Older prisoners are the fastest growing sub-group in the English and Welsh prison estate. They have complex health needs, in spite of which there is a dearth of literature concerning their access to prescribed medication. Literature relating to younger prisoners highlights common issues around maintaining continuity of medication upon reception into prison custody. The objective of the study was to explore the lived experience of older male prisoners regarding continuity of medication upon entry into prison. This paper presents findings from part of a large-scale research project regarding health and social care services for older male adult prisoners. Semi-structured interviews were conducted with male participants (N = 27) aged 60 years and over who had been newly received into prison. Interviews were conducted within the first ten weeks of custody. Participants were asked about their experience of accessing medication on entry into prison. Data were analysed using the constant comparison method. Eighty-five per cent of participants were in receipt of prescribed medication when committed to prison. Older prisoners’ experiences of receiving medication in prison were reflected in four key themes: delays in confirming medicines; changes to medication; communication difficulties; and enforced helplessness. Whilst these experiences mirrored those of prisoners of all ages reported in previous studies, these issues are especially relevant to older prisoners who are likely to have greater and more complex medication needs than their younger peers. In addition, older prisoners experienced unmet needs related to restricted mobility and functional skills that could have impaired their ability to maintain concordance with medication regimes. This study shows that there is need for increased awareness of prescribing issues specific to older prisoners to allay related feelings of anxiety and distress and to ensure they receive appropriate medication.

This study investigates the changes in social network types among older adults in South Korea, and it examines whether, and to what extent, these changes influence their health and psychological wellbeing. Data were obtained from the Korean Longitudinal Study of Ageing. The sample was restricted to respondents over 65 years of age who participated in both the 2006 and 2008 surveys (N = 3,501). The social network types for both years were derived by Latent Class Analysis. Changes in network types over time were then identified. A series of multivariate regression analyses were conducted to examine the effects of social network changes on self-rated health, depressive symptoms and life satisfaction. Restricted, Family, Friend and Diverse network types were derived in each wave of the study. Although the direction of social network changes was not always towards the Restricted type, the Restricted network was the most prevalent and stable type among older Koreans. Older adults who remained in or transitioned to restricted types of social networks were more likely to have poor self-rated health, higher levels of depressive symptoms and lower levels of life satisfaction. This study adds to the limited body of literature on longitudinal network typology, and it expands the knowledge of social network types among older adults in diverse social and cultural contexts.

It is noteworthy that while modernisation, together with population ageing, has happened in Western countries for a rather long period of time, China must confront the challenges of an ageing population before it really becomes an advanced industrial society. Facing rapid societal changes, citizens may react differently to this process. By conducting questionnaire surveys with 445 elders in Wuhan, China, this study examines Chinese older adults' individual modernity modes and reveals its socio-demographic correlates. The results show that facing rapid changes in societal modernisation, participants have reacted differently to this process, with 23.8 per cent of Chinese older participants using an accommodation mode, 27.0 per cent using a resistance mode, 13.3 per cent using a withdrawal mode and 36.2 per cent using a coping mode. In addition, socio-demographic factors such as urban–rural residence, age, gender, socio-economic status, living arrangement and daily activities have been identified as significant correlates of Chinese older participants' individual modernity modes. It is further suggested that governments at all levels should allow for options and opportunities for older people to align themselves in the modernisation process by removing the barriers that may hinder their integration and empowerment efforts. While it is important to respect older adults' different responses in the face of modernisation, their participation in societies should be encouraged and respected by the wider society in the context of modernisation.

