Little is known regarding the ways in which practitioners’ views and approaches impact support for persons with a migration background (PwM) caring for individuals with dementia. This paper responds to this knowledge gap by identifying how practitioners frame dementia care in families with a migration background, and how these frames can be understood in light of the experiences of PwM caring for a family member with dementia. A total of 41 participants were included: ten practitioners (i.e. health and social care workers) and 31 PwM caring for a family member with dementia. All participants were part of a qualitative research project on dementia care in Dutch families with a migration background. Practitioners’ expressed frames were identified through Hochschild’s interpretive framework of ‘framing and feeling rules’. Thereafter, practitioners’ identified frames were related to the care experiences of PwM caring for a family member with dementia. Findings indicate that practitioners operate within an approach that does not sufficiently take into account the uniqueness of each family carer. This leads to frictions within the practitioner–client relationship. We thus highlight the need for discussions about the tenability of practitioners’ views and approaches in an increasingly globalised and diverse society.

International migrants face barriers when accessing health-care in their destination countries. For older migrants, there are additional difficulties due to their age and associated health conditions. Chinese migrants are an understudied group with culture-specific barriers in addition to those shared with other migrant groups. This review aims to understand the barriers and facilitators to health-care access faced by older Chinese migrants in high-income countries. Literature from MEDLINE, Web of Science, EMBASE, Scopus, CINAHL Plus and ProQuest (1 January 2000 to 6 October 2021) were retrieved. Quantitative, qualitative and mixed-methods studies focusing on older Chinese migrants’ access to, utilisation of and satisfaction with health-care services in high-income countries were included. Studies were appraised using checklists from the Joanna Briggs Institute and the Critical Appraisal Skills Programme. Qualitative and quantitative data were extracted and analysed narratively to identify barriers and facilitators to accessing health-care, then applied to Levesque’s five-step health-care access journey framework. We included 33 studies in the analysis. Qualitative evidence identified barriers and facilitators to health-care access in four categories: health-care system, social factors, personal factors and health-care interactions. Quantitative studies found that health status and having insurance were positively associated with using non-preventive care, while time of residence and physician’s recommendations were positively associated with using preventive care. Factors that influence older Chinese migrants’ access to health care include practical barriers (communication, time and cost), social support (family and community), perceptions of health and care needs (beliefs and knowledge) and interactions with health-care professionals (patient–physician trust and support from physicians). Efforts to overcome universal barriers, acknowledgement of cultural contexts, improvements in translation services, and involvement of Chinese families and communities in health-care outreach will benefit this population.

Late-life divorce is a growing phenomenon in the Western world, likely to expand due to increasing expectancy and changes in marital and family values. However, existing research on divorce and its consequences for offspring focuses on young and middle-aged adults, analysing individual rather than familial/dyadic perspectives. Accordingly, our study employs a holistic perspective on the family unit following late-life divorce which is especially relevant to societies that value familism as an essential element in individuals' lives. Coincidingly, the term familyhood expresses an atmosphere of closeness and unity among family members and is a commonly used expression in Israel. Using family systems as a framework, our aim was to examine how, if at all, familyhood is experienced after divorce considering how it was experienced prior to divorce from a long-term marriage in Israel. Semi-structured, in-depth qualitative interviews (N = 72) were conducted separately with divorcees aged 60–81 who divorced at age 56–68 (N = 44), and with their adult children aged 19–40 at the time of their parents' divorce (N = 28). Interviews were given thematic analysis and dyadic qualitative analysis. The findings reveal the meaningfulness of familyhood following late-life divorce via a fourfold typology of familyhood continuity/change experienced as present or lacking, before or after divorce. The typology addresses key elements of when, where, by whom and how familyhood is reconstructed, along with strategies to maintain familyhood. Paradoxes inherent in the intersection of divorce and familyhood, discussed within the Israeli sociocultural context, are located between self-determination and familism. Implications are presented.

