The living arrangements of older people are changing. An analysis of official registration data (1993–1998) in Flanders, Belgium, shows that while the number of single person households has been increasing, the proportion of people aged 75 or more years living alone has been falling and the proportion living with a spouse or partner increasing. No less than one third of the older people who lived alone in 1993 sustain a one-person household into very old age. It was also found that those who are widowed at a very advanced age change house or move very quickly, women to a greater extent and at younger ages than men. The principal destinations are residential care homes and, to a lesser extent, child's households. Living alone appears to be a decreasingly acceptable option. Since very old people with a disability appear to have an increasing preference for residential care and a lessening preference for co-residence with relatives, these developments have consequences for both informal family care and public social services. Particular attention needs to be paid to men who live alone as a risk-group, and residential care provision requires expansion.

In recent decades there has been a rapid expansion of assisted-living facilities for older people in many different countries. Much of this growth has occurred with only limited or no government regulation, but many problems have arisen, typically around the quality of care, which have led to demands that governments act to protect vulnerable residents. This paper examines whether formal legal regulation is the optimal policy to protect the needs and rights of frail residents, while respecting the legitimate interests of others, such as operators and owners. It presents the case for and against direct legal regulation (as in institutions), and suggests that no overall a priori assessment is possible. The analysis is based on the case of Israel, where proposed regulations for assisted-living have been introduced but not implemented. After a brief history of assisted-living in Israel – its recent dramatic growth and why this occurred – the paper concludes that formal direct regulation is not the best route to follow, but that the better course would be to develop totally new ‘combined’ regulatory legislation. This would define the rights of residents and encourage self-regulation alongside minimal and measured mechanisms of deterrence. Such an approach could promote the continued development of the assisted-living industry in Israel and elsewhere, while guaranteeing that the rights, needs and dignity of older residents are protected.

The services used by people with dementia and their carers were measured at three time points over 17 months. This analysis is unusual in that both informal care and formal inputs were costed. The costs estimates for informal inputs developed here may be applied to other data sets. Two hypotheses to explain the inter-relationship between informal and formal care inputs, substitution and supplementation, were compared in analysing the data. This paper explores the variations in costs according to the living arrangements of the people with dementia, by level of dependency and over time, and finds systematic differences. The costs of the inputs from co-resident carers consistently exceeded the costs of formal services, with informal care constituting up to 40 per cent of the total costs burden for dementia care. When informal inputs were included, non-domestic residential care emerged as less, not more, costly than care in the community. There was a shift in costs burden from health services to social services over time as more people moved into non-domestic settings. Multivariate analyses identified several predictors of informal and formal care costs: physical disability, level of cognitive impairment, living in non-domestic settings, and formal care provided. Non-domestic care predicted lower inputs of both formal and informal services. Dementia level was positively associated with informal inputs. Physical frailty was associated with more formal care, but less informal care. More formal service inputs predicted higher informal care inputs. There is evidence of supplementation of informal care by formal services in the early stages of care, followed by substitution as the person with dementia enters residential care.

This paper considers a dimension of social life that has been largely neglected in the research literature on ageing, older men's involvement with informal associations. These affiliations represent an under-valued resource which may contribute to the quality of life of older men by facilitating social interaction and providing a context for continued social productivity. Using the British Household Panel Survey for 1999, we explore the engagement of men aged 65 or more years with civic groups (such as political parties or voluntary agencies), religious organisations, and sports and social clubs. Involvement in civic and religious groups and sports clubs is common among middle class older men, while social club membership is common among working class men. Only a small amount of these differences can be explained by variations in health, income and access to private transport. Compared with partnered older men, widowers are more likely to be involved with sports and social clubs, while men who are divorced or never married are less likely to be a member of any informal group.

Social gerontology, as a distinct discipline, has been slower to develop in France than in Anglo-Saxon countries. Gerontological discourses have been dominated by the medical and physical sciences. At the same time, France has a long tradition of research on ageing that incorporates important social dimensions, particularly in demographic and economic fields. Current developments include research on pensions and related issues such as early-retirement or older people in the labour force; inter-generational relations or family solidarity; disabled elderly people and caring; and ageing among ethnic minority populations. These developments point in the direction of co-ordinated, multi-disciplinary approaches to the life course and ageing in the future.

