This study investigates the variations by older people's socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.

The way frailty is conceptualised and interpreted has profound implications for social responses, care practice and the personal experience of care. This paper begins with an exegesis of the concept of frailty, and then examines the dominant notions of frailty, including how ‘frailty’ operates as a ‘dividing-practice’ through the classification of those eligible for care. The definitions and uses of ‘frailty’ in three discursive locations are explored in: (a) the Oxford English Dictionary, (b) the international research literature, and (c) older women's accounts of their lived experience. Three distinctive discourses are found, and applying a Foucauldian analysis, it is shown that the differences reflect overlaps and tensions between biomedical concepts and lived experiences, as well as negative underlying assumptions and ‘subjugated knowledge’. The concept of frailty represents and orders the context, organisational practices, social representations and lived experiences of care for older people. The evidence suggests that if, as the older women's accounts recommended, socially- and emotionally-located expressions of frailty were recognised in addition to the existing conceptions of risk of the body, frailty might no longer be thought of primarily as a negative experience of rupture and decline. To encourage this change, it is suggested that practice focuses on the prevention of frailty and associated feelings of loss, rather than reinforcing the feelings and experiences which render a person ‘frail’.

Empirical studies in several disciplines including sociology, psychology and communications science have investigated images of older people in the mass media, but analyses to date have failed systematically to apply gerontological concepts and to compare the portrayal of old age with ‘real-world’ evidence. A model of older people's internal and external resources was used to assess the portrayal of older people in prime-time television drama series. Three hours of programmes broadcast over six weeks in 2001 of 32 prime-time television series on the four German networks with the largest market shares were examined. The age of 355 portrayed characters were estimated, and the socio-economic, health-related and psychological resources of the 30 characters rated as 60 years or older were assessed. Observational categories and rating dimensions were developed on the basis of the resource model. Older people were heavily under-represented, especially women and those of advanced old age. Furthermore, the representation of older people's social participation and financial resources was overly positive. Finally, older women and men were portrayed in traditional gender roles. The antecedents and consequences of the biased portrayals (of old and young people) are discussed from a psychological perspective.

Previous research has shown that mobility and the ability to leave the home are among the essential aspects of older people's quality of life. However, surveys of older people's access to transport resources and the impact of mobility on welfare and wellbeing are few. Many previous studies are based on small samples or qualitative data. The questions addressed in this paper are how transport resources are distributed among different groups of older people, to which degree the transport needs of these groups are met and how this is related to their wellbeing. The empirical analysis is based on a Norwegian nationwide survey among 4,723 respondents 65 years and older. The respondents were asked about their access to transport resources, both private and public, health problems connected to use of transport modes, their daily activities and mobility, their uncovered transport needs and the importance of different activities for their life quality. The analysis reveals great differences between groups; especially between men and women, but also between different age groups and by different place of living. The special transport offered by the local authorities is seen as insufficient, and with increasing age a great deal of older people have low mobility and an uncovered transport need that reduces their life quality.

Social isolation is a social and public health problem that affects people of all ages, especially elders. Previous studies have found that social isolation across numerous industrialised countries is associated with negative health outcomes. However, it is unknown whether and how this association differs by race/ethnicity and age. To begin to address this gap, this study examines the association of social isolation and physical and mental health among Black, White and Hispanic elders in the United States of America. Building on Cornwell and Waite's perceived isolation and social disconnectedness dimension model of social isolation, the author used multi-stage survey data from a nationally representative sample of 3,005 community-residing adults aged 57–85 from the National Social Life, Health, and Aging Project. Tests for association were conducted on health by age, gender, marital status, education and race/ethnicity separately. Multivariate logistic regressions were used to test the association of social isolation and health exclusively and separately among these three groups. Results showed that social isolation is strongly associated with physical and mental health. Both perceived isolation and social disconnectedness had a significant negative association with physical and mental health among White elders. For Blacks, social disconnectedness is negatively associated with their physical health while perceived isolation had a negative association with mental health. Among Hispanic elders, there seemed to be no association between social isolation and physical health, but a significant negative association was found with their mental health. Despite various associated patterns, however, social isolation overall was associated with health outcomes that were similar across three elder groups. By identifying factors influencing social isolation and health among minority older Americans, this study has relevance to the development of culturally sensitive health-care practice and services, which may be applicable to minority elders in different countries.

