The significant time older people typically spend at home affects both their level of physical activity and quality of life. This prospective cohort study was designed to identify the effects that living in a high-rise residence retirement community has on physical activity and quality of life in older people with leprosy. The relocation group was comprised of study participants who had relocated voluntarily to a high-rise apartment building. The comparison group was comprised of study participants who had chosen not to relocate to that building. Data were collected using a personal information survey, Modified Baecke's Questionnaire, and the brief version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). The groups were significantly similar in terms of household activities, leisure time activities, total physical activity score, and quality of life physical and social aspects, and significantly different in terms of quality of life overall (F=7.864, p=0.006), psychological (F=5.403, p=0.021) and environmental (F=23.099, p=0.000) aspects. This study indicates that living in a high-rise apartment environment does not decrease physical activity and may promote overall quality of life, and psychological and environmental aspects, in retirement community residents. The findings enhance understanding of the effect of different living environments on physical activity and quality of life. Greater health professional participation in retirement community design to ensure such designs facilitate residents’ health and quality of life is recommended.

Ageing, by definition, involves moving across lived time. Grounded in developmental psychology, particularly lifespan developmental theory, this study examines two time-related factors that may affect psychological wellbeing in adulthood. Particularly, chronological age and perceived time left to live (i.e. future time perspective) are predicted to act as opposing forces in the construction of psychological wellbeing. Young (N = 285, 19–29 years) and middle-aged adults (N = 135, 47–64 years) self-reported their current psychological wellbeing (across six dimensions) and their sense of future time perspective. As predicted, mediation analyses show that higher levels of chronological age (being in midlife), and having a more open-ended, positive future time perspective are both related to higher psychological wellbeing. Note, however, that being in midlife is related to a more limited and negative future time perspective. As such, confirming our conceptual argument, while both age and future perspective are measures of time in a general sense, analyses show that they act as unique, opposing forces in the construction of psychological wellbeing. The current research suggests that individuals can optimise psychological wellbeing to the extent that they maintain an open-ended and positive sense of the future.

This article examines work-related factors and their impact on the retirement decision-making process. We particularly focus on organisational human resources policies and normative climate regarding retirement. Organisations create opportunities and conditions for career extension via their personnel instruments. The normative climate may encourage or discourage retirement. We use a ten-year follow-up study among 1,458 older employees in the Netherlands aged 50–59 at baseline. Results reveal that older workers are sensitive to social approval earned from their co-workers and supervisor. A social climate that supports working up to higher ages is an important requisite for reducing the attractiveness of the early retirement option. Retirement intentions, formed in the years prior to retirement, are shaped by workplace norms and supervisors' attitudes. Results indicate that in order to delay retirement, policy initiatives cannot be reduced to altering financial restrictions surrounding retirement but need to address the forces at the organisational level that channel workers out of employment.

The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder–care-giver relationships in Southern Sri Lanka. Data included four focus group discussions and five in-depth interviews with elderly, and ten in-depth interviews with adult children of the elderly. Discussion guide topics included care-giving arrangements, and roles/responsibilities of elders and care-givers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the care-giver dynamic. Both elders and care-givers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modelling of parental care-giving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Care-giving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and care-givers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.

Many older women reduce the amount of cooking and food preparation they do in later life. While cooking may be seen as traditionally associated with women's family roles, little is known about the impact of such reduced engagement with food on their lives. This paper presents the findings from a one-year qualitative study (Changes Around Food Experience, CAFE) of the impact of reduced contact with preparing and cooking meals from scratch for 40 women, aged 65–95 years, living in Norfolk, United Kingdom. Data were collected through semi-structured interviews, focus groups and observations. Women's reasons for reducing food-related activities included changes in health, loss of a partner or a caring role, and new patterns of socialising. Disengagement from cooking and shopping was not found to entail predominantly negative feelings, passive acceptance or searching for forms of support to re-enable more cooking from scratch. Accounts evidenced the dynamic adaptability of older women in actively managing changed relationships with food. In exploring new meal options, older women were not simply disengaging from their environments. CAFE findings linked women's engagement with their environments to how they were using formal services and, even more, to the value they placed on social engagement and being out and about. Through the connections they fostered with friends, family and community, older women actively enabled their continued involvement in their social, public and family spheres. Reduced contact with preparing and cooking meals from scratch, therefore, did not induce or imply passivity or debility in the CAFE cohort. By contrast, it involved their exploring new means of retaining what was important to them about food in the context of their lived situation and social connections with friends, family, the community and public spheres.