The COVID-19 global pandemic had a major impact on older people's mental health and resulted in changes in alcohol use, with more older adults increasing than decreasing consumption levels among the general population. So far, no studies have focused on older people who were already experiencing problem alcohol use. This qualitative research is the first to provide a nuanced understanding of changes to drinking patterns among older adults engaged in alcohol treatment during the COVID-19 pandemic, and the implications of these for practice. We conducted 30 semi-structured interviews with people in alcohol treatment aged 55+ living in urban and rural areas across the UK. Data were analysed using thematic analysis. We found that changes in alcohol use varied depending on the social, economic and health impacts of the pandemic on older adults. Boredom, lack of adequate medical or emotional support, and key life changes experienced during the pandemic (such as bereavement or retirement) increased the risk of increased drinking. Moreover, some people in longer-term alcohol treatment were struggling to maintain abstinence due to lack of face-to-face peer support. For others, decreased drinking levels were a side-effect of lockdown policies and restrictions, such as alcohol-related hospitalisations, closure of social spaces or inability to source alcohol; these also supported those who decided to cut down on drinking shortly before the pandemic. Generally, older adults who developed home-based interests and self-care practices managed lockdown best, maintaining abstinence or lower risk drinking levels. Based on these results, we argue that multilevel interventions aimed at strengthening resilience are required to reduce drinking or maintain abstinence among older adults. Such interventions should address three domains: individual (coping strategies and mindset), social (support networks), and structural (access to resources). In preparation for supporting older alcohol users through prospective future pandemics, building digital literacy and inclusion are essential.

Rapid demographic changes and heavy reliance on informal care pose significant challenges to meeting long-term care (LTC) needs in China. Understanding changes in unmet LTC needs across different times and places can inform future LTC system planning and care resource allocation, identifying emerging care needs and services gaps in different regions. Drawing on data from 6,030 urban and 5,070 rural residents in the Chinese Longitudinal Health Longevity Survey 2005–2017/18, this study investigates variations in unmet LTC needs across different age groups, periods and birth cohorts among Chinese older adults and their place-based rural–urban differences. We applied the age-period-cohort interaction model to disentangle the three temporal processes, and found that, overall, rural older adults experienced higher risk of unmet LTC needs and had larger variation in age effects, yet the age, period and cohort effects on unmet needs among rural older people differed from their urban counterparts. Although ‘younger’ older adults (aged below 85) had fewer care needs than older adults, they had a higher risk of experiencing unmet needs. The risk of having unmet needs did not change significantly over the 12 years, though unmet LTC needs were more pronounced among more-recent cohorts than previous generations, especially in urban areas. The findings contribute to the social gerontology debate regarding changing patterns in unmet LTC needs, and provide crucial policy insights, underscoring the necessity of targeted interventions to address ‘younger’ older adults’ care needs and increased investmed in the formal LTC system to tackle the escalating care gap.

This paper considers how a diagnosis of dementia affects people's planning for future social care needs and associated costs. It addresses the gap in knowledge about how people recently diagnosed with dementia, and their family carers, engage with planning for social care needs that are uncertain in timing and scale. The paper also considers people's attitudes to planning for care that they may need to pay for privately, and what facilitates or hinders acting on such plans. We conducted and undertook thematic qualitative analysis of 39 in-depth interviews with 27 people newly diagnosed with dementia and/or their carers over a two-year period. Topics included current care and support, planning and co-ordinating care, paying for care, and expectations and planning for the future. The research took place in England. Our findings indicate that whilst people recognised they would have future care needs, with associated financial implications, this knowledge did not necessarily translate into actively planning for care or its cost. A key reason that recognition did not translate into action was uncertainty, manifested in three areas: the timescales and trajectory of their dementia and thus need for care; the potential for care needs to change and so negate care planning efforts; and uncertainty over their own capabilities to plan for and access paid-for care, given the perceived complexity of social care and associated financial arrangements. The paper discusses how anticipated regret may affect decision-making and contributes to debates about appropriate professional support for older self-funders with dementia. It suggests the task for those involved in the care of people with dementia is to identify the points and places in the care system where worries about future self-funded care can be addressed, and carers and the people they care for can be prompted and supported to act.

