The average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.

For about 20 years, Belgium has successfully implemented working-time reduction policies for the older workforce. However, the impact of such policies on health has not been explored yet. Using longitudinal data from Waves 5 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (N = 1,498), the paper assesses whether working-time reduction in late career is associated with a change in self-perceived health, depression (EURO-D) and quality of life (CASP-12). For that purpose, ordered logit and ordinary least squares regressions are performed, using four different models for defining working-time reductions. Results show that people reducing working time with or without additional social benefits tend to have a poorer self-perceived health at follow-up compared with people keeping the same or increasing working time. By comparison, people moving to retirement are more likely to present a better self-perceived health, depression level and quality of life compared to people increasing or keeping the same working-time level. Although, introducing an interaction effect, the paper shows that the change in quality of life for respondents reducing working hours in addition to social benefits tends to be less negative for those who wished to retire early at baseline than for those who did not.

With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005 to 2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified 77 relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

The enormous economic burden of dementia in the United States of America falls disproportionately on families coping with this devastating disease. Black Americans, who are at greater risk of developing dementia than white Americans, hold on average less than one-eighth of the wealth of white Americans. This study explores whether dementia exacerbates this wealth disparity by examining dementia's effect on wealth trajectories of black versus non-black Americans over an eight-year period preceding death, using five waves of data (beginning in 2002 or 2004) on decedents in the 2012 and 2014 waves of the Health and Retirement Study (N = 2,429). Dementia is associated with a loss of 97 per cent of wealth among black Americans, compared with 42 per cent among non-black Americans, while wealth loss among black and non-black Americans without dementia did not differ substantially (15% versus 19%). Dementia appears to increase the probability of wealth exhaustion among both black and non-black Americans, although the estimate is no longer significant after adjusting for all covariates (for blacks, odds ratio (OR) = 2.04, 95% confidence interval (CI) = 0.83, 5.00; for non-blacks, OR = 1.47, 95% CI = 0.95, 2.27). Dementia has a negative association with home-ownership, and the loss or sale of a home may play a mediating role in the exhaustion of wealth among black Americans with dementia.

Men's Sheds are entrenched throughout Australian and international communities due to their popularity in attracting mainly older men to come together and undertake various social and workshop activities. A growing body of research has emerged where men associate regular Shed participation with improved social, emotional and physical wellbeing. However, few studies have examined Aboriginal men's engagement in Men's Sheds. This article reports on a study that investigated how a cohort of older Aboriginal men from one rural Tasmanian community consider the benefits of engaging in their local Shed. A community-based participatory research approach was developed in consultation with Aboriginal community leaders to ensure the study supported the community's expectations. Interview data from ten Aboriginal men combine to represent the Shed environment as an enabling therapeutic landscape, with key themes represented as domains of belonging, hope, mentoring and shared illness experiences. Shed activities were premised on these men co-creating an informal, culturally safe and male-friendly community environment to enjoy the company of other men. The created Shed environment was mutually beneficial as the participants reported improved wellbeing despite living with the effects of declining health and ageing. The findings inform Aboriginal communities and health-care stakeholders to consider the unique role of Men's Sheds for enhancing the health of an ageing male population.

This project was a secondary hermeneutic analysis of text expressing loneliness or social isolation, gathered in an original study exploring how Chinese, Indian and Korean late-life immigrants participated in New Zealand society. It utilised the 24 interview recordings, initially transcribed in participants’ first languages from nine focus group and 15 individual interviews, and translated into English for analysis. Hermeneutic methods were used to extract and analyse quotes indicative of loneliness or social isolation. The data cohered into three notions: being unsettled, feeling sidelined and being oriented towards social connectedness. Being unsettled names the experiences of disconcerting loneliness or social isolation when previously familiar things, people and places were not there in the host society context. Feeling sidelined names the feelings of being put aside by others or feeling opaque with local communities. Being oriented towards social connectedness expresses these late-life immigrants’ longing to communicate with and to join with others in the community through culturally familiar engagements. A mood of loneliness coloured these late-life immigrants’ resettlement experiences in New Zealand. Yet they turned away from loneliness and sought out encounters with other older immigrants within co-ethnic communities.

Research has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.

