This article explores the experiences of social participation among Indigenous, migrant and older people with disabilities in Chile. While substantial evidence shows the importance of social participation in ageing policy, research on how diverse groups of older people in Latin America and the Caribbean (LAC) perceive and engage in it is limited. The article examines the participatory practices of these populations and the challenges they face in accessing and being included in their chosen spaces of engagement. Six focus groups were held with key informants from government offices and community-based organizations, and individual in-depth interviews were conducted with older people. The collected data were then analysed using an inductive content analysis approach. Findings show that several historical and structural factors influence social participation among the three studied groups, particularly their vulnerability to precarity and discrimination in the Chilean context. The dominant perspective of key informants on social participation – as a means of staying healthy, keeping busy and finding contentment – should be contrasted with the actual social, cultural and economic circumstances. Indeed, most of the older participants in this study stated that they use social participation as a means of exercising agency, as it allows them to develop significant and supportive relationships that facilitate their daily lives and provide opportunities for individual and collective empowerment. This article contributes to the development of social gerontology in the Global South by integrating diversity into research design and enhancing understanding of the conditions under which people in Chile age and participate in society.

Older people want to live at home for as long as possible and expect a system of care to enable this. This desire is also recognized in many national policies, where ageing in place with the support of informal caregivers is increasingly seen as a viable solution to institutional care. Despite this, refusal of such care at point of delivery can create further health issues for individuals as well as organizational challenges for care providers. This study aims to explore older people’s perceptions of why homecare is, or may be, refused. It builds on a quantitative study, where 18 per cent of instances of non-delivery of homecare in one major care provider in Scotland were categorized as ‘Service Refusal’. Data from a convenience sample of 17 people, aged 65 years and older, with experience of homecare, from the Greater Glasgow and Clyde area in Scotland, underwent framework analysis. In contrast to the quantitative study, this study uncovered an unexpected propensity for service acceptance; living at home was the presiding value and the main motivating factor to accept homecare, irrespective of its quality. This study provides a deeper understanding of the complexities of homecare from those who receive it, highlighting critical insights to inform governmental initiatives and homecare service providers. Allowing people to remain at home for as long as possible with appropriate and sustainable homecare should be central to national outcomes in Scotland, with the findings of this study also providing useful insights for homecare providers internationally.

Informal care for older people living with chronic life-limiting illnesses is associated with difficulties. The informal care system built around generational values and cultural norms is steadily weakening in rural Ghana because of economic challenges, migration, urbanisation, and changing family structure. In responding to this knowledge gap, we aimed to ascertain how the immediate family, extended family and community support impact on mechanisms underlying provision of informal care for older people living with chronic life-limiting illnesses. Ethnographic interviews were conducted amongst fifteen older people; fifteen informal caregivers; ten health care professionals, after participatory observations during six months of fieldwork utilised to gather the needed data. This study is guided by altruism, empathy, responsibility, self-interest, and social values theories, which provide a very significant structure to understand care relations in rural Ghana. While we find that informal care is sustained by cultural values, it is experiencing financial and human resource challenges.

Assisting older people with body care is a vital aspect of long-term care, but is often considered mundane work and unarticulated in official discourses. Exploring body care practices can offer insights into unintended effects of prevailing discourses on the lives of older people. Drawing on poststructuralist understandings of subjectification in terms of dynamic processes depending on relational negotiations, this study explores how older people dependent on body care assistance negotiate the subject positions offered within the discourses. It draws on ethnographic fieldwork (December 2020–March 2021) including participant observations of 33 body care situations in home care and two residential care homes in Denmark. It analyses three cases, revealing how assisted body care in the context of home is profoundly influenced by dominant discourses of risk, positive ageing and homeliness, subjectifying older people as being at-risk or not-at-risk. At-risk are those not active or engaged in preventing biomedical risks related to old age, non-agentic and with limited possibilities in everyday life, while an acceptance of discourses of positive ageing and homeliness subjectify older people as not-at-risk, agentic and autonomous. A strong focus on positive ageing and homeliness in body care practices paradoxically holds the potential to de-legitimize ageing processes as well as subjective experiences of declining bodies and older people’s desire for a home that is not primarily a site of medical activity. The article highlights the need to critically discuss care practices that, despite being rooted in ideals of autonomy and the home as inviolable, often undermine these ideals in paradoxical ways.

