrence was strongly associated with changes in living arrangements, with the employment status of co-residents, and with widowhood among women. Unemployment during working life associated significantly with negative late-life income mobility. Among those on low incomes, a high share of income from an earnings-related pension had a significant and positive effect in both countries. To reduce downward income mobility in old age, particularly among widows, there is a need to strengthen the social safety-net. Policies are required to encourage flexible living arrangements in old age, as well as to give greater protection in later life from unemployment during working life, especially in Germany.

This paper describes the ways in which older people contribute to their communities and families as informal volunteers. It challenges current ways of thinking that assign an economic value to the productive activities undertaken by older people. Using qualitative data from a study of older people resident in Queensland, Australia, the paper explores the ways that older people contribute to their families and to the community and the outcomes associated with these activities. Two specific themes emerged from the data: first, the ways in which older people contribute to strong inter-generational relations, and second, how they provide essential mutual support that permits many older people to remain living in the community. These contributions, while often small in themselves, are in aggregate critical both to family functioning and to the maintenance of sustainable and healthy communities. Many are reciprocal interactions that add value to the lives of individuals and offer positive social roles in later life, and they may be particularly important for those from minority cultural backgrounds or at risk of social isolation. The findings suggest that older people are integral to community and civil society and, therefore, that social policy should respond to the ageing of Australia's population and recognise the positive contributions of older people, rather than emphasising the costs of demographic change.

This paper explores social exclusion among older Europeans from ten different countries with three types of welfare regime: Nordic, Mediterranean and post-socialist. Data from the first round of the new European Social Survey are used to explore indicators of social exclusion. A measure of social exclusion and insecurity is constructed from indicators of: the regularity of meeting with friends and relatives, taking part in social activities, self-rated physical health and mental health, self-rated income, and the quality of the local area. The results confirm the findings of previous research that show a link between developed welfare regimes and low rates of social exclusion in old age. At the same time, more developed welfare regimes appear to deal less well with the effects of separation and divorce. The Mediterranean welfare regimes show distinctive signs of stress, which suggests that the supplementation or replacement of weakened immediate and extended family ties has not taken place. In all countries, a higher level of education appears to play a crucial role in reducing the chances of being insecure or socially excluded in old age.

Managing the assets of older people is a common and potentially complex task of informal care with legal, financial, cultural, political and family dimensions. Older people are increasingly recognised as having significant assets, but the family, the state, service providers and the market have competing interests in their use. Increased policy interest in self-provision and user-charges for services underline the importance of asset management in protecting the current and future health, care and accommodation choices of older people. Although ‘minding the money’ has generally been included as an informal care-giving task, there is limited recognition of either its growing importance and complexity or of care-givers' involvement. The focus of both policy and practice have been primarily on substitute decision-making and abuse. This paper reports an Australian national survey and semi-structured interviews that have explored the prevalence of non-professional involvement in asset management. The findings reveal the nature and extent of involvement, the tasks that informal carers take on, the management processes that they use, and that ‘minding the money’ is a common informal care task and mostly undertaken in the private sphere using some risky practices. Assisting informal care-givers with asset management and protecting older people from financial risks and abuse require various strategic policy and practice responses that extend beyond substitute decision-making legislation. Policies and programmes are required: to increase the awareness of the tasks, tensions and practices surrounding asset management; to improve the financial literacy of older people, their informal care-givers and service providers; to ensure access to information, advice and support services; and to develop better accountability practices.

This paper examines the extent of mental ill-health and probable depression among older people in long-term care. It presents selected findings from a study in Greater Belfast, Northern Ireland, that compared the quality of life, autonomy and mental health of older people living in nursing and residential homes with those of older people living in private households who were receiving domiciliary care. Structured interviews were conducted with 214 residents in institutions and 44 older people receiving domiciliary care. The study found that those in private households were more severely physically-impaired and had a higher level of mental ill-health than the residents of institutional homes. It is suggested, however, that the mental ill-health effects were associated less with physical impairments than with the restrictions placed on the older person's decisional autonomy, and that long-term care environments that constrain the older person's autonomy contribute to the development of depression. Although the UK National Service Framework for Older People specified that those with depression should be given treatment and support, priority should also be given to preventing the depression associated with living in long-term care settings.

Assistive technology (AT) is defined in this paper as ‘any device or system that allows an individual to perform a task that they would otherwise be unable to do, or increases the ease and safety with which the task can be performed’ (Cowan and Turner-Smith 1999). Its importance in contributing to older people's independence and autonomy is increasingly recognised, but there has been little research into the viability of extensive installations of AT. This paper focuses on the acceptability of AT to older people, and reports one component of a multi-disciplinary research project that examined the feasibility, acceptability, costs and outcomes of introducing AT into their homes. Sixty-seven people aged 70 or more years were interviewed in-depth during 2001 to find out about their use and experience of a wide range of assistive technologies. The findings suggest a complex model of acceptability, in which a ‘felt need’ for assistance combines with ‘product quality’. The paper concludes by considering the tensions that may arise in the delivery of acceptable assistive technology.