There is a lack of comparative and quantitative research on how poverty manifests itself in the economic wellbeing of older people across European countries. In this study, we focus in on two central dimensions of economic wellbeing: the ability to pay for usual expenses and unexpected expenses. Our aim is to find out how often older people living at risk of poverty experience hardship on these dimensions, how these dimensions overlap, and whether the incidence of hardship differs between the poor and the non-poor. The study is based on the cross-sectional component of the European Union Statistics on Income and Living Conditions (EU-SILC) 2018 survey, involving 29 countries and 148,432 respondents aged 65+ years. The analysis builds on both descriptive statistics and multinomial logistic regression, which takes into account differences in household characteristics between the poor and the non-poor. The results reveal that for the poor, meeting unexpected expenses is a more common problem than meeting usual expenses, although they typically experience hardship on both dimensions. Hardship among the poor is more frequent in Central Eastern and some Southern European countries, while poor people living in Continental and Nordic countries tend to fare better, even though relatively large numbers in these countries lack cash margin. The non-poor do also experience hardship, but to a lesser extent. The poor experience combined hardship relatively often in Continental European countries. Based on the results, we conclude that studies should pay closer attention to the different dimensions of economic wellbeing in old age.

Until now, the body image literature has largely ignored older men. In particular, little is known about how older men perceive and experience their ageing bodies, despite the importance of the body to men's practice of masculinity and their position within gendered hierarchies. Addressing this gap in the research, we conducted 15 in-depth interviews and ten focus group discussions (N = 60) with older men aged 60–82 years. Drawing upon the intersectionality approach and Bourdieu's theory of practice, we examined how older men with low socio-economic status give meaning to their ageing bodies in relation to ideals of masculinity. The findings suggest that body strength is vital capital for older men with low socio-economic status, and that changes in their bodies as they age affect their ability to actualise themselves as ‘real’ men and undermine their sense of masculinity. The inability to live up to masculine ideals left most of these men feeling inadequate and ashamed. The findings further reveal that stress caused by ageing bodies, exacerbated by older men's socio-economic conditions, constituted a threat to their survival and overall wellbeing. Interventions should take older men's perceptions of and adaptations to the ageing body into account. In addition, when designing interventions for older men, practitioners should consider the socio-economic and cultural context in which older men are embedded. Particularly important is a gender-transformative intervention that raises awareness of negative masculine norms.

Understanding the process of seeking long-term care (LTC) in old age helps identify what contributes to delays and inequalities in accessing it. Current research highlights the roles of individual and policy factors, but pays little attention to how these factors interact. This qualitative study aims to fill this gap by identifying facilitating factors and mechanisms in the initial approaches to LTC policies. It examines care-seeking in two towns in northern Italy, where a demand-based approach, high fragmentation and poor coordination pose significant challenges. In a bottom-up approach to policy implementation, the experiences and perspectives of both care-seekers and professionals are integrated. Indeed, the data collection (April 2023–May 2024) triangulates 100+ hours of participant observation and semi-structured or vignette-based interviews. The study finds that care-seeking entails three interrelated steps: recognising care needs, being willing to receive LTC, and reaching an entry point. At each stage, three mechanisms operate at intrapersonal and interpersonal levels and can be promoted by LTC policies to facilitate care-seeking, especially for those experiencing barriers. The mechanisms are (1) taking the initiative to raise awareness of care needs and share information about available solutions; (2) fostering trust between professionals and care-seekers, who often rely on confidential relationships to discuss care arrangements; and (3) combining primary information with tailored guidance on the local offer, enabling care-seekers to make informed decisions. The findings provide actionable insights into policies and practices that facilitate care-seeking, and offer a conceptual framework that explains the driving factors behind this process and its mechanisms.

Discourses and how they construct policy ‘problems’ delimit ‘solutions’, including the scale, shape and structure of services. This article discusses how the adult social care sector in England is presented as a policy problem, with the greater use of technology the associated ‘common-sense’ solution – both to the ‘crisis of care’ in a society with an ageing population and as a means to stimulate the national economy. It draws upon critical discourse analysis to examine English policy documents and other government texts published between 2020 and 2022. In doing so, it de-objectivises and de-universalises semiotic claims around care and technology and explores omitted alternatives. In discourse, ageing and care are framed as both problems to be solved and opportunities for entrepreneurship. Technologies are bound together with efficiency, with limited exploration of how use of the former necessarily entails the latter. Technology is, in addition, presented as agentic, inevitable and unassailable, closing off debates as to whether other, less seemingly ‘innovative’ options for reform and change could entail more favourable outcomes. Discourse thus limits the role of the state to stimulating the environment required for technological advancement.