The purpose of this article is to analyse with longitudinal data from Norway the caring activities of sons and daughters who were the primary care-giver to a parent aged 80 or more years. The study sample consists of the 227 offspring care-givers in the Larvik study, which examined the illnesses and disabilities and the informal and formal care received until their deaths of all those aged 80 or more years in the town's population in 1981. Prospective and retrospective data were collected from that year about the health, functional losses and formal service utilisation of the older people. After the death of an older person in the study, the next-of-kin was interviewed about the informal care provided by relatives and friends during the same time span. The sequences and content of the care-giving activities differed little for son or daughter care-givers, except during a short escalation phase. The average duration of informal home care was shorter for sons than for daughters, primarily because a minority of the daughters had very long care-giving careers. The duration of the care recipients' stays in acute or long-term care institutions before death did not differ by the gender of the carer. Compared with many earlier studies, few gender differences in offspring care-giving activities were found. The findings suggest that the potential of sons to provide informal care to frail older parents is underestimated in modern societies.

For some time in Britain, it has been difficult to recruit clinical psychologists and other health professionals to work with older people. This pattern of under-recruitment has also been reported in other countries. With the growing number of older people in western societies, the issue of under-recruitment warrants further attention. This research reported here aimed to explore this issue among the next generation of clinical psychologists: those currently training. Questionnaires were posted to 25 of the clinical psychology training courses in the United Kingdom, and 371 trainees returned questionnaires. Among the questions posed, the trainees were asked to set down their thoughts as to why it might be difficult to recruit to the older adult specialty and how recruitment could be improved. The results suggest that many trainees believe that clinical psychology, despite many recent advances, has less to offer older people than other age groups. The responses contain evidence of both ageism and the fear of ageing and death. To improve recruitment into the older adult specialty of clinical psychology, the predominant recommendations were for good quality placements and teaching during training, as well as a need for improved marketing by clinical psychologists working in this specialty, and also for improved support, terms and conditions.

Personal values are framed by social contexts and carried through a person's lifecourse, but are sufficiently malleable to adapt to changing conditions. The dynamic character of personal values should be more frequently recognised in studies of inter-generational ties. This study examines the relationships between two generations of Singaporean women and their divergent values about gender roles, preference for the gender of children, family formation, care-giving and living arrangements. Younger women embrace more western views, while their older counterparts uphold Confucian values. Previous studies have tended to characterise inter-generational ties as conveying ‘conflict’ or ‘solidarity’, but here the concept of ‘ambivalence’ is employed to show that contradictory values co-exist, and that inter-generational ties encapsulate the negotiated outcome of complex attitudes, values and aspirations.

Studies in environmental gerontology have progressed our understanding of the ways in which older people respond to and manage the environments in which they live, including their decisions about relocation and the influencing factors. Much of this work, however, has been done with relatively healthy and mobile older people living in domestic environments. It is often the case that when care-home residents move, the decisions are taken by others while the residents are passive and maybe hardly consulted. Far from the residents' preferences and initiatives being instrumental, they are moved by imposition. In the United Kingdom, the setting of this study, such imposed moves are common, partly because registration regulations restrict the range of care that a home can provide, and make some moves unavoidable. A questionnaire was distributed to care homes in two English local authorities to determine the incidence of relocation, and 10 homes were approached to take part in further studies, which included case-note audits, and interviews with staff and 12 older people who had relocated. The study found that the pattern of moves was complex, and that some residents were active in deciding to relocate and in the selection of the relocation home. The study concludes, however, that for residents to have an active role, they must be given support both to access the information required for decision-making and to implement their decisions.