What constitutes a ‘good place to grow old’? This study aimed to characterise salient features of built and social environments that are essential to support low-income ageing residents. Seated and mobile interviews were conducted with community-dwelling older participants (aged 55–92, mean = 71 years) in three distinct socio-economic and geographic samples of the Minneapolis (Minnesota, United States of America) metropolitan area. The interviews prompted participants to evaluate their homes and neighbourhoods, and probed for particular socio-spatial characteristics that impact residential wellbeing. Qualitative thematic analyses focused on 38 individuals living in subsidised housing and homeless shelters. Four interrelated themes encompassed essential residential qualities: (a) safety and comfort, (b) service access, (c) social connection, and (d) stimulation. These broad ideals, when achieved, enabled participants to cultivate residential wellbeing and fulfilling place attachment. Analyses of the empirical data complicate theoretical assumptions by recognising unequal access to, irregular opportunities for and potential dangers of place attachment. Rich descriptions of participant homelessness, health hazards, crime, lack of supportive infrastructure and social isolation illustrate how place attachment is not inherently positive or necessarily attainable; rather, it is problematic and can involve risk. This article extends geographical gerontology's address of socio-spatial inequalities by focusing on disadvantaged ageing individuals.

The study explores the role of clothing in the constitution of embodied masculinity in age, contrasting its results with an earlier study of women. It draws four main conclusions. First that men's responses to dress were marked by continuity both with their younger selves and with mainstream masculinity, of which they still felt themselves to be part. Age was less a point of challenge or change than for many women. Second, men's responses were less affected by cultural codes in relation to age. Dress was not, by and large, seen through the lens of age; and there was not the sense of cultural exile that had marked many of the women's responses. Third, for some older men dress could be part of wider moral engagement, expressive of values linked positively to age, embodying old-fashioned values that endorsed their continuing value as older men. Lastly, dress in age reveals some of the ways in which men retain aspects of earlier gender privilege. The study was based on qualitative interviews with 24 men aged 58–85, selected to display a range in terms of social class, occupation, sexuality, employment and relationship status. It forms part of the wider intellectual movement of cultural gerontology that aims to expand the contexts in which we explore later years; and contributes to a new focus on materiality within sociology.

Gardening has well-established physical, social and emotional benefits for older adults in varied circumstances. In Detroit, Michigan (United States of America), as in many cities, policy makers, funders, researchers, community organisations and residents regard gardening as a means of transforming bodies, persons, communities, cities and broader polities. We draw on ethnographic research conducted during one gardening season with 27 older African Americans in Detroit to foreground the social dimensions of wellbeing in later life and thus develop a more robust and nuanced understanding of gardening's benefits for older adults. Based on anthropological understandings of personhood and kinship, this article expands concepts of wellbeing to include social relations across multiple scales (individual, interpersonal, community, state) and temporalities (of the activity itself, experiences of ageing, city life). Even when performed alone, gardening fosters connections with the past, as gardeners are reminded of deceased loved ones through practices and the plants themselves, and with the future, through engagement with youth and community. Elucidating intimate connections and everyday activities of older African American long-term city residents counters anti-black discourses of ‘revitalisation’. An expansive concept of wellbeing has implications for understanding the generative potential of meaningful social relations in later life and the vitality contributed by older adults living in contexts of structural inequality.

While considerable scholarly attention has been given to factors influencing productive activity, less is known about how multiple forms of resources predict the maintenance or initiation of such activity over time. Using two-wave panel data of older adults from the National Social Life, Health, and Aging Project (NSHAP), the study investigated the relationship between measures of capital and changes in multiple types of productive activity. Findings showed that all three types of capital were associated with volunteering in cross-sectional analyses, but only education, neighbourhood socialisation and religious service attendance remain significant predictors of continued volunteerism. Human capital strongly influenced employment both cross-sectionally and over time. Aspects of social capital – marital status and network size – were linked to participation and initiation of care-giving activities. The findings demonstrate that different patterns emerge in cross-sectional and two-wave panel data of multiple productive activities, adjusting for baseline activity level and selective attrition. The project also suggests factors that promote or hinder continued engagement in productive activity.