Although many positive social changes have been achieved over the past 30 years, members of LGBT, Sistergirl and Brotherboy communities continue to encounter negative experiences with health and ageing service provision. In this article, 232 responses from a survey exploring ageing and care concerns and preferences among LGBT, Sistergirl and Brotherboy communities in Australia were analysed using chi square analysis. The largest proportion of participants were aged 55–64 years (26.4%, n = 61), with the majority residing in metropolitan regions (67.7%, n = 154). The three most frequently selected gender identities were cisgender woman (40.1%, n = 93), cisgender man (39.7%, n = 92) and non-binary (11.6%, n = 28). The three most frequently selected sexual orientations were gay (39.2%, n = 91), lesbian (32.0%, n = 77) and queer (17.7%, n = 41). While many concerns demonstrated no age-related differences, concerns regarding physical differences, respect and inclusion, finances and standard of care reflected higher levels of concern among younger participants compared with older participants. Preferences for receiving information reflected a desire for LGBT, Sistergirl and Brotherboy communities-specific resources for options for support from participants approaching retirement, that is, aged 55–64 (x2 (5, n = 178) = 11.08, p = 0.050); less desire for information provided through public health service services among participants aged 65+ (x2 (5, n = 178) = 15.58, p = 0.008); and variation in preferences regarding supports provided by LGBT, Sistergirl and Brotherboy communities. Results suggest that different generations of LGBT, Sistergirl and Brotherboy members may prefer to receive services and information in different ways. Further research is needed to understand how concerns, expectations and preferences are influenced across generations.

Involuntary retirement has negative effects on an individual’s health and satisfaction with life. However, it remains unknown whether the recent European policy shift from early retirement towards extending working lives has impacted retirement voluntariness.

This study examines how socio-demographic factors affect retirement voluntariness, which is classified as ‘involuntary’ (e.g. being laid off), ‘voluntary’ (e.g. wanting to spend more time with family) or ‘regular’ (e.g. reaching the state pension age). The analysis is based on SHARE data (Survey of Health, Ageing and Retirement in Europe), covers ten European countries and differentiates between two retirement cohorts (1994–2004 and 2005–2015) during which the policy shift took place.

At the individual level, we find that gender and socio-economic status correlate with retirement voluntariness. At the company level, the sector of employment and job tenure also show an association with retirement voluntariness. The results indicate that, between the two cohorts, the share of those who experience their retirement as ‘regular’ has increased, while the share with ‘involuntary’ retirement has decreased. However, these shifts differ by educational groups, with a stronger increase of voluntary retirement for those with high education, suggesting a rise in social inequalities in retirement-transitions, likely owing to an accumulation of (dis)advantages over the lifecourse.

Purpose in life has been found to decline from middle to later life in several ageing studies. Because the decline has negative impacts on health-related outcomes, it is important to identify factors contributing to purpose in life to enhance wellbeing among the ageing population. This study first examined the role of subjective social economic status (SSES) in the relationship between age and purpose in life. Subsequent analyses estimated whether the construct Artistic Creativity as a Source for Meaning in Life (ACASMIL) played a role in cultivating purpose in life among ageing individuals. Moreover, the analyses determined whether this effect was strengthened by creative self-concept (i.e. self-conviction about personal identity and self-efficacy in the global domain of creativity). Results from a sample of 224 individuals from middle to third age (mean age = 54.08, standard deviation = 10.08, range = 40–84) revealed that the relationship between age and purpose in life was only positive among those with relatively high SSES, controlling for gender and country of residence. Controlling for gender, country of residence, age and SSES, it was found that ACASMIL did not play a mediator role. Moreover, creative self-concept played a moderator role in the relationship between artistic creativity and ACASMIL. However, this moderation effect of creative self-concept was negative. Implications and suggestions for future directions are discussed.

