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This research examines the comparative perceived income adequacy among older Swedes and older Americans. The persisting issue of ‘poverty’ and income adequacy, and the use of monetary-unit income (dollars, kroner, etc.) as a basis for determining levels of poverty or of income adequacy has severe limitations. In an attempt to simplify the problem of developing standard measures for different monetary-unit systems, i.e. between nations, this study utilises a typology of perceived income adequacy to examine, among older persons in Sweden, the extent to which they believe their incomes support a satisfying standard of living. Additionally, the research examines differences in income adequacy between the U.S. and Sweden. Results from the 1981 NCOA/Harris survey data in the U.S. are compared with findings from a representative survey of older Swedes conducted by SIFO in 1986. Among other results, it is found that for older Swedes only 20% feel financially hard-strapped, compared to 35% of older Americans. Discussion of this and other findings is included. Income adequacy of the elderly in Sweden should be of particular interest to policymakers in the U.S. because of the widely held belief that Sweden has achieved a level of income security beyond the ‘safety net’.
A comparative analysis of the life circumstances of older people in Poland and Norway is presented. It examines differences and similarities in attitudes to both family- and state-provided care, for those living in their own homes. In more prosperous Norway, public services are more frequent, elderly people are more independent and play a more active role in the labour market. In Poland formal care is seen as the last resort, with the responsibility for supporting elderly people placed firmly with the family. State services are directed towards those without families. The Norwegian system places no legal obligation on families, which results in a higher proportion living in institutions.
The focus of this paper is on the beginnings of dementia – on the grey area where normal and abnormal ageing seem to overlap, but where a diagnosis can be established. We look at a group of elderly people diagnosed as suffering from mild dementia and at the relatives most closely involved with them and whom we had assumed to be their carers. Our principal interest is in the relatives' perception of the deterioration in intellectual function, and in their awareness of and response to problems associated with it. Contrary to expectation, these relatives did not see themselves as carers, or the elderly person as demented. Spouses often saw their partner as no more disabled than themselves; and, more generally, the relationship between them often showed a high degree of reciprocity. Sons and daughters were usually aware of changes in their parents' behaviour but tended to explain them in terms of normal ageing. Improvement in the process of early identification and the creation of more appropriate services are generally seen as desirable. Questions are raised about the usefulness and justification for intervention in a situation which is not yet recognised by those involved as requiring it.
Using contributions from moral philosophy and sociology, this paper explores the decisions confronting care professionals when discharging frail elderly people from hospital. It is based on research into hospital discharge in South Glamorgan that has illuminated the nature of professional decision-making in multi-disciplinary ward meetings. Two key dilemmas are identified and examined in detail: first, the dilemma of discharging elderly people who, while thought by professionals to be incapable of looking after themselves and therefore ‘at risk’, nevertheless want to go home, and secondly, the dilemma of finding residential care for elderly people who are defined as being ‘partly sick and partly well’. Whilst the principle of autonomy may be used to support individual choice, it may also be interpreted as encouraging self-reliance, and as a way of denying a collective responsibility to elderly people's care needs. The dilemma of institutional care for the ‘partly sick and partly well’ is found to be a persisting problem, fraught with conceptual ambiguities and resource-boundary negotiations between ‘medical’ and ‘social’ care. An examination of both dilemmas serves to highlight the role of political ideology in discharge decisionmaking.