This study investigated the determinants of Successful Ageing (SA) in a sample of 4,151 Peruvians aged between 65 and 80 years and living in poverty. A key contribution of this study is to combine the conceptual appeal of SA to measure wellbeing in old age with the multi-dimensional poverty counting approach developed in the economic literature. This setting allows for moving beyond the dichotomy of successful and usual ageing to take advantage of the full distribution of success along a set of dimensions of wellbeing. The data are drawn from the Encuesta de Salud y Bienestar del Adulto Mayor (ESBAM) survey, which is the baseline to evaluate the non-contributory public pension programme Pension 65. Nine indicators of SA have been used to assess the dimensions of physical health, functioning, cognition, emotional health and life satisfaction. The variables associated with a higher number of satisfied indicators were male gender, younger old age, literate, employed, low food insecurity, good nutritional status, normal blood pressure, absence of disabilities, non-smoker, empowerment, good self-esteem, absence of mental disability and less frequent contact with a social network. From a policy perspective, the results of this study report a remarkably stable effect of three variables affecting SA that can be relatively easy to measure, monitor and influence by public intervention. These variables are food security, nutrition quality and self-esteem.

Being married reduces the mortality risk of older persons. More generally, living arrangements that include co-residence with a source of support and a close care-giver are associated with a lower mortality risk. We build a detailed typology of private and collective living arrangements, including marital status, and check its association with mortality risks, controlling for health status. Using administrative data from the population register, we identify the living arrangement of all individuals aged 65 years and over living in Belgium as at 1 January 2002, and their survival during the year 2002. Data on health status are extracted from the 2001 census. We use binary logistic regression with the probability to die as outcome and living arrangement, health, age and gender as covariates. Our results show that mortality is more closely associated with actual living arrangements than with marital status. This association is age and gender-specific and remains even at very old ages. Living with a spouse is confirmed to be beneficial for survival but in older age living alone becomes more favourable. Of all living arrangements, older persons living in religious communities experience the lowest mortality risk whereas those living in nursing homes experience the highest risk.

Contemporary Western social policy encourages older adults to maintain independence in the community. Socio-cultural norms of independence have recently become associated with successful ageing. Personal autonomy and self-responsibility are cultural markers by which older adults increasingly define their lives and identity. Many older adults seek to remain independent within their communities, while coping with age-related decline, and living alone with decreased social connectedness. These characteristics have also been associated with personal and social vulnerability and explain why older adults are at higher risk of experiencing disproportionate negative outcomes during disasters. This paper describes findings from narrative interviews with a sample of independent community-dwelling New Zealand older adults. The interviews sought to explore their views about disaster preparedness. However, within their accounts was a collective and bigger story about personal preparedness, and social relationships in later life, which extended beyond the context of preparing for a future disaster event. Older adults identified age-specific preparedness as a way to maintain independence in the everyday context of their lives. Concerns about health influenced their choices and actions as they evaluated and prioritised goals and strategies to maintain independence and wellbeing. Social relationships were also considered an important resource to support independence. Understanding the role of preparedness in the everyday lives of older adults has implications for improving the disproportionate negative outcomes this vulnerable age group can experience during a disaster. Therefore, health, gerontology and emergency management have much in common when considering older adults' preparedness during non-disaster times.

The present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care.

Many older adults experience what is clinically recognised as frailty but little is known about the perceptions of, and attitudes regarding, being frail. This qualitative study explored adults' perceptions of frailty and their beliefs concerning its progression and consequences. Twenty-nine participants aged 66–98 with varying degrees of frailty, residing either in their homes or institutional settings, participated in semi-structured interviews. Verbatim transcripts were analysed using a Grounded Theory approach. Self-identifying as ‘frail’ was perceived by participants to be strongly related to their own levels of health and engagement in social and physical activity. Being labelled by others as ‘old and frail’ contributed to the development of a frailty identity by encouraging attitudinal and behavioural confirmation of it, including a loss of interest in participating in social and physical activities, poor physical health and increased stigmatisation. Using both individual and social context, different strategies were used to resist self-identification. The study provides insights into older adults' perceptions and attitudes regarding frailty, including the development of a frailty identity and its relationship with activity levels and health. The implications of these findings for future research and practice are discussed.