This paper examines the impact of childhood and adulthood socio-economic status (SES) on personal network characteristics in later life. Data are derived from 2,285 married older adults (born between 1903 and 1937) who participated in face-to-face interviews for the Dutch survey on ‘Living arrangements and social networks of older adults’ conducted in 1992. Childhood and adulthood SES were indicated by the father's and own level of education and occupation. Multivariate analyses showed that SES in adulthood has more impact on network features in old age than father's SES. People with low lifetime SES or with downward SES mobility had small networks, low instrumental and emotional support from non-kin, but high instrumental support from kin, when compared with the upwardly mobile or those with high lifetime SES. The level of education was a better indicator of network differences than occupational prestige. It is concluded that obtaining a high SES during life pays off in terms of having more supportive non-kin relationships in old age. The small networks and less supportive non-kin relationships of low-status older adults make them more vulnerable to situations in which kin are unavailable or less willing to provide support. This study underscores the distinction between types of support and types of relationships in the SES–network association. Further research on the social pathways of socio-economic inequality in health and wellbeing should take these distinctions into account.

This paper is a contribution to the developing understanding of social relationships in institutional care settings. It focuses on two areas that have been neglected in research: the reasons for and types of social interaction in institutional settings, and the ways in which the context of people's lives shapes social interaction. The paper draws on ethnographic observations conducted in four care settings in Scotland using a symbolic interactionist perspective. It finds that residents communicate and interact, and that the personal, cultural and structural contexts frame social interaction and influence the ways that residents use humour, express sexuality, and show hostility. The paper concludes that residents create social interactions in which action is embedded, but do so within specific structural and cultural contexts. These contexts ‘control’ resident action by establishing frameworks for the interpretation of meaning. At the same time, each facet of context is ‘controlled’ by the ways in which residents actively take on the ‘role’ of others, and project ‘self’ and a ‘label’.

This paper reports an analysis of the relative influence of work-related, care-related and personal factors on carer outcomes among 204 working female carers. To examine the importance of personal factors, the ‘Motivations in Elder Care Scale’ (MECS) and the ‘Relationships in Elder Care Scale’ (RECS) were developed. In a qualitative pilot study, interviews with working-age carers were drawn on to form the items for inclusion. The MECS included items for external pressures to care, e.g. guilt, the older person's expectation of care, and perceived disapproval of others, and for internal desires to adopt the caring role, e.g. carer's resistance to other forms of care, living up to one's principles and caring nature. Psychometric tests revealed that two subscales had greater reliability, the EXMECS (extrinsic motivations to care) and the INMECS (intrinsic motivations). The RECS included both positive items, e.g. respect, admiration for the older person, and lack of generational differences, and negative relationship items, e.g. struggle for power, and older person's resistance to caring efforts, and had good reliability. Measures of carer stress and carer satisfaction were included as outcome variables. Multiple regression analyses showed that the RECS and the MECS were the most significant predictors of carer outcomes. Greater extrinsic motivations to care and poorer quality of the relationship with the older person were the most significant predictors of carer stress. Better relationship quality and greater intrinsic motivations to care were the most significant predictors of carer satisfaction.

As the population ages and more people are living alone, social isolation amongst older people is emerging as one of the major issues facing the industrialised world because of the adverse impact it can have on health and wellbeing. This article reviews the empirical literature published over the last 20 years on the effectiveness of interventions that target social isolation amongst older people. The results reveal that although numerous such interventions have been implemented worldwide, there is very little evidence to show that they work. It is concluded that future intervention programmes aimed at reducing social isolation should have evaluation built into them at inception, and that the results of the evaluation studies, whether positive or negative, should be widely disseminated. Where possible, as a cost-effective measure, pilot or demonstration projects should precede these interventions. Some key elements of successful interventions to counter social isolation amongst older people are presented.

Loneliness and isolation can be a major cause of unhappiness and can contribute towards depression and mental illness in older age. These associations are recognised by academics, policy makers and older people's representative organisations alike in several countries, and many corrective ad hoc and country-specific initiatives have been supported. This study examines the opinions of the users of a local home-visiting befriending service in the United Kingdom. The befrienders are volunteers, and most users were introduced to the service by female relatives or health service professionals. Positive opinions of the service predominated, and users placed a high value on the reliability of their befrienders. The service provided the users with an opportunity to develop a new bond, and many reported friendly reciprocity, which they recognised as an ingredient of ‘real’ friendship. These friendships sometimes developed beyond the agreed rules and remits of the ‘formal’ service, and incorporated various forms of supplementary assistance and social activities. The paper demonstrates the value of befriending services and examines carefully the aspects of their implementation that required exceptional sensitivity.

