Hearing loss is frequent in old age and has been associated with fewer social activities and depression. However, hearing problems have also been associated with other comorbidities, which prevent more definitive conclusions about the unique role on older people's wellbeing. Moreover, little attention has been paid to the psychological processes through which this relationship occurs. This study aims to investigate the effect of hearing loss on older adults’ wellbeing from a longitudinal perspective. Using data from three points in time, we investigated the mutual relationship between hearing loss, depression and social activities. Based on longitudinal data of the Survey of Health, Ageing and Retirement in Europe (SHARE) from ten European countries, we conducted the test of competing auto-regressive cross-lagged theoretical models. Results show that hearing loss reduces social activity, which is mediated by depression. The adequacy of this model (versus a model proposing that social activity restriction mediates the relationship between hearing loss and depression) was supported in each of the countries of the sample. Findings showing that hearing loss can contribute to depression and, subsequently, to restriction in social activities have implications for early detection and clinical interventions on hearing loss.

In Western welfare states, notions of age-friendly communities and ageing-in-place are increasingly important in new health policies. In the Netherlands, care reforms are modifying the former welfare state to be more participatory; local governments are seeking collaborative solutions. Municipalities and housing, care and welfare organisations in the southern part of the country developed the concept of ‘lifecycle robust neighbourhoods’, envisioned as places where older people can age-in-place. Although many scholars have used the concept ageing-in-place in their studies of neighbourhoods, we aim to unravel this concept further by exploring how this particular ageing policy plays out in practice. This paper explores what the development of ‘lifecycle robust neighbourhoods’ means in relation to notions of ageing-in-place and age-friendly communities. We used ethnography (interviews, observations and focus groups) to reveal how, on the one hand, the policy makers, housing, care and welfare directors and representatives of older people, as developers of ‘lifecycle robust neighbourhoods’ and, on the other hand, older people, give meaning to places to age-in-place. It becomes clear that ageing-in-place has a different meaning in policy discourses than in practice. While developers mainly considered place as something construable, older people emotionally attached to place through lived experiences.

The literature is divided with regard to how older persons cope with traumatic situations of war and terror, and few studies have focused on continuous exposure to traumatic situations. To fill the gap in existing knowledge, the present study examined how older people cope with a continuous security threat which includes periods of intensive attacks. Three focus groups were conducted among older residents of rural localities situated near the Israeli border with Gaza. Content analysis of transcripts from the group sessions revealed four main aspects that concern the older participants when they cope with situations of war: (a) moral issues; (b) emotional issues; (c) intergenerational issues; and (d) resilience and future challenge. The analysis revealed that the older participants’ coping patterns derive from a combination of their stage of life, the changing lifestyle in their communal rural localities, and the ways that the older residents and younger residents of the communities cope with exposure to a continuous security threat. The theoretical framework for discussion of the findings is based on social theories of trauma and resilience. In addition, recommendations are provided for interventions at the individual and community levels.

In health and chronic illness, satisfying marriages promote wellbeing and life satisfaction, yet stroke research has focused on either the stroke survivor as the patient or the spouse as a care-giver. Using Pope, Mays and Popay's framework for synthesising qualitative and quantitative methods, we conducted a systematic review and synthesis of 39 peer-reviewed studies to determine what happens to marital relationships after one partner has suffered a stroke. All the articles examined the impact of stroke. Three overarching themes characterise the evolution of marriage after stroke: chaos in the marriage, work to re-establish the marriage and evolution of the marriages. While both the stroke condition itself and the survivors’ need for care undermined the emotional qualities of the relationship for some couples, about two-thirds were able to retain or regain the relationship closeness. As in other chronic illnesses, the relationship closeness and a couple's ability to collaborate contributed to the survivor's recovery and to the satisfaction with life of the stroke survivor and the spouse. Our results underscore the need to consider the quality of, and the qualities of, the relationship between stroke survivors and their spouses. Future research could include a greater focus on qualitative or mixed-methods approaches to explore the interactions between stroke survivors and spouses that impact the wellbeing of both partners.