One of the major aspects of successful ageing is active engagement in later life. Retirement and widowhood are two significant life transitions that may largely influence leisure engagement patterns among older adults. Limited findings exist regarding the impact of life transitions on leisure activity engagement due to the scarcity of longitudinal data with repeated measurement of older individuals’ leisure engagement. This study longitudinally examined changes in leisure activity engagement as influenced by retirement and widowhood using five waves of national panel data from the Health and Retirement Study and its supplementary Consumption and Activities Mail Survey. Multi-level modelling was conducted with retirement and widowhood status as time-varying variables. Socio-economic status, depressive symptoms, cognitive function, self-rated health and functional limitations were also included as time-varying and time-invariant covariates. Findings show that engagement in mental, physical, social and household activities significantly decreased during an eight-year period. Moreover, transition from working to retired status was associated with increased engagement in mental, social and household activities but decreased engagement in physical activities among men only. Transition from married to widowhood status was associated with decreased engagement in household activities among women only. Encouraging active leisure engagement among individuals who experience either or both life transitions may help maintain their health after transition.

Substantial research shows that cardiovascular disease is a major cause of disability in the United States of America (USA) and worldwide. Despite the well-documented significance of intimate partnerships for cardiovascular health and disease management, how relationship quality contributes to the functional health of older adults diagnosed with cardiovascular disease is much less understood than mental health and mortality risk. Informed by the disablement process model and the lifecourse perspective, this study examines the association between relationship quality and functional limitations among partnered older adults aged 50 years and older diagnosed with cardiovascular disease in the USA. Data are from the Health and Retirement Study, 2006–2012 (N = 1,355). Multi-level linear regression analyses show that baseline negative relationship quality is significantly associated with increased functional limitations over the two- and four-year follow-ups. Additionally, the link between negative relationship quality and functional limitations is stronger among older adults with lower household income over a two-year span, compared to their higher-income counterparts, suggesting that these older adults are doubly disadvantaged by higher relationship strains and limited economic resources. Our findings demonstrate the significance of relationship quality for the functional health of older adults with cardiovascular disease and shed light on the importance of marriage/partnerships as an important social context for a critical stage in the disablement process (i.e. functional limitations).

Services providing practical support are a key component in the spectrum of social care assisting older people to age in place. Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu/Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ), a longitudinal study of Māori and non-Māori in advanced age, aims to determine predictors of successful ageing and to understand trajectories of health and wellbeing. This paper investigates whether household living arrangements (living alone or with others) might explain previously reported gender and ethnic differences in support service utilisation. We had shown that women and non-Māori received more services than men and Māori despite better health. The results of analyses in this paper show that, as expected, poorer physical function led to increased service use. After controlling for functional status, household living arrangements (living alone) were the next strongest driver of service use. In a fully adjusted model, previously observed differences around gender and ethnicity were no longer significant predictors of support service use. However, gender and ethnicity do shape living arrangements in advanced age. Women in advanced age are more likely to live alone, consequently needing more outside support, whereas men are more likely to have a spouse/partner able to provide care. Māori are more likely to live in multigenerational households, the care available at home meaning they are less likely to qualify for formal support. This study points to a need for understanding how gender and ethnicity interact with living arrangements and suggests that inequities may not be absent when the presence of others in a household renders an older person ineligible for formal care.

User choice in care for older people has assumed that care is like any other commodity; which is in contrast with the concept of care defined by the feminist and ethics of care literature, which includes a relational component beyond care tasks – caring relationships. This study aims to understand how caring relationships impact the decisions of older users of care and their perceived satisfaction. Semi-structured qualitative interviews were conducted with 24 Direct Payments (DPs) older users, including proxies, in three Local Authorities in the Greater London area. Users fell into three groups according to their use of DPs: those purchasing care from agencies, those employing acquaintances as Personal Assistants (PAs) and those employing strangers as PAs. Decisions on and perceived satisfaction with care were both influenced by caring relationships. All users recognised that caring relationships can have instrumental value in improving care delivery or allowing greater leeway in negotiating tasks. Many users placed intrinsic value on continuity of care and the development of close caring relationships and clearly favoured employing PAs. The latter involved higher levels of uncertainty, emotional investment and reciprocal gift exchanges. Agencies were often chosen due to users’ preference for more detached caring relationships. The findings confirm that caring relationships involving reciprocal emotional investment are an important outcome of care, with salient implications for user behaviour.