This paper explores how people reason about Alzheimer's disease by telling stories about others who have the disease. More specifically, the paper is a cross-linguistic investigation of the narrative and linguistic devices used by African Americans in English, Mexican Americans in Spanish, and refugees/immigrants from the former Soviet Union (to the United States of America) in Russian in their oral productions of such stories. We examine the narratives as instances of case-based reasoning in which lay people (non-medical professionals) distinguish, represent and ‘perform’ symptomatic behaviours and construct a ‘case’ of the disease as a way of probing the difference between the normal and the pathological in conversational contexts. In particular, we examine situations in which stories are accepted and confirmed and situations in which stories are contested and negotiated. Common narrative and discursive devices across the three languages include concatenation, intertextuality, conjunction and conjunctive adverbs, lexical opposition, past progressive tenses, temporal adverbials, reported speech and prosodic cues. The fine-grained analysis of these narrative and discursive devices lays bare the inner-workings of case-based reasoning as a conversational task and suggests specific linguistic tools for intervening in lay narrative reasoning in clinical settings and in public health messaging about Alzheimer's disease.

In an increasingly ageing society, its older members are receiving considerable political and policy attention. However, much remains to be learnt about public perceptions of older age, particularly the views and experiences of older individuals themselves. Drawing on qualitative interviews carried out with members of two British cohorts (N = 60) who have reached the ‘third age’, this paper discusses perceptions of age, focusing particularly on how perceived advantages and disadvantages differ by respondents' self-reported physical capability. The interviews were carried out in 2010 as part of the HALCyon (Healthy Ageing across the Life Course) collaborative research programme. Findings suggest there is some difference in the way older people view aspects of ageing by capability and that although advantages are widely perceived, physical decline and associated health concerns were the overwhelming theme across the conversations. The article concludes by making tentative suggestions to inform the positive ageing agenda and its related policies.

This study investigates how (a) the reliance on public care and (b) the type of public care received by older people in the Netherlands depends on the availability of partners and adult children. Older people aged 65 years and older were surveyed in the Netherlands Kinship Panel Study at two time-points. Survey results were linked to registry data on public care receipt at the two time-points. Multilevel models revealed that receiving frequent help in the household from children was not associated with public care receipt. Only men having a partner were less likely to receive public care. Further analyses comparing the receipt of skilled and unskilled forms of public care revealed that female partners are especially important in rendering unskilled care unnecessary compared to skilled care. Two arguments may explain our findings. One is that a gender-bias exists in processing public care requests – men are perceived as less able to provide care to their female partners. Another is that men lack the skills, or perceive themselves as lacking the care skills that female partners have. Caution is advised against introducing policy measures that increase pressure on female partners.

Workplaces, managers and employers who are seeking to maintain the standing, capacities and productivity of their workplaces are now facing two crucial facts: (a) an ageing workforce and (b) all workers, regardless of age, need to adapt to the changing requirements for workplace performance. These facts mean that managers and supervisors need to confront issues found in the changing demographics of their own workforce. That is, as the portion of workforces aged over 45 years (i.e. older workers) increases, it is these workers who are available to be employed, and supported in sustaining their ongoing employability. To address these issues requires understanding of particular workers' capacities and aspirations and then acting to develop further their capacities based on new understanding, and rebutting social sentiments about these workers that are often value-laden, contradictory and biased. The case here is made through drawing on literature and analyses of interview data of Australian managers of older workers, that the current logic of management relies upon deeply held and widely shared beliefs of age-blind meritocracy and equal opportunity rather than informed views.

This paper engages with a cultural politics of ‘older’. At the centre of this politics are essentialist discourses of corporeal ‘ageing’ that limit and stigmatise the subjective experience of ‘older’. Drawing together theoretical insights from Foucault's work on care of the self with data from in-depth interviews with ‘older’ people who have undergone cosmetic surgery and cosmetic surgery practitioners, this paper advances the proposition that cosmetic surgery can be re-imagined as an ethical practice of self-care. To critique the limitations imposed by ‘natural ageing’ through an ethic of ‘ageing gracefully’, the paper explores how older people who have undergone cosmetic surgery stylise the ethical experience of ‘older’ through active resistance of an ‘elderly’ identity. It argues that the practice of cosmetic surgery by ‘older’ people constitutes a cutting critique of the limits of ‘older’ and an experiment with the possibility of exceeding and ultimately transforming those limits.