Lifecourse perspectives on ageing need to consider more seriously the meaning of ‘self-actualisation’, as it is currently used by the burgeoning industries that service the needs of those in the middle years. The prevalent meaning derives largely from an existentialist ontology, which is radically individualistic and cannot adequately account for the inter-connectedness of generations; that is, the need for one generation to provide for the needs of the next. Nor can an existentialist ontology adequately prepare mid-lifers for their older age and the life crises that accompany later life. This paper uses Giddens's notion of ‘life trajectory’, a very influential theory of the self in high modernity, to highlight this problem. The existentialist ontology that informs Giddens's notion reflects those values of youth that the new social movements have brought to the political agenda as ‘life-politics’. These values may well be challenged as the youth of the 1960s reach middle age and begin to confront their mortality. The paper argues that Erikson's notion of ‘generativity’ might provide a more useful ontology for lifecourse politics, and is more attuned to an inter-generational perspective.

This article considers the hypothesis that ‘older people in full-time employment normally receive earnings below the level previously enjoyed’, by examining the money and real earnings of older British full-time employees as they age. After a review of the factors that influence earnings, data from the New Earnings Survey of Great Britain are used to estimate average gross weekly money and real earnings of two cohorts of manual and non-manual workers as they age. The two cohorts were born respectively in 1927 and 1937, and male and female employees are considered separately. The estimates are used to develop time series age-earnings profiles of real earnings. These suggest that the average full-time older employee normally benefits over time from rising real earnings as a consequence of increases in national prosperity, although the increases vary by gender, occupational group and cohort. Older female employees benefited more than males from significantly higher percentage increases in their average real earnings, and between 1981–2000 average real earnings in non-manual occupations rose relative to manual workers' earnings.

As part of a suite of policy documents on older people's issues, the ‘New Labour’ British government has published a joint housing and health strategy, Quality and Choice for Older People's Housing. In this they attempt to map out the problems facing older people. The strategy also suggests that among the solutions there should be more opportunities for older people to make choices and for their deeper involvement in housing matters. This paper sketches the background to this strategy and reviews the literature to determine whether there is a foundation of dialogue with older people on housing issues. While there have been increasing efforts to build socially inclusive processes, particularly in the major ‘regeneration’ programmes, it is still the case that older people are usually excluded. The core of the paper is a case study from the Better Government for Older People programme which explored the process by which older people worked alongside professionals to remodel a local authority dwelling. An analysis of the dialogue provides a window onto the self conceptions of professionals. Older people gained as individuals and as a group from the housing project, and were able to develop collective influence through a representation role. Learning by the local authority was more incremental. The paper ends with a discussion of the broader lessons for service providers.

Population ageing and constraints on public sector spending for older people with long-term health problems have led policy makers to turn to the social networks of older people, or the ‘informal sector’, as a source of long-term care. An important question arising from this policy shift is whether these social networks have the resources to sustain the high levels of care that can be required by older people with chronic health problems. In the face of both dire warnings about the imminent demise of the informal sector, and concurrent expectations that it will be the pillar of community long-term care, it is timely to undertake a critical analysis of the caring capacity of older people's social networks. In this paper we argue that the best way to understand the caring capacity of informal networks of frail older people is to establish their membership and caring capacity. It is useful to make conceptual distinctions between ‘social’, ‘support’, and ‘care-giving’ networks. We argue that transitions of networks from social through support to care roles are likely to show systematic patterns, and that at each transition the networks tend to contract as the more narrowly defined functions prevail. A focus on ‘care networks’, rather than the more usual ‘care dyads’, will move forward our understanding of the caring capacity of the informal sector, and also our ability to forge sound social and health policies to support those who provide care.