Is growing older a process of decline or of keeping active? Foucauldian theory suggests particular regimes of fitness will discipline ageing bodies in distinctively different ways. This paper reports a comparative ethnographic and qualitative interview study of a ‘fitness exercise’ and a ‘dance exercise’ group for the over-fifties. The findings demonstrate the ways in which contradictory cultural discourses in the fitness training curricula are associated with different subjective experiences of physical and psychological ageing. The ‘fitness exercise’ group focused on individual fitness levels for the ageing body in the terms of the cultural discourses of health and physiology. The ‘dance exercise’ group focused on the graceful ageing body in the terms of the cultural discourses of the psycho-social benefits of movement in relation to others. The study combined phenomenological and social constructionist dimensions, and exemplifies the ways in which the subjective experience of the ageing body may become embedded in particular cultures of fitness.

This qualitative study explores the conditions and experiences of older adults' ‘formal’ volunteering through non-profit organisations (NPOs) in Toronto from both organisational and individual perspectives. In spite of the ageing population and the need for NPOs to expand their services, the participation of Canadian seniors in community volunteering has been stagnant for 15 years. What organisational and structural supports might encourage the expansion of volunteering among this group? How do current administrative conditions impact upon senior volunteers? What do older adults expect to gain from community volunteering? The qualitative data collected through interviews, documents and participant observation are analysed using an inter-disciplinary framework that combines theories of the moral economy of ageing, adult development and transformative learning. The results include a socio-demographic profile of senior volunteers in 12 Toronto NPOs, and the administrative characteristics of the six organisations that engage the majority. It is argued that the self-help and transformative mechanisms embedded in community volunteering provide opportunities for retirees to sustain their self-esteem and sense of wellbeing, while cultivating ‘generativity’ in late adulthood. Promoting transformative learning enables community volunteering to provide meaningful roles for seniors, and promotes citizenship participation and the social economy in an ageing society.

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

This article is an initial scoping exercise for a research agenda on the international political economy of ageing. It begins with a brief review of the various critiques of the political economy perspective that have been made over the 25 years since the first article on the subject. Remarkable for its absence has been criticism of the neglect of an explicit international perspective. Then the article emphasises that it is not globalisation per se that is problematic but its dominant neo-liberal economic form. It is mainly because of this globalisation and the related growth in the power of international governmental organisations, such as The World Bank, that an international political economy of ageing is required. The bulk of the article is devoted to an outline of the eight key elements that might comprise a theoretical and empirical research agenda for social gerontology. These key elements are: global inequality in old age, development and ageing, globalism and the power of international governmental organisations, trans-national corporations, the nation state, supra-national regional structures, the United Nations, and international non-governmental organisations. In the spirit of the other articles that have celebrated the journal's 25th anniversary, this paper is intended to stimulate scientific debate.

Opportunities for older people to take part in decision making about public policies and services are expanding in the United Kingdom and elsewhere. This paper considers the potential of older people's participation in policy processes for both transforming the policy process and for achieving socially just outcomes. It argues that the way in which such participation takes place, in particular the nature of the deliberative processes, affects both who will feel able to take part and the capacity to develop new policy discourses which can challenge official perspectives and assumptions. It draws from critical perspectives on deliberative democracy to provide a theoretical framework. This work emphasises the importance of story telling and forms of exchange designed to offer recognition to others, as well as the rational argument more usually associated with deliberation on matters of public policy. The argument is illustrated with examples of participation initiatives that have involved ‘active’ older people and those who are users of social care services. Different styles and processes of exchange are distinguished in the three case studies. In one, active facilitation enables individual stories of ageing and of service use to be woven into collective narratives that offer an alternative vision of care services. In another, a strong emphasis on ‘greeting’ enables conflicting views to be expressed without participants falling out. In the third, styles of exchange familiar in formal debate limit the development of an alternative discourse. The conclusion suggests that attention needs to be given to the process of participation as well as to outcomes.

To prepare the care system for a rising population of older people, it is important to understand what factors predict the use of care. This paper reports a study of transitions in the use of informal and professional care using Andersen-Newman models of the predictive predisposing, enabling and need factors. The study has drawn on Longitudinal Ageing Study Amsterdam (LASA) data on the use of care and the contextual factors. The data were collected at three-yearly intervals from a random, sex- and age-stratified, population-based sample of adults aged 55–85 years. In summary, the findings for those who initially did not receive care were that almost one-third received some kind of care three years later, most of which was provided by informal care-givers. Need factors were important predictors of most transitions in care, and predisposing and enabling factors, such as age, partner status and income, also played a role. On the relationship between informal and professional care, evidence was found for both ‘compensatory processes’, i.e. informal care substitutes for professional care, and ‘bridging processes’, i.e. informal care facilitates professional care. In view of the increasing discrepancy between the demand for professional care and its supply, the significant impact of predisposing and enabling factors offers opportunities for intervention.

Quality of life has become increasingly important as an outcome in medical research. The influence of health status is often emphasised, but other dimensions are important. In order to improve quality of life, there is a need to know what people themselves consider important to their perception of quality of life. The aim of this study was to investigate what older people consider to be important for their quality of life, and to explore the impact of gender, education and health status on individual perceptions. The study was of 141 randomly selected people aged from 67 to 99 years that formed a control sample for a study of suicide among older people. They were interviewed in person about their health, socio-demographic background and, using an open-ended question, what they considered to constitute quality of life. Their answers were grouped into eight categories, with social relations being the most frequent response, followed by health, activities, functional ability, wellbeing, personal beliefs and attitudes, their own home and personal finances. In addition, they were asked to choose from a ‘show card’ three items that they regarded as important to quality of life. Functional ability was the most frequently selected domain, followed by physical health, social relations and being able to continue to live in one's present home. Our conclusion is that social relations, functional ability and activities influence the quality of life of elderly people as much as health status.