Increased mortality after spousal bereavement has been observed in many populations. Few studies have investigated the widowhood effect in a traditional culture where the economy is underdeveloped. The reasons for the widowhood effect and its gender dynamic are not well understood. In this study, we assessed whether the widowhood-associated excess mortality exists and differs by gender and living arrangement in rural China. We used a six-wave panel of data derived from rural people over 60 years old in the Chaohu region of China. Cox regression analyses suggest that there was a positive effect of spousal loss on mortality for older rural Chinese and this effect was gender different. Our findings also suggest that living with adult children after spousal loss played a protective role in reducing the risk of older men's death, though it tended to increase older men's mortality risk in general.

The mouth may be presented and understood in different ways, be subject to judgement by others and, as we age, may intrude on everyday life due to problems that affect oral health. However, research that considers older people's experiences concerning their mouths and teeth is limited. This paper reports on qualitative research with 43 people in England and Scotland, aged 65–91, exploring the significance of the mouth over the lifecourse. It uses the concept of ‘mouth talk’ to explore narratives of maintaining, losing and replacing teeth. Participants engaged in ‘mouth talk’ to downplay the impact of the mouth, demonstrate socially appropriate ageing, and distance themselves from ‘real’ old age by retaining a moral identity and sense of self. They also found means to challenge dominant discourses of ageing in how they spoke about missing teeth. Referring to Leder's notion of ‘dys-appearance’ and Gilleard and Higgs’ work on the social imaginary of the fourth age, the study illustrates the ways in which ‘mouth talk’ can contribute to sustaining a sense of self in later life, presenting the ageing mouth, with and without teeth, as an absent presence. It also argues for the importance of listening to stories of the mouth in order to expand understanding of people's approaches to oral health in older age.

This is a retrospective cohort study based on data from five nursing homes which aims to appraise how physical and cognitive characteristics of nursing home residents were associated with the use of restraints, and to provide information on their prevalence in Spain. The goal was to assess, in a visual way, the possible interactions between the nursing homes residents’ characteristics and their association with the use of restraints. Motivation, risk factors, characteristics of the residents analysed by validated rating systems that assess mobility, level of dependence, cognitive condition and nutritional status, and their association with the use of restraints, were described by means of linear and non-linear multivariate approaches in the form of self-organised maps. Findings showed that the prevalence of restraints was high when compared to other developed countries. The visual analysis reinforced the knowledge that a greater impairment was associated with the use of restraints and vice versa. However, the residents’ characteristics were not always associated with the use of restraints. Subjective factors seem to play a relevant role in decision-making, so it is important to assess risk factors continuously and determine the actual need for the use of restraints from an individual perspective by basing the criteria on specific objectives, and on consistent, reproducible and reliable methods. Initiatives to minimise these subjective factors should be promoted. Likewise, a clear definition of physical restraints should be offered at each centre. In addition, effective legislation that clearly states the need, alternatives and motivation for the use of restraints is needed.

The impact of an ageing workforce on the workplace is a concern internationally. Governments are increasingly encouraging the continued labour market participation of older workers, seeking to remove previous barriers to the extension of working lives and give more choice to workers. Despite these legislative drivers, research has consistently found a lack of systematic approaches by employers to prepare and benefit from these demographic and labour market changes. In this paper, qualitative research is drawn upon to examine how managers and older workers think about age and ageing in the workplace; the support put in place for older workers, as well as future priorities; and the lived experiences of the older workers. It is highlighted that employees’ age and fitness for work is treated on an individual basis, rather than having formal plans to manage the workplace for older workers. This thus indicates a hands-off approach from management.

In recent years, there has been an increasing number of studies addressing older people's political participation. Much of this literature, however, can be criticised for neglecting important aspects of seniors’ political participation, such as its dynamics across the lifecourse, its gendered nature and the influence of the particular socio-political contexts in which participation occurs. In this paper we bring together all these issues to explore the relation between lifecourse transitions and participation in political organisations in Spanish men and women. We conducted life-story interviews with 40 highly engaged older political activists regarding their lifetime story of political commitment, and identified eight different lifecourse transitions affecting their participation in political organisations. Three of these transitions were related to the work domain and five to the family domain. Most of them were clearly gender-dependent, affecting men's and women's engagement in political organisations in different ways and to different degrees. Our study expands on previous research on lifespan-related aspects of political participation by showing that considering biographical, gendered and historical aspects is key to understanding the relationships between life transitions and participation in political organisations across the lifecourse.