In 2002, the World Health Organization emphasised the concept of active ageing to manage and increase the last third of life. Although many efforts have been made to optimise treatment management, less attention has been paid to health promotion initiatives. To date, few shared guidelines exist that promote an active life in healthy older targets. To fill this gap, we conducted a systematic review to map health promotion interventions that targeted an active and healthy ageing among older citizens. Articles containing the key term active ageing and seven synonyms were searched for in the electronic databases. Because we were interested in actions aimed to promote healthier lifestyles, we connected the string with the term health. A total of 3,918 titles were retrieved and 20 articles were extracted. Twelve of the 20 studies used group interventions, five interventions targeted the individual level and three interventions targeted the community level. Interventions differed for the health focus of the programmes, which ranged from physical activity interventions to social participation or cognitive functioning. Most of the studies aimed to act on psychological components. The review suggests that different interventions promoted for active ageing are effective in improving specific healthy and active lifestyles; however, no studies were concerned directly with a holistic process of citizen health engagement to improve long-term outcomes.

An increasing number of middle-aged and older Americans are using social network sites (SNSs), but little research has addressed how SNS use is associated with social wellbeing outcomes in this population. Using a nationally representative sample of 1,620 Americans older than 50 from the 2012 Health and Retirement Study (HRS), we examine the relationship between older adults’ SNS use and social wellbeing associated with non-kin and kin relations and explore how these associations vary by age. Results of ordinary least-squares regression analyses suggest that SNS use is positively associated with non-kin-related social wellbeing outcomes, including perceived support from friends (β = 0.13; p < 0.001; N = 460) and feelings of connectedness (β = 0.10; p < 0.001; N = 463). Regression models employing interaction terms of age and SNS use further reveal that SNS use contributes to feelings of connectedness to a greater extent as people age (β = 0.10; p < 0.001; N = 463). Of all kin-related social wellbeing outcomes, SNS use only predicts increased perceived support from children (β = 0.08; p < 0.05; N = 410), and age negatively shapes this relationship (β = −0.14; p < 0.001; N = 410). As older people engage with an increasingly smaller and narrower network with a greater proportion of kin contacts, our results suggest that SNS use may help older adults access differential social benefits throughout later life.

As Japan faces the challenge of the increasing demand for home care from its ageing population in an era of economic constraints, the expectation has evolved that the voluntary sector will fill the shortfall in statutory provision through semi-volunteers providing affordable home care. Drawing on qualitative interviews with managers from 15 voluntary organisations, this article explores their experiences in trying to meet this expectation. Even though most organisations provided supplementary home-care services, the empirical evidence indicates a limited capacity to deliver this expectation, with respondents aware of the deteriorating situation. It has been ascertained that supply mechanisms differ between the traditional voluntary – and the new hybrid – organisations. The former employ ‘cost-efficient’ labour such as ‘paid volunteers’ on below minimum pay rates. In contrast, the ‘hybrids’ use paid employees at regular pay rates, a finding that contradicts optimistic assumptions about the ideological role of ‘traditional’ voluntary organisations. This article suggests the importance of acknowledging diverse responses from the voluntary sector, including the new hybrids with their acknowledgement of voluntary and commercial imperatives. Open mindedness and a preparedness to revise interpretations of the earlier ‘models’ of the voluntary sector are essential. The conclusion proposes that the best strategy to unlock the voluntary sector's full potential to deliver supplementary home care is a multi-platformed approach, with adequate public purse funding, which pragmatically maximises resources.

Improving responsiveness to the needs of older people from minority ethnic communities has been emphasised as a goal in England since the publication of the National Service Framework for Older People in 2001. Despite this, people from minority ethnic groups consistently give poorer ratings of their health services than ‘majority’ populations, both in England and across many other health-care systems. Language barriers have been shown to play a particularly important role, and appear to be a stronger predictor of perceived quality of care than ethnic origin per se. This paper reports findings from a larger study exploring older people's experiences of care transitions, focusing on the findings from one case study area which explored the hospital and discharge experiences of older people from minority ethnic communities. A participatory approach was adopted, with older people from the local area collaborating in the design, delivery and analysis of the research as ‘co-researchers’. Twenty-four in-depth narrative interviews were carried out with people who had experienced a recent hospital stay as a patient or a family member providing care and support. Our findings show that many aspects of the hospital experience, including the desire for personalised and humanistic approaches to care, are important to older people irrespective of ethnic background. However, older people from minority ethnic communities can also face language and cultural barriers which negatively affect the quality and experience of care. People who had limited English proficiency struggled to understand, communicate and participate in their care. Where professional services were not available or requested, interpreting was provided informally by other patients, family members, hospital staff in clinical and domestic roles, or not at all. We conclude that targeted strategies are required to ensure appropriate and effective hospital services for a multicultural population.