With an increase in the proportion of Australians aged over 65, and high government expenditure on residential care, there is a strong imperative to find smart, safe solutions to support older people to stay in their own homes. There is a growing interest in Australia for assistive technologies that provide home monitoring to promote health and wellbeing. This solution will only be viable if it meets with the expectations of older residents and their families. In the first smart homes pilot in Australia, we sought to ascertain barriers and facilitators of this technology. There was an overall positive response to the system, despite a slight tendency for residents to modify their behaviour due to perceived surveillance. Positive outcomes included increases in family communication, health autonomy and advances in technology uptake. Our findings suggest that a combination of considered placement of in-home technology, straightforward medical devices and a supportive human element will ensure that the technology meets the balance of service provision and preservation of dignity. Smart homes could mitigate the challenges associated with aged care while affording peace of mind for seniors and families.

The purpose of this study was to examine older adults' experiences and perspectives regarding transportation mobility. Using a community-based participatory research approach, residents of Arlington, Texas, age 55 and older, participated in individual interviews (N = 15) or one of six focus groups (N = 45) as part of an overall study about ageing well in a large ethnically diverse city in the United States of America. Thematic analysis was conducted using inductive and deductive qualitative methods and social equity as a sensitising concept. Findings indicate that older adults who are transportation-disadvantaged experience limited access to health care, goods and services and are isolated from familiar lifestyle habits and social networks. Access to affordable, adequate transportation is compromised through social and political forces, which marginalise historically disadvantaged populations. Implications for cross-disciplinary practice and future research on sustainable transportation and policy development are discussed within a social justice and social equity framework.

Transportation is critical to older adults’ ability to participate in social activities in their community. We examined the association between modes of transportation and restrictions in social activity (i.e. visiting with others, religious attendance, clubs and organised activities, and going out for enjoyment), with particular attention to the moderating effects of economic vulnerability. We used logistic regression to analyse data from 7,197 community-dwelling older adults from the 2011 wave of the National Health and Aging Trends Study, a representative sample of adults aged 65 and over in the United States of America. Economic vulnerability moderated the association between transportation mode and social activity restrictions. Findings suggest that even when economically vulnerable older adults have access to driving, walking or public transit, they may be at a higher risk for social exclusion than their counterparts with more financial resources.

Older people living in long-term facilities (nursing and residential homes providing 24-hour care) spend the majority of their time inactive, despite the known health and wellbeing benefits of physical activity and reduced time spent sedentary. In order to successfully embed interventions that aim to increase physical activity or reduce sedentary behaviour, it is necessary to understand the features of the care environment that influence residents’ routine patterns of movement. Drawing on an organisational perspective, this paper explores the structures and mechanisms that shaped different care practices concerning residents’ movement in two contrasting care homes in the north of England. This study adopted an ethnographic approach, using a combination of qualitative observations, informal conversations and interviews. A grounded theory approach to data analysis was adopted. The findings illustrate the importance of translating espoused values of care into tangible and acceptable care practices, systems of management, staff training and development, and the use of care planning in residents’ routine patterns of movement. Understanding how organisational factors shape routine movement among care home residents will help inform the development of embedded and sustainable interventions that enhance physical activity and reduce sedentary behaviour. This study is part of a wider programme of research developing and testing a complex intervention, embedded within routine care, to reduce sedentary behaviour among care home residents.

Intergenerational help and care among members of the family belong to the most important dimensions of contemporary welfare regimes. Recent research has indicated that a major part of caring responsibilities is placed on the middle-aged generation. The ‘pivot generation’ is expected to provide help to their adult children and grandchildren as well as to their ageing parents. It has been hypothesised that people helping their parents are discouraged from looking after their grandchildren because they experience lack of energy and time. Using data from the four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper analyses the effect of providing help to ageing parents on the likelihood and intensity of looking after grandchildren. It takes a four-generation perspective: grandchildren, children, parents and grandparents. The results show that the support of parents is not associated with less-frequent and less-intense care of grandchildren. On the contrary, a positive association between caring responsibilities has been observed. The highest tendency to care for grandchildren has been found for people regularly helping their parents. This effect holds after controlling for grandparents’ characteristics and country effects. It is suggested that caring responsibilities tend to accumulate rather than compete with one another and therefore could represent a potential risk of overburden for those who have a general tendency to care.

This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence.