This study contributes to the literature on mobility and wellbeing at older ages through an empirical exploration of the meanings of free bus travel for older citizens, addressing the meanings this holds for older people in urban settings, which have been under-researched. Taking London as a case study, where older citizens have free access to a relatively extensive public transport network through a Freedom Pass, we explore from a public health perspective the mechanisms that link this travel benefit to determinants of wellbeing. In addition to the ways in which the Freedom Pass enabled access to health-related goods and services, it provided less tangible benefits. Travelling by bus provided opportunities for meaningful social interaction; travelling as part of the ‘general public’ provided a sense of belonging and visibility in the public arena – a socially acceptable way of tackling chronic loneliness. The Freedom Pass was described not only as providing access to essential goods and services but also as a widely prized mechanism for participation in life in the city. We argue that the mechanisms linking mobility and wellbeing are culturally, materially and politically specific. Our data suggest that in contexts where good public transport is available as a right, and bus travel not stigmatised, it is experienced as a major contributor to wellbeing, rather than a transport choice of last resort. This has implications for other jurisdictions working on accessible transport for older citizens and, more broadly, improving the sustainability of cities.

Scholars and policy makers have expressed concern that social and economic changes occurring throughout Asia are threatening the wellbeing of older adults by undercutting their systems of family support. Using a sample of 1,654 men and women aged 45 and above from the Chitwan Valley Family Study in Nepal, we evaluated the relationship between individuals' non-family experiences, such as education, travel and non-family living, and their likelihood of receiving personal care in older adulthood. Overall, we found that among individuals in poor health, those who had received more education, travelled to the capital city, or lived away from their families were less likely to have received personal care in the previous two weeks than adults who had not had these experiences. Our findings provide evidence that although familial connections remain strong in Nepal, experiences in new non-family social contexts are tied to lower levels of care receipt.

This paper reports on the study of a subsidy programme that was established in Quebec for alternate housing models (AHMs), which allows private and community organisations to offer housing services within the framework of a partnership with public health-care services. The research objectives were: (a) to compare how facility characteristics and services provided by AHMs and nursing homes (NHs) differ; (b) to examine the personal characteristics of residents living in AHMs; and (c) to compare residents with similar characteristics within AHMs and NHs in terms of unmet needs, quality of care, satisfaction with care and services, and psycho-social adaptation to the residence. A cross-sectional study was undertaken with individually matched groups to assess whether AHMs meet the needs of elders in a way similar to NHs. Overall, residents in both groups had moderate to severe levels of disability and about 60 per cent had mild to severe cognitive problems. While their general features were heterogeneous, the AHMs were more comfortable and homelike than the NHs. The quality of and satisfaction with care was appropriate in both settings, although AHMs performed better. Only one-quarter of residents in both settings, however, evidenced a good level of psycho-social adaptation to their residence. This partnership approach is a good strategy to provide a useful range of housing types in communities that can respond to the needs of elders with moderate to severe disabilities.

This paper examines how the relationships between the factors (predisposing, enabling and illness) of the 1973 Andersen framework and service use are influenced by changes in the caring role in older women of the 1921–26 cohort of the Australian Longitudinal Study on Women's Health. Outcome variables were the use of three formal community support services: (a) nursing or community health services, (b) home-making services and (c) home maintenance services. Predictor variables were survey wave and the following carer characteristics: level of education, country of birth, age, area of residence, ability to manage on income, need for care, sleep difficulty and changes in caring role. Carer changes were a significant predictor of formal service use. Their inclusion did not attenuate the relationship between the Andersen framework factors and service use, but instead provided a more complete representation of carers' situations. Women were more likely to have used support services if they had changed into or out of co-resident caring or continued to provide co-resident care for a frail, ill or disabled person, needed care themselves, and reported sleep difficulties compared with women who did not provide care. These findings are important because they indicate that support services are particularly relevant to women who are changing their caring role and who are themselves in need of care.

Older people are increasingly being cared for in the community across Europe. Dependent care in Spain largely remains a private issue involving family carers and migrant women from developing countries. Qualitative research on respite care has contributed to our understanding of respite as a subjective experience. Nonetheless, how care-givers relieve the burden of care is still not fully understood. Migrant care-givers are present in family life but their need for rest remains unseen. The aim of the study presented in this paper was to contrast family care-givers and migrant care-givers' strategies for relief from their caring role. Care-givers rest by thinking, doing and being but in a different manner from that of care-giving, that is: when they are a different person. To leave the life of care-giving is the general strategy that family care-givers use to rest from their care-giving selves while turning to one's own world describes the way migrant care-givers seek to relieve the burden of care. The comparative analysis shows that both strategies have in common the necessity to disconnect from the care-giving identity and that both migrant and family care-givers employ strategies that are false exits to a care-giving identity: they apparently relieve the burden of care. Respite goes beyond places, times and activities; as family care itself, it requires identity.