The neo-liberal ideologies that point to individual responsibility for risks increasingly influence countries of the global North. The anti-ageing industry reflects this dictate and encourages middle-aged people to use their products and services to manage their ageing. However, given the negative connotations attached to the term ‘anti-ageing’, which is usually seen to focus on aesthetics and thus be a woman's concern, men may be likely to disavow being involved in such activities. The article uses interview data collected from men aged 42–70 from Finland and the United States of America to explore whether and how men adhere to the call to manage their ageing when such anti-ageing activities are seen to be potentially feminising. We find that these men reflected neo-liberalism in the sense that they felt that, although ageing cannot be prevented, it can be controlled. Also while they generally rejected anti-ageing products and services that they judged to affect aesthetics, they reported that they use those that they define as promoting health and performance instead. For them, masculinity is the instrumental focus on performance to the exclusion of beauty or attractiveness. Masculine anti-ageing bodily strategies must also be ‘natural’, involving hard work rather than the use of products, which they regard as never having been scientifically proven to enhance performance. Thus, in talk of their anti-ageing, men distance themselves from women.

The trajectory of modern China, namely from dire poverty and communist fever to economic boom and marketisation under an authoritarian regime, makes the country a unique social laboratory for examining how social environment affects human development of individuals. This study investigated the correlation between childhood adversity and depressive symptoms of Chinese middle-aged and older adults, as well as how urbanisation moderates the correlation. A sub-sample (N = 14,681) of the baseline of the China Health and Retirement Longitudinal Study was analysed. Seven variables were used in the latent class analysis to establish a childhood adversity typology. Three urbanisation statuses were identified according to the Hukou (household registration system) status and neighbourhood type: non-urbanised, semi-urbanised and fully urbanised. The correlation between childhood adversity and depressive symptoms and the moderation of urbanization on the correlation were assessed with factorial analysis of covariance. Three latent classes for childhood adversities were identified: ‘normal childhood class', ‘low childhood socio-economic status and health class' and ‘traumatic childhood class'. The class membership was significantly correlated with depressive symptoms (p = 0.015), and the urbanisation status, also significantly affecting depressive symptoms (p = 0.05), had significant moderating effect on the correlation (p = 0.002). It is suggested that more social inclusive policies need to be adopted in order to guarantee the equal distribution of wellbeing led by urbanisation.

This study explores how common spaces in assisted living schemes for older persons are used by the residents. Observation studies, group interviews with staff and individual interviews with residents, relatives, architects and key stakeholders in the context of Swedish elder-care were conducted. Common spaces are the major location for in-house social interaction on the units. The results show a higher presence on the dementia units, compared to the somatic units. No significant correlation was found between the residents' mobility limitations and their degree of presence in the common spaces. The results also suggest a contradiction between the staff's intentions to provide a social context and the capabilities of the residents. Although common spaces are not used much between meals, the residents stress their importance for social interaction, suggesting that common spaces have important qualitative aspects, rather than quantitative. The results also show that few of the residents used the common spaces together with their relatives. The increasing use of assistive technology creates a shortage of space, suggesting a conflict between the efforts to create a home-like environment and the use of assistive technology.

Sweden has in the last 20 years undergone an extensive process of marketisation of its home care sector. Where the public sector once was the only provider of home care services, there is now a wide array of different, private alternatives for older people to choose from, using their publicly funded voucher. The publicly funded home care services in Sweden are, in other words, to a large extent organised according to the principles of a quasi-market. Older people with care needs are therefore now considered to be consumers of home care since they are expected to make an informed choice of home care provider according to their own preferences. This paper studies the extent to which older people with care needs assume this role and how they do it, using Hirschman's well-known theory on ‘exit, voice and loyalty’ and theory on the difference between care and market logic. The study is based on results from a research project using telephone interviews to ask a large number of older people in three Swedish cities about their experience of making this choice. The results show that they had difficulty understanding how to choose and what the purpose of the choice was. The conclusion of this study suggests some possible reasons why policy makers in Sweden continue to favour the freedom-of-choice model in spite of these poor results.