In this paper, we examine predictors and consequences of living arrangements among community-dwelling older Singaporeans. We take a holistic approach and consider a range of social and economic as well as emotional and physical wellbeing indicators. Two waves (2009, 2011) of the Panel on Health and Ageing of Singaporean Elderly (PHASE) are analysed to (a) provide an overview of living arrangements in 2009 and assess the extent to which living arrangements change by 2011; (b) examine the predictors of living arrangements in 2009; and (c) examine the consequences of living arrangements over a two-year period. The majority (88%) of older Singaporeans co-reside with either their spouse and/or children. A small yet growing proportion live with others (5%) or live alone (6%). Very little change in living arrangements is observed over the two years. Our results show that women, the oldest-old and older adults with fewer children are more likely to live alone. Older adults who live alone are not particularly disadvantaged compared to those who live with their spouse and children or spouse only in their social and economic wellbeing. It is, in fact, older adults who live with their children that are disadvantaged in many aspects of social, economic and mental wellbeing. Measures to engage older adults living with their families (along with those living alone and with others) in broader social activities are imperative.

Older persons with alcohol problems have today become an all too common part of everyday elder care, but research in this area is still scarce. This article has a Swedish context with the aim of describing and analysing home care workers’ narratives about older people who can be characterised as heavy drinkers, i.e. people with severe alcohol problems who need considerable care for extended periods. Limited knowledge is available concerning this age group. This article therefore fills a knowledge gap about home care workers’ perspective about body work and the abject, and breaches the myth that older individuals should be able to drink as they prefer and/or notions of drinking alcohol as a last enjoyment in life. The care workers talked about how they got drawn into the daily lives of the care recipients and how they ended up in situations where they, on the one hand, removed the consequences of drinking, and on the other, felt that they sustained the drinking by cleaning out dirt and washing the care recipients’ bodies.

Older adults living with human immunodeficiency virus (HIV) are at risk of experiencing difficulties in their intimate lives due to the combined effects of HIV and ageing. To date, little research has focused on the lived experience of sexuality. This article seeks to fill in the gap by documenting the challenges faced by this population with respect to their intimate relationships and sexual lives. Based upon the results of a qualitative study conducted in Montreal (2010–2012) using semi-structured interviews with a diverse sample of 38 people aged 50–73 and living with HIV, this study revealed several difficulties, including those related to their social location, whereby HIV and ageing intersect with other social determinants (including gender, sexual orientation and drug use). Difficulties that were identified include lower sexual desire linked to ageing, erectile changes, difficulty in using condoms, stigma related to HIV and/or ageism, changes in appearance caused by HIV and/or ageing, along with the impact of their lifecourse experiences. Our results shed light on the specific nature of the difficulties experienced by older adults living with HIV with regard to their intimate lives, as well as on the importance of using an analysis that combines the theoretical approaches of intersectionality and lifecourse to enhance our capacity for understanding complex and unique experiences.

Due to the growing elderly population, adult children care-givers (ACCs) are increasingly providing complex care for one or both elderly parents. Social support from similar peers can mitigate care-giving-related health declines. To date, ‘peer similarity’ amongst care-givers has been predominantly investigated in the context of peer-matching interventions. However, because peer similarity is especially influential in ‘naturally occurring’ support networks, care-givers' everyday peer support engagement warrants further attention. Our goal was to explore care-givers' everyday peer support engagement and the influence of peer similarity on support perceptions. We employed a mixed-method design using Web-based surveys and in-depth qualitative interviews. The quantitative data were analysed using a hierarchical multiple while qualitative data were thematically analysed. Seventy-one ACCs completed the online questionnaire and 15 participated in a telephone interview. Peer similarity was positively and significantly associated with perceived support (β = 0.469, p < 0.0005) and explained 18.5 per cent of the additional variance. ACCs' narratives suggested the most important aspect of similarity was ‘shared care-giving experience’ as it optimised the support received from peers, and also enhanced the quality of the relationship. In conclusion, both data-sets underscored that peer similarity importantly influences support perceptions. The importance of ‘shared care-giving experience’ suggests that a more comprehensive understanding of this concept is needed to optimise peer-matching endeavours. Peer similarity's influence on relationship quality should also be explored.

The European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions about intervention facilitators, moderators and barriers were coded into two themes: working with stakeholders and project management. We concluded that EIP-AHA partners are providing interventions addressing physical, cognitive and wellbeing elements of frailty. However, there needs to be an increase in the proportion of interventions that consistently apply valid methods of screening and/or measuring frailty and pre-frailty. Most, but not all projects are targeting pre-frail older adults, suggesting an appropriate balance of prevention in a useful ‘intervention window’ but also a growing understanding that frailty at later stages is amenable to intervention. Findings suggest design manipulations to improve outcomes and adherence to interventions, specifically inclusion of a perceived benefit/reward for older adults, e.g. a social aspect or health-care promotion.