Second couplehood in old age following widowhood or divorce is a phenomenon developing with the increase in life expectancy and is yet to be accepted as part of the normative ageing process. The aim of this paper is to examine how family members of three generations perceive second couplehood in old age as a new phenomenon within a changing society and a dynamic family structure. The multigenerational families of 19 second-couplehood dyads (a total of 38 multigenerational families) were recruited using criterion sampling. The second-couplehood dyads were composed of men who repartnered at age 65+ and women at 60+, with children and grandchildren from a lifelong marriage. We tape recorded and transcribed verbatim 107 semi-structured qualitative interviews with older partners, their adult children and grandchildren. Analysis was based on grounded theory and dyadic-analysis principles adapted to families. Two main themes were found that presented gaps between reality and ideality experienced by the participants regarding second couplehood: as a problem through its disadvantages, and as a solution through its advantages. The gaps in both themes were bridged by the account: ‘as long as it's good’. Findings are discussed in the context of modernisation theory, the lifecourse and the family lifecycle perspectives relating to changes in family structure and ambivalence and how to deal with them on the macro, mezzo and micro levels.

Drawing primarily upon data from the various censuses conducted in Ireland after the Act of Union in 1800, this paper seeks to elucidate the changing position of older people in Ireland during the Victorian period. Following the Great Famine of 1845–1849, it is argued, Ireland was transformed from a young, growing country to one that, by the end of the 19th century, had become ‘prematurely’ old. By the end of Victoria's reign, not only had Ireland grown ‘old’, but its older population were more likely to be identified as paupers. Later-life expectancy decreased and sickness and infirmity among the over-60 s increased. By employing a stricter form of ‘less eligibility’ in the drafting and implementation of the Irish Poor Law, proportionately more older people received indoor relief than outdoor relief compared with the rest of the British Isles. Not until the Old Age Pensions Act in 1908 did these disparities begin to change, by which time many of these ‘other’ Victorians had passed away.

In ageing societies, policy makers aim for more contact between informal and formal care-givers as it may enhance the quality of care. So far, the linkage between formal and informal care-givers is generally studied from a one-sided or a single dyadic perspective, without taking into account that care networks of community-dwelling older adults often exist of multiple informal and formal care-givers. The current study examines discussion of care between all potential informal–formal care-giver dyads in a care network, and relates this to characteristics of the older care recipient, the care network and the care-givers. Seventy-four Dutch older care recipients provided information on all care-givers who helped with five different types of tasks; 410 care-givers reported on the contact between all care-givers identified. Multi-level logistic regression was conducted in 2,150 informal–formal care-giver dyads and revealed that in 26 per cent of all these dyads discussion on care occurred. This was more likely when both care-givers performed multiple types of tasks, the informal care-giver was residing with the care recipient, and contact within the formal and the informal sub-network was higher. To enhance discussion of care between informal and formal care-givers in care networks where no discussion occurs at all, home-care organisations may need to allocate formal care-givers who form a bridge with an extra-residential care-giver of care recipients living alone.

This article explores experiences of relational intimacy (including sexual intimacy) in long-term relationships when one partner has dementia. An emerging body of research focuses on living with dementia, but work on relationships between people with dementia and their family and loved ones tends to focus on understanding the experience of caring, and on constructs like ‘care burden’. Research concerned with the lived experience of relationships themselves is less frequent, and very little published work focuses on experiences of sex and intimacy. This qualitative study explores how six participants experience their intimate relationships with their partners with dementia. Semi-structured interviews provided a rich source of data which were analysed using Interpretive Phenomenological Analysis. Three master themes emerged from our analysis: ‘everydayness’, ‘absent presence’ and ‘I don't know if you want to know this…’. Participants explored how living with dementia constructed specific, everyday relational challenges, and disrupted everyday intimacies. Intimacy, including sexual intimacy, remains an important element of older couple relationships. Relational experiences present specific and difficult to articulate experiences for the partners of people living with dementia – particularly experiences related to sex and sexuality. Representations of older adults (particularly older adults with a long-term illness) as relatively asexual beings can make elements of these relational challenges particularly difficult to express.

The benefits of exercise are well documented, nevertheless, physical activity decreases progressively with age, a trend exacerbated in those who have fallen. An important predictor of exercise behaviour is the extent to which motivation for exercise has been internalised into one's identity, however, we know little about changing health behaviours in older people, with calls for longitudinal studies to aid understanding. Grounded in self-determination theory, the present study explored the role of self-talk in the process of identity change during the initial ten weeks of an exercise referral falls prevention programme. Six participants identified at risk of falling completed weekly measures of their physical activity-related cognition and identity; in-depth interviews were completed at course commencement and ten weeks later. During this initial phase of the behaviour change programme, participants developed stronger physical activity identities, with themes reflecting a transition from a physically impaired and negative self to a more future-orientated, capable and integrated self-identity. Concurrently, autonomy-supportive and competence-reinforcing self-talk significantly increased, with non-significant increases and decreases in controlling and amotivational self-talk, respectively. The data suggest that self-talk may be usefully conceptualised as a process through which social messages are interpreted and internalised to integrate a new behaviour into one's existing self-concept.