Few studies explore the application of literature on care home closures in practice or how it can influence residents' experiences. The aim of this study was to investigate from multiple perspectives how a protocol, designed by a local council for the involuntary relocation and safe transfer of older adult residents, was adhered to and the influence that the protocol had on the experiences of residents who relocated from two care homes. Interviews were conducted with 34 stakeholders, including relocated residents (N=11), relatives (N=2), care home staff (N=13), managers (N=6) and advocates (N=2), and analysed using framework analysis. The protocol covered key aspects of guidelines extracted from research evidence grouped into four themes: involvement; staff approaches; preparation; and consistency and familiarity, with the majority of the guidelines being followed in practice. Two further themes that centred on the processes of transitional adjustment and impact of relocation were influenced by the protocol but were also mediated by factors relating to the environment and the resident. Involvement of residents, relatives and advocates, extensive planning and a person-centred approach were of particular importance in improving residents' experiences of relocation. A model that places residents' experiences at the centre of relocations is proposed, which draws on and applies the themes identified in this study and applies them within the context of opportunities and risks.

The number of children women have is a critical determinant of their future wellbeing. Often, adult children confer some protection against adverse conditions in their older ages. In many sub-Saharan African societies, it is expected that older women who typically have had many children, will benefit from their investment in children. Yet it is unclear if this is really the case. Using data from the 10 per cent micro-sample of the 2002 Senegalese Population and Housing Census, this study investigates the effect of the childbearing histories of older women (aged 60–85) on the likelihood that their households experienced food insecurity in the past year. Women who had had no children and those who had ever had two or more, were not significantly different from those who had had five or more – only those who had had one child were adversely affected. Based on principles of intergenerational altruism and moral obligation, I expected that food insecurity would decrease with increases in the number of surviving children. This pattern was generally found. However, among women in the bottom 40 per cent of the wealth distribution, the relationship was, at best, weak with respect to all of the fertility variables (children ever had, living, co-resident). The benefits of high fertility seem to accrue to relatively richer women – those in the top 60 per cent of the wealth distribution. Yet among these richer women, having fewer than three children and co-resident adult children were significant risk factors of food insecurity.

Organisational culture of institutions providing care for older people is increasingly recognised as influential in the quality of care provided. There is little research, however, that specifically examines the processes of care home culture and how these may be associated with quality of care. In this paper we draw from an empirical study carried out in the United Kingdom (UK) investigating the relationship between care home culture and residents' experience of care. Eleven UK care homes were included in an in-depth comparative case study design using extensive observation and interviews. Our analysis indicates how organisational cultures of care homes impact on the quality of care residents receive. Seven inter-related cultural elements were of key importance to quality of care. Applying Schein's conceptualisation of organisational culture, we examine the dynamic relationship between these elements to show how organisational culture is locally produced and shifting. A particular organisational culture in a care home cannot be achieved simply by importing a set of organisational values or the ‘right’ leader or staff. Rather, it is necessary to find ways of resolving the everyday demands of practice in ways that are consistent with espoused values. It is through this everyday practice that assumptions continuously evolve, either consistent with or divergent from, espoused values. Implications for policy makers, providers and practitioners are discussed.

The objectives were to investigate the associations between social and financial living conditions in childhood, education and morbidity in old age. The study population (N = 591; 76+ years old) was assembled from two nationally representative Swedish surveys, in 1968 and 2011, that together made longitudinal analysis possible. Morbidity in old age comprised self-reported measures of musculoskeletal disorders, cardiovascular disease, self-rated health and impaired mobility. There were no independent associations between adverse childhood living conditions and morbidity. However, adverse childhood living conditions were associated with an increased likelihood of low education. Moreover, low education was associated with a higher probability of health problems in old age. The results did not show any associations between adverse childhood conditions and late-life morbidity. However, adverse childhood conditions were associated with lower levels of education which, in turn, was associated with health problems and attrition from the study. These results suggest that adverse childhood conditions may indeed be associated with health and survival in old age, but mainly through mechanisms acting earlier in the lifecourse.