Issues of ‘disability’ and ‘ageing’ are usually approached separately in theorising, activism and policy making. Yet people with disabilities age and many people will experience disability if they live long enough. Human rights approaches to disability enshrined in the UN Convention on the Rights of Persons with Disabilities (CRPD) are not often applied to older people experiencing disability. This article presents findings of a systematic qualitative analysis of reports made by 28 European states to the UN Committee on the Rights of Persons with Disabilities, the independent body that monitors CRPD implementation, focusing particularly on Article 19 CRPD (‘Living independently and being included in the community’). While states’ reports refer to older people or ageing in different contexts, their approach can be characterised as ambivalent. Reports tend to constitute older people experiencing disability as ‘older’ rather than ‘disabled’; they do not demonstrate a thorough engagement with disability experienced in older age, and display a limited focus on people ageing with lifelong disability. Several reports detail exclusions of ‘older people’ from disability supports to live in the community and some exclude impairments associated with ageing from definitions of what ‘disability’ is. The reports provide almost no evidence of consultation with organisations working on ageing. The article concludes that while the CRPD’s potential to contribute to realising rights for older people with disabilities is under-recognised among scholars and non-governmental organisations, the fact that states refer to older people in their reporting under the CRPD provides a starting point for more engagement.

Average lifespans for people with physical disabilities are increasing; yet there is limited knowledge about their perceptions of what it means to age well. The criteria for Rowe and Kahn’s influential model of successful ageing effectively preclude people ageing with a long-term disability. Several authors have attempted to develop more-inclusive models of successful ageing. The aim of this study was to explore what successful ageing means for people ageing with either spinal cord injury (SCI) or post-polio syndrome (PPS). We used an emic-based methodology, and recruited from Australia 17 participants aged 40–78 years. Nine participants (one male, eight female) had acquired poliomyelitis in childhood and experienced PPS, and eight participants (seven male, one female) had acquired an SCI 15 or more years ago. We used semi-structured interviews to elicit participants’ views on the dimensions important to ageing successfully with a disability, and analysed the transcripts using inductive thematic analysis. We identified eight themes, which related to: (1) maintaining physical health, (2) retaining cognitive abilities, (3) a sense of safety and security, (4) being treated with fairness and respect, (5) positive psychological resources, (6) independence and autonomy, (7) social engagement and participation in community and (8) a sense of purpose. We used the findings to construct a multi-dimensional successful ageing model for those ageing with SCI or PPS. The model includes insights from lay perspectives that further illustrate the role broader society plays in supporting or hindering individuals to age successfully, and has implications for health-care and government services.

High-quality intergenerational relationships positively influence cognitive functioning in older parents. However, there is insufficient information on how they shape the trajectories of mothers’ and fathers’ cognitive functioning decline in multi-child families, owing to the complexity of intergenerational relationships, such as multi-dimensional and ambivalent natures and differences varying across children. Drawing on three waves of data (2014, 2016 and 2018) from a nationally representative survey – the China Longitudinal Ageing Social Survey (N = 9,404) – we used the k-means clustering method to discern patterns of intergenerational relationships in multi-child Chinese families, as well as the growth curve models, to examine the associations between parent–child relationship types and the trajectories of older parents’ cognitive functioning. Five types of intergenerational relationship were identified: alienated, stressfully interacting, independent, beneficially interacting and tight-knit. We then investigated the associations between trajectories of cognitive functioning and the most distant type, the closest type, and the heterogeneity of parent–child relationships across multiple children. The most distant parent–child relationship was significantly related to cognitive functioning trajectories with the alienated (tight-knit) type associated with the lowest (highest) levels of cognitive functioning and the fastest (slowest) cognitive decline. However, the closest parent–child relationship was not significantly related to cognitive functioning trajectories. Moreover, greater variation in relationships with multiple children was correlated with lower levels of cognitive functioning and faster cognitive functioning decline. These associations were stronger among mothers than fathers. This study provides new insights into the potentially protective role of intergenerational relationships in older parents’ cognitive functioning and their gendered differences.

Loneliness and social isolation among older adults are emerging public health concerns. Older adults from ethnic minority communities or with immigration backgrounds may be particularly vulnerable when encountering loneliness and social isolation due to the double jeopardy of their old age and minority status. The goal of this study is to conduct a scoping review of published journal articles on ethnic minority/immigrant older adults’ loneliness and social isolation experiences to show the extent, range and nature of empirical studies in this area across several high-income countries (i.e. European countries, United States of America (USA), Canada, Australia and New Zealand). This review uses Arksey and O’Malley’s five-state framework, a well-established scoping review method. We identify and analyse 76 articles published between 1983 and 2021. This evidence base is largely US-focused (54%) with the vast majority (76%) having a quantitative design. We summarise and map factors of loneliness and social isolation into a multi-dimensional socio-ecological model. By doing so, we show how ethnicity/immigration-specific factors and general factors intersect in multiple dimensions across places and time, shaping ethnic minority/immigrant older adults’ heterogeneous experiences of loneliness and social isolation. Several critical gaps that should be at the forefront of future research are highlighted and discussed.