As an increasing number of Government services have moved away from traditional modes of provision to online formats, there has been a corresponding need to ensure greater access to the internet. Although older people (those over 60) are least likely of all age groups to have access to the internet in their homes, the internet holds much potential as an information and advice resource for those older people who may find it difficult to access advice over the telephone or in person. Realising this potential extends beyond issues of physical access; consideration must necessarily be given to issues of internet literacy and the inclination of this cohort to utilise what may be new and unfamiliar technology. This paper examines these matters in the context of the resolution of everyday problems with a legal dimension. Looking first at the use of the internet for information and advice seeking related to such problems, we find that those aged over 60 demonstrate the least use of the internet for problems with a legal dimension. Simultaneously, those aged over 60 are also the group with the lowest level of home access – a particular issue given that for over 60-year-olds, home access is a far stronger determinant of internet use for problems than it is for other age groups. Examining use of the internet for advice seeking over the last decade, findings demonstrate the existence of a general increase in use amongst all age groups over time, albeit with a lower rate of growth amongst those currently over 60. As an indication of future growth, this will have implications for the provision of services. Whilst the ‘young old’ will utilise the internet to a greater degree and will require websites which are tailored to their needs, those individuals at the older end of the age spectrum may best be served by continued access to face-to-face or outreach advice. The implications these findings pose for policy makers in setting priorities in the remit of online service provision are discussed, with results having particular relevance in England and Wales given planned changes to civil legal aid.

Relatively little attention has been paid to understanding and addressing the potential health-related barriers faced by older workers to stay at work. Using three representative samples from the Canadian Community Health Survey, we examined the relationship between seven physical chronic conditions and labour market participation in Canada between 2000 and 2005. We found that all conditions were associated with an increased probability of not being able to work due to health reasons. In our adjusted models, heart disease was associated with the greatest probability of not working due to health reasons. Arthritis was associated with the largest population attributable fraction. Other variables associated with not being able to work due to health reasons included older age, female gender and lower educational attainment. We also found particular combinations of chronic conditions (heart disease and diabetes; and arthritis and back pain) were associated with a greater risk than the separate effects of each condition independently. The results of this study demonstrate that chronic conditions are associated with labour market participation limitations to differing extents. Strategies to keep older workers in the labour market in Canada will need to address barriers to staying at work that result from the presence of chronic conditions, and particular combinations of conditions.

It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellness. We undertook a longitudinal qualitative study to explore ‘wellness and resilience’ in a group of older people who reported chronic joint pain and considered themselves healthy. We interviewed 27 people and followed them up with monthly diary sheets, responding to reports of changes using their chosen contact method. This article focuses on how resilience relates to how people consider themselves to be well. Participants' experience of the adversity of their pain varied, and was influenced by context and meaning. Participants described ‘keeping going’ in body, mind and everyday life. Flexibility and pragmatism were key aspects of keeping going. The findings support a broader version of resilience that incorporates vulnerabilities. In the context of health care we suggest that treating the frail body should not come at the expense of undermining an older person's sense of a resilient self.

This study explored associations between socio-economic status (SES) at different phases in the lifecourse and regular internet use among older adults. A sample (N = 11,035) from the 2010 wave of the United States Health and Retirement Study was used. Odds ratios were estimated to explore the relationship between regular internet use in older adulthood and measures of SES in childhood and in adulthood, and cumulative SES. Findings provided support for the lifecourse perspective, suggesting that variations observed among older adults are reflective of cumulative experiences. Three main themes emerged: higher SES in childhood increased the odds of being an internet user in older adulthood; SES advantages tended to accumulate, so that having at least one period of high SES in the lifecourse increased the odds of being an internet user in older adulthood; age did not appear to modify the positive relationship between cumulative SES and internet use.

A group of 141,345 immigrants from the Netherlands Antilles, a former colony, live in the Netherlands. An increasing number of these migrants are at or above retirement age, and for them, the question of where they want to grow old becomes relevant. It is important for people to age in a place where they feel at home, as attachment to place increases wellbeing in old age. In this article we discuss how older Antillean migrants in the Netherlands make their house and immediate living environment into a home. We focus on home-making practices in a broader cultural context, and in relation to wellbeing. These topics are addressed by drawing on qualitative life-history interviews with Antillean older people, who live in a co-housing community for older adults. It turns out that objects which remind the participants of their home country play an important role in making a home. Also, the community, with people from similar backgrounds, contributes to a sense of home. Finally, the presence of children and other family members is a key motivation for the participants' decision to age in the Netherlands.