The 2024 Noto Peninsula earthquake forced many residents to evacuate to Special Needs Shelters (SNS)—facilities designed to accept individuals requiring special consideration, such as older adults and those with sensory disabilities. This case report describes a woman in her 90s with untreated cataracts and hearing loss, who was neglected and abused by her son. After evacuation, she was diagnosed with cataracts at the shelter and referred for surgery, significantly improving her vision and her ability to undertake activities of daily living. SNS can serve as a gateway to medical services for those deprived of adequate health care. Integrating medical services into disaster response plans and deploying professionals at these shelters is crucial for improving health outcomes and quality of life for vulnerable individuals. This case highlights how appropriate shelter services with seamless medical care connections can enhance evacuees’ long-term well-being beyond the immediate disaster response.

Reforms to the means tests in England for state-financed long-term care were planned for implementation in 2025. They included a lifetime limit (cap) on how much an individual must contribute to their care, with the state meeting subsequent care costs. We present projections of the costs and distributional impacts of these reforms for older people, using two linked simulation models which draw on a wide range of data. We project that by 2038 public spending on long-term care for older people in England would be about 14% higher than without the reforms. While the main direct beneficiaries of the lifetime cap would have been the better off who currently receive no state help with their care costs, the reforms also treated capital assets more generously than the current system, helping people with more modest incomes and wealth. When analysing the impacts of the reforms it is therefore important to consider the whole reform package. Our results depend on a range of assumptions, and the impacts of the reforms would be sensitive to the levels of the cap and other reformed parameters of the means test on implementation.

The aim of this study was to explore the perspectives of older medicinal cannabis consumers and those advising them on older Canadians’ experiences accessing cannabis and information about it, as well as how stigma may influence their experiences. A concurrent triangulation mixed methods design was used. The design was qualitatively driven and involved conducting semi-structured interviews with older adults and advisors and developing a survey for older adults. We used a Qualitative Descriptive approach for the analysis of qualitative data and descriptive statistics for quantitative survey data. Findings demonstrate that many older adults are accessing information about cannabis for medical purposes from retailers, either because they are reticent to talk to their healthcare professionals or were rebuffed when bringing up the subject. We recommend cannabis education be required for healthcare professionals working with older persons and that future research examines their perspectives on medicinal cannabis and older adults.

Objective: Uncoupled sleep is a phenomenon characterized by a discrepancy between sleep patterns and sleep complaints. This study aimed to evaluate the effect of sleep report feedback utilizing information and communication technology combined with health guidance on improving subjective and objective sleep outcomes in community-dwelling older people with and without uncoupled sleep.

Methods: This study was conducted in Sakai City, Japan. The Athens Insomnia Scale (AIS) was employed to evaluate subjective sleep outcomes. Participants were categorized as complaining sleepers if they reported their overall sleep quality as markedly or very unsatisfactory, in addition to having a total AIS score ≥10. Non-wearable actigraphy devices were placed under participants’ bedding to continuously measure their objective sleep outcomes. Sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE) parameters were recorded. Participants were classified as poor sleepers if their actigraphy-measured SL was ≥31 min or SE was＜85%, or WASO was ≥31 min. All measurements were taken prior to and following a 3- month intervention program.

Statistical analysis was conducted using SPSS Version 26. This study received approval from the Institutional Review Board of Osaka University.

Results: A total of 105 participants completed the study, with 65 females (62%). Among them, 8 were complaining good sleepers, 12 were complaining poor sleepers, 42 were non-complaining good sleepers, and 43 were non- complaining poor sleepers. Improvements in subjective sleep quality were observed across all sleeper classifications (P < 0.05). Specifically, subjective SL (P = 0.009) and WASO (P = 0.023) improved in complaining poor sleepers without uncoupled sleep. Objective and self-reported changes in sleep parameters were demonstrated in non- complaining poor sleepers with uncoupled sleep, specifically manifested as improvements in objective WASO (P < 0.001), SE (P < 0.001), andsubjective sleep quality (P = 0.038). However, there were no significant changes in objective sleep outcomes among complaining good sleepers, non-complaining good sleepers, and complaining poor sleepers (P > 0.05).

