In most western nations, laws discourage discrimination in paid employment on the basis of disability, but for these policies to be of benefit, individuals must define their functional limitations as disabilities. There is a strong relationship between age and disability among those of working age, yet it is unclear whether older workers attribute their limitations to disability or to ‘natural ageing’. If the latter is true, they may not believe that they need or qualify for workplace accommodations (i.e. adaptations or interventions at the workplace). Similarly, if an employer ascribes a worker's limitation to ‘natural ageing’, rather than to a disability, they may not offer compensatory accommodation. Using data from the Canadian 2001 Participation and Activity Limitation Survey, this paper asks whether workers who ascribe their functional limitation to ageing are as likely as those who do not to report a need for a workplace accommodation. It also addresses whether those who identify a need for compensatory accommodations and who ascribe their limitation to ageing have unmet workplace-accommodation needs. The findings suggest that, even when other factors are controlled, e.g. the type and severity of disability, the number of limiting conditions, gender, age, education, income and occupation, those who made the ageing attribution were less likely to recognise the need for an accommodation; and among those who acknowledged a need, those who ascribed their disability to ageing were less likely to have their needs met.

This paper reports findings of a study in 2004 of the development of specialist services for older people in the National Health Service (NHS) in England, as recommended in the Department of Health's National Service Framework for Older People (NSF-OP). The study was funded by the Department of Health as part of a programme of research to explore the Framework's implementation. Information was collected through a questionnaire survey about the nature of specialist developments at three levels of the NHS: strategic health authorities (SHAs), provider Trusts, and service units. This produced an overview of developments and a frame from which to select detailed case studies. Analysis of the survey data showed that there were variations in the way that the NSF-OP was being interpreted and implemented. In particular, there was inconsistency in the interpretation of the NSF-OP's anti-ageism standard; some concluded that the strategy discouraged services exclusively for older people, others that it encouraged dedicated provision for them. The tension between creating age-blind and age-defined services was played out in the context of existing service structures, which had been shaped over decades by many local and national influences. These conceptual and historical factors need to be taken into account if services are to change, as developments are shaped by ‘bottom-up’ local processes as well as ‘top-down’ policy initiatives. In particular, the tension inherent in the NSF-OP between negative and positive ageism, and its varied interpretations at local levels needs to be taken into account when evaluating progress in implementation.

‘Caring for carers’ is high on the United Kingdom policy agenda for community care. Although recent policy advocates the provision of services directly to the carer, research suggests that an alternative way of helping carers is through targeting enhanced services towards the cared-for person. This paper reports a randomised controlled trial of the effects on carer distress of an additional specialist clinical assessment for vulnerable older people at risk of residential or nursing home placement. The sample was composed of 142 informal carers of older people, randomly assigned to receive either the additional specialist assessment or the usual social services assessment. Carers were assessed using the modified Social Behaviour Assessment Schedule (SBAS), and data were also collected on older peoples' service use throughout the study period. Regression analyses indicated that changes in older peoples' behaviour, as opposed to carer or service-related factors, predicted changes in carer distress, and that the carers of the older people who experienced depressive symptoms received the greatest benefit from the specialist assessment. The study suggests that an effective means of improving outcomes for carers may be to target services towards the distressing behaviours of the person for whom they care, with symptoms of depression being particularly important.

This paper examines older people's contrasting images of older people as ‘those like us’ and as ‘others’. It draws on data from a qualitative study about the experience of ageing that was undertaken in partnership with two local groups of older people in England. Whilst the informants acknowledged their chronological age, changes in appearance and physical limitations, most did not describe themselves as old. They challenged the idea of older people as being ‘past it’. Older people who personified their own values of inter-dependence, reciprocity and keeping going were seen as ‘heroines’ of old age, but negative stereotypes were ascribed simultaneously to others, ‘the villains’. Aspects of behaviour which evoked censure were ‘giving up’; ‘refusal to be helped’ and ‘taking without putting back’, and were usually attributed to acquaintances known only at a distance. The victims of old age were primarily people with dementia, who were perceived as ‘needing to be looked after’ and objects of pity and concern. The paper explores the ways in which these various images of old age related to people's self-identity and management of the ageing process; especially in a society that has ambivalent conceptions of old age. The findings contribute to an understanding of how people's values underpin their conception of ‘a good old age’ and how they shape their interpretation of societal stereotypes. They also indicate the importance of considering whose voices are heard in the context of exploring the identity and contributions of older people to achieve a more inclusive society.

Productivity among older adults manifests in engagement in paid work, voluntary work, giving support to others, home maintenance and housekeeping. This paper reports an investigation into the extent to which levels of participation in the different productive activity types in The Netherlands are associated with age, gender and the settings in which older people live. The regional and urban–rural dimensions of variation are examined. The data were derived from the European Study of Adult Well-Being survey (ESAW). The results show that the oldest women tended to restrict their productivity to the private domain of housekeeping, while the oldest men were more often productive in the community, and that regional variations were stronger for women than for men. Traditional gender roles particularly affected the way in which older women living in a peripheral region participated in productive activities. In contrast, the urban–rural dimension was more important for men than for women, partly because a group of older men in the cities were not involved in paid work. Overall, strong gender influences on the variations in productive engagement were found. Processes of age-related contraction and convergence in patterns of participation in productive activities were imputed from the cross-sectional data. A full understanding of the ageing and cohort effects underlying the reported patterns would require much more detailed information on the spatial and temporal dimensions of older people's activity patterns.

Ever since Erving Goffman (1962) discovered unexpected social bonding and elaborate social networks among the ‘inmates’ of total institutions, researchers and policy makers have used ‘community’ to refer to those very persons (nursing-home residents, in-patients in psychiatric hospitals, and others incarcerated for diverse disabilities) believed to be ‘its principal victims’ (Hazan 1995: 211). The concept ‘community’ was built upon Tönnies's (1955/1887) concept of Gemeinschaft, which depicted homogeneous groups integrated through multiple social linkages and face-to-face relations. By the 1970s, scholars of community studies called into question the conceptual underpinnings and potentially negative implications of the concept. They reframed ‘community’ as a concept that addressed more refined questions concerning locality, and reserved the term for the social networks that reflected group interests and provided symbolic evidence of identity formation or belonging (Davies 2003). Nonetheless, the term retains prominence for the institutions that provide residential care for people with various disabilities.