Previous research has demonstrated that family transitions, specifically births and deaths of preceding and following generations within families, are associated with individuals’ later-life wellbeing and health. However, lifecourse, family systems and role theories suggest that this relationship might be complex because, as individuals age, they can experience multiple such events and their effects might be interconnected. Therefore, this study asks whether and how transitions into and out of multiple intergenerational family roles are associated with later-life wellbeing and health. We account for the occurrence, timing and ordering of the parents’ death and the birth of the first child and grandchild. To this end, we use the concept of ‘generational placement trajectories’. They capture the vertical position of individuals in their intergenerational family over age and reflect the changing family roles and kinship reservoir of individuals across their lifecourse. Applying sequence, cluster and regression analyses to data from the German Ageing Survey (N = 3,617), we investigate associations between generational placement trajectories from birth to age 60 and four dimensions of later-life wellbeing and health, namely life satisfaction, depressiveness, functional limitations and physical health problems. Results support, first, the notion of salutary effects of a larger kinship reservoir and multiple social roles in the family and, second, indicate that ‘off-time’ transitions are associated negatively with various later-life wellbeing and health outcomes. Importantly, the effect of temporal deviations from the ‘normative’ family lifecourse might be affected by individual socio-economic differences. We enhance previous research by demonstrating that the occurrence, timing and ordering of transitions into and out of multiple kin relations and family roles across the lifecourse relate to individuals’ later-life wellbeing and health.

Scholars have not yet explored the relationship between community social capital and self-rated health (SRH) among older adults in China in depth, including potential moderators in this relationship. In response to this gap, this study aimed to investigate the association between community social capital and SRH among urban Chinese older adults and the moderating roles of instrumental activities of daily living (IADLs) and smoking. We used a quota sampling method to recruit 800 respondents aged 60 years and older from 20 communities in Shijiazhuang and Tianjin, China. SRH was used as the dependent variable. Binary logistic regression models with interaction terms were used to analyse the data. The results showed that trust (a cognitive social capital indicator), volunteering (a structural social capital indicator) and family social capital were significantly associated with SRH when controlling for other social capital indicators and covariates. Difficulties with IADL and smoking significantly moderated the association between community social capital and SRH. Cognitive social capital was only positively associated with SRH health among respondents who did not experience difficulty with IADLs. The positive association between citizenship activities and SRH was only significant among those who experienced difficulty with IADLs. The number of organisational memberships was negatively associated with SRH among respondents with a history of smoking. Volunteering was positively associated with SRH in respondents with a history of smoking. These findings highlight the important role of social capital in promoting SRH among older adults in urban areas of China and notably identify within-population heterogeneity in the associations between social capital and SRH. This study offers insights useful for developing social capital policies and interventions to meet the specific social needs of older adults with varied levels of difficulty with IADLs and health behaviours.

This exploratory qualitative study aimed to evidence how community-based gardening groups can be used to support the psychological, physical and social health of those living with dementia. The views of people living with dementia in the community, care partners and group leaders were sought to better understand the benefits gained from gardening groups, as well as the features of gardening groups that are cited as enabling positive outcomes. Going beyond the existing single-group studies in this area, this research aimed to identify common themes across multiple gardening groups. Semi-structured interviews were conducted with six group leaders, three people living with dementia and ten care partners from seven gardening groups, either in person or remotely. Thematic analysis of the interview transcripts highlighted broad enablers – ‘the garden setting’, ‘features of activities’ and ‘organisational components’ – that were cited as facilitating a range of positive wellbeing outcomes, creating an environment that provides ‘physical and cognitive benefits’, ‘affirmation of identity’, ‘social connection’ and ‘benefits for care partners and others’. The wide-ranging benefits and enablers cited by participants within this research support the use of gardening groups as community-based interventions to reinforce positive psychological, physical and social outcomes for people with dementia. Themes also provide a clear framework for the design, implementation and evaluation of future gardening groups.