Research on the correspondence between retirement intentions and subsequent behaviour is scarce. We aimed to explore possible associations between retirement intentions and behaviour, using five-year high-quality quantitative panel data on Norwegian senior workers. Retirement intentions operate at different levels of firmness: (a) considerations; (b) preferences; and (c) decisions. Compared to work continuation considerations, a targeted age for retirement improved predictive power whether the target was preferred or decided, and particularly so if the target (i.e. the preferred or decided age of retirement), corresponded with a normative retirement age. Because more workers are able to state a preferred age of retiring than a decision about when to retire, preferences may be better proxies for retirement behaviour than decisions, when the issue is planning for policies. The correspondence between intentions and behaviour varies primarily by health, education and type of work. Older workers with poor health, and workers with low education, often retire earlier than they prefer. Blue-collar workers often retire earlier than they had decided. These findings illustrate the possible effect of labour market resources, not only for senior workers' labour market participation, but also for their opportunities to work up to the age they prefer or had decided. Even for white-collar workers and those in good health, constraints seem to apply when they wish to retire late.

Autonomy is a pervasive concept in Western lifestyles today. However, people in the fourth age are assumed not to be autonomous but dependent on other people. The data of this study consisted of interviews with Finnish community-dwelling 90–91-year-old people. The study aim was to examine how these people see their own autonomy in their everyday lives. The analysis was based on membership categorisation analysis. Our respondents considered their autonomy through three distinct themes. Functional ability was considered in terms of being physically capable of managing daily tasks. Independence in decision making was based on material and financial self-sufficiency and on the respondents' supposition that they were capable of making decisions due to an absence of memory disorders. Additionally, autonomy was considered as contesting norms of age-appropriateness. Among respondents, chronological age seemed to have been replaced by functional and cognitive ability as a definer of categorisations; age-others became ability-others. Our study revealed that the perceptions of autonomy also included gendered features as they were linked with differing gendered ideals, roles and life domains of women and men. The results highlight the internal diversity among the oldest old and challenge the third/fourth age division. Instead, they suggest the existence of a certain ‘grey area’ within old age, and urge an analysis on the subtle meaning making involved in older people's constructions of age-categorisations.

Active Ageing is conceptualised to measure the extent to which older people remain actively engaged with life. However, there is no evidence that the concept of Active Ageing is actually associated with the activity levels of older persons. Influences of age, ethnicity and spirituality on Active Ageing are also unexplored. Using the Active Ageing Index (AAI), this study examines whether the level of Active Ageing predicted the actual activity level of 120 Singaporeans of Chinese, Malay and Indians ethnicities, aged 55–64 years old or 65 years and above. Spirituality, measured by the Spirituality Index of Well-Being, was added to the AAI, to see if the predictive power of AAI improved. Hierarchical multiple regression showed that the AAI alone (controlling for age) did not significantly predict the activity level of older persons. The predictive power of the AAI improved significantly with spirituality included. Two-way between-groups Analysis of Variance revealed main effects of age and ethnicity, with higher AAI in those aged 55–64 and in Indian-Singaporeans. These findings suggest that the theoretical construct of Active Ageing needs further examination to identify the domains that distinguish it from chronological age, and support broadening the construct by including spirituality in Active Ageing.

Increasing social participation among older individuals to increase health and wellbeing has become a distinct policy goal of many national governments and the European Commission. However, to date the evidence on how social participation affects health, both subjective and objective, remains limited, especially since most studies do not account for the reciprocal relationship. The aim of this study is to analyse how changes in social participation affect both the subjective and objective health of older Europeans as well as how changes in health status affect social participation. Using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), the results suggest that both the uptake as well as the continuation of social activities increase the chances of improvements in subjective as well as objective health. Furthermore, improvements in self-rated health as well as grip strength significantly increase the chances of taking up new activities as well as continuing with existing ones. Country effect is not as strong as expected and the benefits could be homogeneous across different cultures once we control for socio-economic status. Overall, the results stress the need for taking into account the reciprocal relationship between social participation and health. The paper highlights the importance of focusing on both uptake and continuation of social participation when devising policy aimed at improving healthy ageing.

This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice.