This paper traces the emergence and evolution of the concept of ageism with respect to employment matters in the UK, and challenges some features of the emerging concept as defective and undermining of efforts to eradicate age discrimination in employment. Also revealed is some loosening in recent years of the association of the term ‘ageism’ with older employees. This latter observation informed the focus of our empirical work, which examined the views of 460 Business Studies students concerning age and employment. A significant proportion had experienced ageism directly in employment, and a large majority favoured the introduction of legislative protection against age discrimination, with blanket coverage irrespective of age. Though negative stereotypes regarding older workers were by no means uncommon among the sample, little firm evidence emerged of intergenerational tensions or resentment towards older people. The concluding section considers the policy implications of our findings, including the relative merits of weighting policy responses towards older employees. It is argued that initiatives restricted in this way, and further constrained by commercial imperatives and macro-economic objectives, are likely to prove divisive and self-defeating as a means of combating ageism.

Although the loneliness of both older adults and immigrants is frequently asserted, knowledge regarding the implications of immigration for loneliness in later life is limited. In particular, little attention has been directed to the impact of factors that might differentiate individuals within the immigrant population. Using data from the 2007 General Social Survey (GSS-21) conducted by Statistics Canada, this study examined the effects of immigrant status as well as immigrant generation, length of residence in Canada and race/ethnicity on loneliness among adults aged 60 and over (N=10,553). Regression analyses (ordinary least squares) estimating both the general and age-specific effects of immigrant experience on loneliness, indicated that immigrants report higher levels of loneliness than native-born Canadians, that race/ethnicity influenced loneliness particularly among immigrants and that generational status as well as length of residence also had an impact, but one that differed across age groups. Immigration-related variables appeared less consequential for loneliness in the oldest-old (aged 80+) than in younger elderly age groups. These findings attest to the significance of immigrant status for an understanding of loneliness in later life but suggest a need to acknowledge the diversity of immigrant experiences associated with lifecourse and other factors.

The goal of this study was to explore the concepts of successful ageing held by elderly people in Taiwan. Data were obtained from the Successful Ageing of the Elderly in Taiwan survey of 2004. The sample was drawn from the population aged 65 or more years in one county in Taiwan by probability proportional-to-size sampling. The participants were asked: ‘What do you think are the essential components of an ideal and satisfactory life in old age?’ They were also asked to score the relative importance of 23 ‘successful ageing’ concepts. The replies to the initial open-ended question were grouped in six categories: physical health and independence, economic security, family and social support, engagement with life, spiritual well-being, and environment and social welfare policy. The most highly rated ‘successful ageing’ concepts were physical health, independence, living without chronic disease, living with family, and receiving emotional care. All the responses were subjected to a factor analysis, and five factors accounted for 58.7 per cent of the variance: family and social support, mastery over life, health, enjoyment of life, and autonomy. It is concluded that elderly people in Taiwan most value health and independence, and also place considerable importance on economic security and family support, which they see as inter-related. Many are also concerned about the social environment and social policy, indicating that their awareness of and participation in socio-political debates affects their quality of life.

There has been little systematic research into the design of care environments for older people. This article reviews empirical studies from both the architectural and the psychological literature. It outlines the instruments that are currently available for measuring both the environment and the quality of life of older people, and it summarises the evidence on the layout of buildings, the sensory environment and the privacy of residents. The conclusion is drawn that all evidence-based design must be a compromise or dynamic and, as demands on the caring environment change over time, this compromise must be re-visited in the form of post-occupancy evaluation.

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

The concept of age-friendly communities has garnered international attention among researchers, policy makers and community organisations since the World Health Organization launched its Global Age-friendly Cities Project in 2006. Despite the growth of the age-friendly communities movement, few studies have examined age-friendly characteristics within different community contexts. The goal of the present study was to use a participatory methodology to explore older adults’ perceptions of age-friendliness. The study employed the photovoice technique with 30 community-based older adults in one urban community and three rural communities in the province of Manitoba, Canada. Participants were provided with cameras and took photographs to illustrate the relative age-friendliness of their communities and to generate discussion in interviews and focus groups. Themes from photographs, interviews and focus groups were organised into three broad categories: age-friendly features, contextual factors and cross-cutting themes. The age-friendly features we identified in this study generally correspond to the World Health Organization domains of age-friendliness. In addition, we identified three contextual factors that impact the experiences of older adults within their community environment: community history and identity, ageing in urban, rural and remote communities, and environmental conditions. Finally, independence, affordability and accessibility were identified as cross-cutting themes that intersect with various community features and contextual factors.