This study sought to identify factors which influenced how a group of people with dementia living in their own homes participated in community-based physical activity and explored the effect that exercise groups, dance and walking had on their wellbeing. A broadly ethnographic approach was adopted in which participant observation and interviews were employed. Nineteen people with dementia and seven formal and informal carers were included in the participant observation phase. Eleven people with dementia were interviewed. The analysis and interpretation of data was informed by embodiment and social constructionist theoretical perspectives. Findings suggest that a complex interplay between attitudes and beliefs, retained embodied abilities, and aspects of the physical and social environment influenced how individuals engaged in physical activity and the degree to which they experienced wellbeing as a result. Findings suggest that when certain factors co-exist, physical activity can provide a context within which people with dementia are able to use embodied skills in order to support fragile identities, connect with others and express themselves.

The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to investigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman's concept of performance as a theoretical framework together with Bourdieu's thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi-structured interviews were conducted with 14 elderly people (aged between 67 and 87 years) and meal observations were carried out with 11 of these people. Participants were found to manage food and meal practices by continuously adjusting and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the façade and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as ‘fuel’ where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance.

This study investigates gender differences in trajectories of support from close relationships among adults in the transition from middle to old age, taking into account stability and change in the identity of the closest persons. Multi-level modelling was used to estimate gendered age-trajectories in three dimensions of support: emotional support, practical support and negative encounters, which were repeatedly measured over ten years amongst 6,718 Whitehall II participants. Men were more likely than women to nominate their partner as their closest person throughout follow-up; whereas women drew support from a wider range of sources. Gender differences were only evident in age-related trajectories of emotional support, and were contingent on stability and change in the closest relationships. Men reported increased emotional support from closest relationships with age, except for those who transitioned out of a partnership. For women, emotional support was stable among those whose closest person remained consistent, but decreased among those who changed their closest person. Further, emotional support increased with age for all married men, which was only the case for married women who nominated their partner as their closest person. Our analysis highlights gender-specific trajectories of perceived support from adults’ closest relationships in late life, and indicate more pronounced socio-emotional selectivity in older men than women.

Malaysia has an ageing population and an increasing number of older people who live alone. This study explores the social support and care arrangements of older people living alone in rural Malaysia. The study took a qualitative approach: semi-structured interviews were conducted with a purposive sample of Malay (N = 20) and Chinese (N = 20) Malaysians aged over 65. Five cross-cutting themes were identified through a thematic analysis: degrees of aloneness; relationships and social support; barriers to social support; and future illness, care and death. All participants said they lived alone; living arrangements, however, were often complex. For Malays, most support came from nearby adult children and relatives, whereas Chinese participants, who less frequently had adult children living locally, emphasised support from friends and neighbours. Emigrant adult children's assistance was mostly informational and financial, instrumental assistance was either substituted for money, or provided solely during periods of ill-health. Physical decline, limited telephone use, inadequate transportation and fears of crime were barriers to social support. Participants avoided thinking or talking about future care needs. These findings have implications for Malaysian old age policy, which is currently focused on supporting families to care for older relatives. Child migration and a growing preference for a period of independent living in old age may require policies and resources directed at older people as individuals to support their own efforts to remain independent, active and age ‘in place’.

Understanding patterns of intergenerational support is critical within the context of demographic change, such as changing family structures and population ageing. Existing research has focused on intergenerational support at a given time in the individuals' lifecourse, e.g. from adult children towards older parents and vice versa; however, few studies have focused on the dynamic nature of such support. Analysing data from the 1958 National Child Development Study, this paper investigates the extent to which the receipt of parental help earlier in the lifecourse affects the chances of adult children reciprocating with support towards their parents later in life. The findings show that three-quarters of mid-life adults had received some support from their parents earlier in life, and at age 50 more than half were providing care to their parents. Patterns of support received and provided across the lifecourse differ markedly by gender, with sons being more likely to have received help with finances earlier in the lifecourse, and daughters with child care. The results highlight that care provision towards parents was associated with support receipt earlier in life. However, the degree of reciprocity varies according to the type of care provided by children. Such findings have implications for informal care provision by adult children towards future cohorts of older people, and by extension, the organisation of social care.