This study examines discursive constructions of older people by analysing the talk of members of parliament in parliamentary discussions in Finland. While the perceptions of older people that are constructed in various public and private arenas have been relatively widely examined, the talk of political decision makers has not been studied to any large extent. However, decision makers' understandings of older people are likely to influence the ways in which service systems are developed and services organised for older people. The parliamentary discussions examined in this study were related to the process of enacting legislation to secure services for older people. Using discourse analysis, three ways of constructing older people – as ‘the dependent’, ‘the active’ and ‘the deserving’ – are identified. Although the results are to some extent in accordance with previous findings, indicating that older people are constructed as either totally dependent and passive or extremely active, this study also breaks this dichotomous view and highlights the overlap between those constructions. Nonetheless, the picture of older people remains fairly one-dimensional. There was an absence of recognition of diversity among older people, which might inhibit the development of a customer-oriented service system.

The rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.

Departing from the proposition that, in the sociological debate about whether there has been a shift towards a de-standardised lifecourse in advanced economies, little attention has been devoted to the infrastructural arrangements that would support such a transition, this paper explores the changing role of standards in the governance of ageing societies. In it, I outline a sociological theory of age standard substitution which suggests that contradictory rationalities used in the implementation of chronological age fuelled the emergence of a critique of chronological age within the diverse strands of gerontological knowledge during the 20th century. The paper analyses how these critiques were linked to a proliferation of substitute, ‘personalised’ age standards that aimed to conjoin individuals’ unique capacities or needs to roles or services. The paper suggests that this configuration of age standards’ production, characterised by uncertainty and an opening of moral and epistemic possibilities, has been shrouded by another, more recent formation where institutional responses to decentred processes of standardisation moved research and political investment towards an emphasis on biological age measurement.

Behaviours of concern (e.g. aggression) are often present in residents of long-term care (LTC) facilities diagnosed with dementia and may impact quality of life. Prior uncontrolled research has shown that an intervention involving sharing resident life histories may be effective in reducing aggressive behaviours and improving quality of life, perhaps by increasing staff empathy. We used a randomised controlled design, involving a considerably larger sample than previous investigations. We also examined staff perceptions of LTC resident personhood in relation to aggressive behaviour. Seventy-three residents were randomised to either a life history intervention (N = 38) or a control condition (N = 35). Ninety-nine nurses and care aides answered questionnaires about their own attitudes and the residents' behaviours and quality of life at baseline, post-intervention and at follow-up. Results of mixed-effects modelling indicated significant differences between groups in personhood perception and resident quality of life. Personhood perception mediated the relationship between the intervention and improved quality of life. We identified significant negative correlations between resident cognitive impairment and staff perceptions of resident personhood. Qualitative findings suggested that staff primarily changed their verbal interactions with residents following the intervention, which may be particularly helpful for residents with the most severe dementia. Our results indicate that LTC residents benefit when life histories are constructed with their families and shared with nursing staff.

There has been an increasing emphasis on choice for older people in long-term care in both England and Japan. However, despite the emphasis on the importance of choice, the perspectives of older people have been given little attention. Considering national and local policies in Bristol, England and Kyoto, Japan, the article explores how older people are exercising (and not exercising) choice in care practice through examining the perspectives of the older people themselves, as well as key informants in the field. Empirical data were collected from interviews with older people and key informants in the two countries, and were analysed using qualitative and comparative approaches. Choice in policy is regarded as a mechanism of the market with an assumption of the independent autonomous individual who can exercise ‘rational choice’. However, the findings have reflected older people's relational decision-making, which does not conform to the rational model of decision-making, and illustrates the value of ‘interdependence’. The findings from care practice have shown that choice was considered an important value in involving older people's views and ensuring their needs are met sensitively and respectfully. The findings also suggested that consideration of the psychological aspects of choice is an important aspect of ‘care’, facilitating the inclusion of older people's views in the process of making judgements, in order to meet their needs.

Family relationships play a major role in individuals' lives and can be a source of comfort, support and protection during the entire lifecourse. Particularly in the context of life events, such as widowhood, family relationships may be salient for (older) adults in coping with feelings of grief, loss and loneliness. Using Dutch survey data and 18 in-depth interviews from a sub-sample, this study examines the role of family relationships through the lifespan in reducing loneliness among ever-widowed older adults (i.e. persons who have at some time during their life experienced the death of a spouse). Particular attention was paid to childhood memories, family ties and support from siblings. Quantitative analyses examined associations between loneliness and childhood experiences of relationships with parents, family ties and sibling support. Qualitative data elucidated how ever-widowed adults recall relations with parents and siblings and experience current family relations. Quantitative and qualitative data showed that emotional support from siblings reduced loneliness. Additionally, positive memories of childhood relationships and current family ties were negatively related to loneliness. In times of ever-increasing longevity, work detailing how family relationships across the lifecourse are supportive in alleviating loneliness is a key issue on the social research and policy agenda.