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.

India, like many other developing countries in the world, is presently witnessing rapid ageing of its population. Almost eight out of 10 older people in India live in rural areas. Urbanisation, modernisation and globalisation have led to changes in economic structure, erosion of societal values and the weakening of social institutions such as the joint family. In this changing economic and social milieu, the younger generation is searching for new identities encompassing economic independence and redefined social roles within, as well as outside, the family. The changing economic structure has reduced the dependence of rural families on land, which had provided strength to bonds between generations. The traditional sense of duty and obligation of the younger generation towards their older generation is being eroded. The older generation is caught between the decline in traditional values on the one hand and the absence of an adequate social security system, on the other. This paper explores the nature and extent of the social and economic pressures that are impinging on intergenerational relationships and discusses the implications for policy towards improving the wellbeing of India’s senior citizens.

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

This paper introduces the theme of the special issue on wellbeing, independence and mobility. We begin with outlining the complexity of each of these notions and then turn towards their interdependence. It is argued that the links between wellbeing, independence and mobility are manifold and contextual in older people's everyday lives: they differ between places, between individuals and across phases in each individual's unique lifecourse. The inherent complexity of those links can be examined fruitfully and understood better if a geographical or environmental analytical perspective is adopted. We also suggest that the interdependence of wellbeing, independence and mobility in later life needs to be understood in the context of neo-liberal governmentality and the creation of particular ways of being and acting for older people. The piece concludes with a brief description of the papers brought together in the special issue.

There is growing recognition of the need for outcome measures which reflect the aims of services for people with dementia. The development and application of existing outcome measures has often marginalised people with dementia. ‘Experts’ and carers have been viewed as primary sources when identifying relevant outcomes or domains of quality of life, and proxy respondents have often been responsible for rating outcomes on the resulting measures. This paper reports a small consultation with people with dementia and their carers to identify the desired outcomes of community care. While there was considerable overlap in the outcomes identified by people with dementia and their carers, a number of limitations of relying solely on carers as proxy respondents were identified. A key outcome, which has been relatively neglected in previous work, was maximising a sense of autonomy. A range of outcomes related to the ways in which services are delivered were also identified. Future evaluative studies should encompass both quality-of-life outcomes and service-process outcomes (the impacts of the ways in which services are delivered) in addition to other outcome measures relevant to the aims and objectives of the service.

There is increasing recognition of the importance of social and cultural differences in shaping the diversity of the ageing experience in contemporary Britain. Various social and cultural factors, such as those associated with class, ethnicity, gender and disability, influence people's living circumstances and sources of support in later life. While they have been the subject of considerable speculation, ageing in a non-heterosexual context remains remarkably under-studied. This paper examines the difference that being non-heterosexual makes to how people experience ageing and later life. It draws on quantitative and qualitative data gathered for a British study of the living circumstances of non-heterosexuals aged between the fifties and the eighties. Previous work has overwhelmingly emphasised how individuals manage their sexual identities, but this paper focuses on the factors that shape the non-heterosexual experience of ageing and later life. Particular attention is paid to the relational and community contexts in which non-heterosexuals negotiate personal ageing. This not only provides insights into the specific challenges that ageing presents for non-heterosexuals, but also offers insights into the challenges faced by ageing non-heterosexuals and heterosexuals in ‘detraditionalised’ settings.

Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population.

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.

There have been fundamental changes in the intergenerational family, and yet families continue to be an important part of people's lives. We use the convoy model to describe the factors that influence supportive relations within intergenerational families, beginning with a description of the changing structure of the intergenerational family. We next outline support exchanges, detailing how personal characteristics, especially gender, race, age and socio-economic status, and situational characteristics, in particular family structure and intergenerational context, influence support exchanges. Instrumental and emotional family exchanges are described, with special attention to the unique circumstances of care-giving in intergenerational families. We also examine the importance of recognising differences in the quality of intergenerational relations, again noting the influence of personal and situational characteristics. Variations in support quality, e.g. positive, negative and ambivalent, and its influence on wellbeing are discussed. As families and individuals change, differences emerge at the individual, family and societal levels. We consider the implications of changes and stability in intergenerational relations and make recommendations about how best to envisage and plan future intergenerational family support. Societies with fewer resources as well as individuals and families with diverse individual histories must be innovative and creative in meeting the needs of older people as well as those of all family members.