Conclusion: The implementation of sleep report feedback and health guidance intervention for community- dwelling older people has demonstrated improvement in subjective sleep quality across all sleeper classifications. Furthermore, it shows promising effects on non-complaining poor sleepers with uncoupled sleep, as evidenced by both objective and subjective sleep measures.

Reducing loneliness amongst older people is an international public health and policy priority, with signs of decreasing importance in the UK. A growing body of research on tackling loneliness indicates it is a complex challenge. Most interventions imply they address loneliness, when in fact they offer social connectedness to address social isolation and can inadvertently responsibilise the individual for the causes and solutions for loneliness. This article presents research that explored loneliness in an underprivileged community in South Wales through interviews and focus groups with nineteen older people and eighteen local service providers. Their perspective supports a growing body of evidence that loneliness amongst older people is driven by wider structural and socio-cultural exclusion. Interventions to build social connections will be more effective if coupled with policies that reverse the reduction in public services (including transport and healthcare), and challenge socio-cultural norms, including a culture of self-reliance and ageism.

To explore the associations between nutrition literacy (NL) and possible sarcopenia in older Chinese adults. A cross-sectional study was conducted. NL was assessed using a twelve-item short-form NL scale. Possible sarcopenia was identified using SARC-CALF. Logistic regression was used to calculate OR and 95 % CI for NL and the incidence of possible sarcopenia. A total of 1338 older individuals, aged 71·41 (sd 6·84) years, were enrolled in this study. After confounders were adjusted for, older adults in the upper quartile of NL were found to be 52 % less likely to have possible sarcopenia than those in the lower quartile of NL (OR = 0·48, 95 % CI: 0·29, 0·77). The associations between NL and possible sarcopenia were present only in those who lived in rural areas (OR: 0·38, 95 % CI: 0·19, 0·77), had a primary school education or less (OR: 0·21, 95 % CI: 0·09, 0·48), had a monthly income < 3000 RMB (OR: 0·39, 95 % CI: 0·22, 0·70) and had chronic diseases (OR: 0·37, 95 % CI: 0·22, 0·63). Moreover, an interaction effect was observed between having a chronic disease and junior high school education and being in the upper quartile of NL. The prevalence of possible sarcopenia in older Chinese adults is substantial, with prevalence decreasing with increasing NL. Moreover, the association between NL and possible sarcopenia varies by residence type, education level, monthly income and chronic disease experience. Targeted NL interventions are required to prevent and manage sarcopenia in older adults, particularly those with low socio-economic status and chronic diseases.

As the population of Aotearoa New Zealand ages, informal family carers will play an increasingly important role in caring for older adults at home. Multi-generational living arrangements are a growing trend, particularly among Māori communities, where caring for older relatives within the family home is widespread. This article uses in-depth, semi-structured interviews with Māori whānau (extended family members) caring for kaumātua (older family members) at home to explore how carers experienced care coordination in the broader care collective. The findings centred on three interconnected factors that described the collective organisation of care: (1) whānau care as normal; (2) whānau care as collective coordination; and (3) whānau carer knowledge and needs as unseen. The findings show that although whānau care of kaumātua is highly valued, ‘structural holes’ within care systems contribute to challenges in care coordination. Despite extensive whānau support for kaumātua, primary carers often felt that their knowledge, preferences and self-care needs remained unseen and not translatable to those outside the everyday care situation. Rather than assuming an artificial binary difference between ‘collective’ and ‘individually oriented’ care contexts and cultures, analysing the cultural norms surrounding whānau care-giving confirms that collective care system members face similar and different challenges to carers with smaller caring capacities.

Frailty is a common but complex phenomenon that is approached from theoretical and professional perspectives but rarely from the perspectives of older people and their essential stakeholders. Different or opposing perspectives on frailty at personal, organisational, and community levels can negatively affect care for frail older people. This systematic integrative review synthesises the perspectives on frailty of older people, health/social care professionals, informal caregivers, managers and policymakers, using thematic analysis. We use the Joanna Briggs Institute–Critical Appraisal Checklist to appraise the quality of 52 qualitative and mixed-method studies drawn from the PubMed/MEDLINE, CINAHL, PsycINFO, Embase, and Web of Science databases (inception–December 2023). Of these, 33 include the perspectives of older people, 27 of health/social care professionals, four of managers, and six of informal caregivers. Structuring the perspectives along six themes – ‘the multi-dimensional nature of frailty’, ‘the dynamics of frailty’, ‘the complexity of frailty’, ‘frailty in relation to age’, ‘frailty in relation to health’ and ‘frailty in relation to dependence’ – revealed substantive similarities in the conceptualisation of frailty between older people and professionals, e.g. regarding frailty’s dynamic and multi-dimensional nature. However, older people and professionals differ in their interpretations of frailty: older people take a personal view, while professionals take a more practical view. The identified discrepancies in perspectives may affect care relationships and care for frail older people. Therefore, we advocate a systems approach that incorporates multiple perspectives to form a comprehensive view of frailty and allows for a situation-specific shared understanding of frailty in older people.