The aim of the current study is to examine the associations between the quality of relationships and life satisfaction of older mothers in Estonia, Germany, Russia and the People's Republic of China, based on the assumptions of the Family Change Theory. The role of satisfaction with family life as the probable mediating factor is considered. Estonian older mothers reported the least admiration and intimacy in their relationships with their adult daughters, and the least satisfaction with family life compared to German, Russian and Chinese mothers. German older mothers perceived the most admiration from their adult daughters and were the most satisfied with both their family and general life. Russian older mothers were the least satisfied with their general life compared to their counterparts in Estonia, Germany and China. The results from the Structural Equation Modelling showed that the relationship between satisfaction with family life and general life satisfaction was statistically significant in all countries except Russia. The satisfaction with family life as a mediating factor might strengthen the positive and negative aspects of intergenerational relationships on the life satisfaction of older mothers. The findings indicated that the emotional closeness and intergenerational relationships in families during the process of transition and globalisation play an important role in the life satisfaction of older mothers in these four countries.

How can social participation by older people support their wellbeing? We explore the elder-focused community support system developed in Minamisanriku town after the Great East Japan Earthquake of 2011. Many elderly people lost all their material possessions and were moved from their devastated home communities to temporary housing. We conducted semi-structured interviews with 17 participants including 14 community workers and three members in the Minamisanriku Council of Social Welfare (MCSW) in a programme framed by the MCSW's disaster-response model. Thematic analysis highlighted how older people's involvement in the visiting programme of their temporary community, and conducting twice-daily visits to other vulnerable elders, enabled them to provide valued social support to isolated and homebound peers. It also helped reconstruct their own social identities shattered by the dissolution of former communities, the shock of displacement and loss of possessions. This positive social participation was heavily influenced by strong bridges between their temporary community and MCSW support staff and infrastructure that promoted and supported their visits. Our study highlights how strong and empowering relationships amongst older people can be facilitated by an active government-funded support agency that is immediately responsive to the needs and deeply respectful of the world-views of vulnerable groups.

Population ageing is a global trend that affects individual life plans, family arrangements, market structures, care provisions and pension schemes. We combine insights from demography and lifecourse research to understand better the causes of population ageing. Demography explains population ageing by describing changes in fertility, mortality and migration rates. Lifecourse research argues that these rates are interconnected because they are embedded in the lifecourses of individuals. An individual's experiences at an early age can influence behaviours at a later age, thereby creating continuity throughout the lifecourse. Additionally, lifecourse research underlines that social networks – such as families – and countries influence lifecourse. Thus, historical events and past experiences have already set the course for today's demographic changes. Moreover, the effects of policies that strive to influence population ageing will not be evident for years or even decades to come. This paper introduces a conceptual framework that explains how the lifecourse perspective can be applied to the phenomenon of population ageing and illustrates the framework through a case study of Germany. The case study highlights that insights from the micro-, meso- and macro-levels need to be combined to achieve a deeper understanding of population ageing. Scholars can use the framework presented in this paper as a guideline for merging arguments from demography and lifecourse research in future studies.

With demographic changes and the growing numbers of older people living alone, concerns have been raised about the care of the ageing population. Increasingly, developments in technology are being seen as the solution to these concerns. For those who do not see themselves as old or frail enough to require personal care provision, and who prefer to maintain their identity as autonomous and independent individuals, the development of assistive technologies such as ambient home monitoring systems is one answer. However, this involves careful negotiations with older people's understandings of safety and privacy, and their experiences and relationships with technology, their carers and relevant service-providers. In two trials of a home monitoring system funded by the United Kingdom Technology Strategy Board, older people were interviewed pre-trial and post-trial about their perspectives on these issues. This paper presents a conceptual analysis of the qualitative data using a sociological framework of trust that considers habitual action, and relationships with kin and with wider institutions. The research found that older people's habits and norms do not need to be disrupted by the ambient system. What was of more importance was relationships between the older person and her or his ‘monitor’ based on trust, as well as institutional providers who need to instil or earn trust.