Personality disorders can worsen with age or emerge after a relatively dormant phase in earlier life when roles and relationships ensured that maladaptive personality traits were contained. They can also be first diagnosed in late life, if personality traits become maladaptive as the person reacts to losses, transitions and stresses of old age. Despite studies focusing on late-life personality disorders in recent years, the amount of research on their identification and treatment remains deficient. This article endeavours to provide an understanding of how personality disorders present in old age and how they can be best managed. It is also hoped that this article will stimulate further research into this relatively new field in old age psychiatry. An awareness of late-life personality disorders is desperately needed in view of the risky and challenging behaviours they can give rise to. With rapidly growing numbers of older adults in the population, the absolute number of people with a personality disorder in older adulthood is expected to rise.

The aim of this article is to critically review the scientific literature about the changes in travel behaviour and mobility amongst older adults caused by the COVID-19 pandemic across various countries, identify unmet travel needs and highlight patterns of inequalities in older adults’ mobility. We have collected articles from four academic databases: PubMed, Scopus, Transportation Research International Documentation (TRID) and Web of Science. Papers were considered for inclusion if they were published online in 2020 or later, written in English, and referred to urban or rural changes in travel behaviour and mobility of older adults over 50 years old. We examined the pre-existing models developed before the outbreak and classified the articles based on Musselwhite and Haddad’s hierarchy of older adults’ travel needs. The synthesis of the selected 25 articles shows a general decline in literal mobility amongst older adults, an increased share of virtual travel and their decreased capacity to fulfil different levels of travel needs. Findings also indicate an increased gap in older adults’ mobility across geographical regions with various levels of transport infrastructure and digital capital. We conclude the paper with the lessons learned, the opportunities ahead, and the challenges that must be overcome to achieve sustainable development and the United Nations Decades of Healthy Ageing goals in the post-pandemic world.

Visual representations of aging have historically relied upon binarized clichés: idealized youthfulness versus frailty and illness. To challenge these oversimplified depictions, graduate students developed a community outreach project titled ‘Seniors of Canada’. The aim of this project was twofold: (1) share images and stories of people in later life; and (2) challenge dominant narratives and stereotypes of aging. In this note, we outline the prevailing discourse of what aging ‘looks like’, how we collected stories and images, and implications for knowledge mobilization and research in Canada. This article highlights insights gained since the inception of the project, including three key learnings: (1) Building bridges across academia and community, (2) Intergenerational connection and digital tools, and (3) The power of visual storytelling. We provide a practical overview of a successful knowledge mobilization/community outreach project and showcase the power of bridging academia and community for social change.

This article explores the temporalities experienced by persons aged 70 years and over during the first months of the COVID-19 pandemic in Finland. Although the temporalities of the pandemic have been analysed from multiple perspectives, we contribute to this line of research in two ways. First, we show how deeply the pandemic affected older people's experiences of temporality. Second, we further develop the concept of forced present to highlight the consequences that the restriction measures had on older persons’ situations and perceptions of temporality. More specifically, we asked the following question: How did older people perceive time (past, present and future) during the pandemic? We used thematic analysis to examine a dataset consisting of written letters (N = 77) collected between April and June 2020. The findings showed that social isolation forced older people to live in the present without being able to plan their near future because they had no knowledge of when they would be ‘free’ again, which made some participants feel anxious and depressed. Furthermore, we found that the present became intertwined with the personal past as well as with the collective past, as evidenced by participants’ descriptions of war, previous pandemics and hardships. This article deepens our understanding of older people's everyday lives during the pandemic and highlights the problematic nature of social isolation of older people as a safety measure. Overall, this article reveals the particularity of older people's experiences in unequal pandemic times and the ageism inherent in the restriction measures.