There is a growing body of literature documenting the positive effects of both religiousness and spirituality on human health, particularly among those who are ageing or diagnosed with a life-limiting illness. These positive effects provide buffers to life's stressors such as those associated with mental illness, care-giver burden, substance abuse and social disruption resulting from war. An important aspect of health care for individuals of all ages involves completion of a spiritual assessment. This paper explores the concept of spirituality and spiritual assessment, which has many definitions in the literature, and also provides examples of assessment tools from theology, nursing, social work and medicine.

The media shape both what people consider significant and how people think about key issues. This paper explored the cultural beliefs and stereotypes that underlie media portrayals of nursing homes. The analysis of texts of 157 articles about nursing homes published from 1999 to 2008 on the front pages of four major-market American newspapers (The New York Times, Chicago Tribune, Los Angeles Times and The Washington Post) was conducted using a qualitative approach inspired by comparative narrative and critical discourse analysis. Results suggest two major themes, each with several narrative components: (a) managing disposable lives (bodies outliving bank accounts; making frailty affordable; and the economics of triage); and (b) retaining purchasing power as successful ageing (consumption as a sign of market participation, spending money as an indicator of autonomy; and financial planning as preparation for future decline). Thus, the results indicate that nursing home residency in-and-of-itself is not a marker of unsuccessful ageing. This, instead, depends, in part, on the extent of choice available as a result of the level of financial solvency. This study shines light on the betwixt and between zone that distinguishes the Third and Fourth Ages; that is, independence versus dependence in old age. If individuals in a nursing home retain control over the management of their lives through the maintenance of financial independence, even if physically frail, association of nursing home residence with the Fourth Age may be ameliorated.

Improving responsiveness to the needs of older people from minority ethnic communities has been emphasised as a goal in England since the publication of the National Service Framework for Older People in 2001. Despite this, people from minority ethnic groups consistently give poorer ratings of their health services than ‘majority’ populations, both in England and across many other health-care systems. Language barriers have been shown to play a particularly important role, and appear to be a stronger predictor of perceived quality of care than ethnic origin per se. This paper reports findings from a larger study exploring older people's experiences of care transitions, focusing on the findings from one case study area which explored the hospital and discharge experiences of older people from minority ethnic communities. A participatory approach was adopted, with older people from the local area collaborating in the design, delivery and analysis of the research as ‘co-researchers’. Twenty-four in-depth narrative interviews were carried out with people who had experienced a recent hospital stay as a patient or a family member providing care and support. Our findings show that many aspects of the hospital experience, including the desire for personalised and humanistic approaches to care, are important to older people irrespective of ethnic background. However, older people from minority ethnic communities can also face language and cultural barriers which negatively affect the quality and experience of care. People who had limited English proficiency struggled to understand, communicate and participate in their care. Where professional services were not available or requested, interpreting was provided informally by other patients, family members, hospital staff in clinical and domestic roles, or not at all. We conclude that targeted strategies are required to ensure appropriate and effective hospital services for a multicultural population.

This study examines discursive constructions of older people by analysing the talk of members of parliament in parliamentary discussions in Finland. While the perceptions of older people that are constructed in various public and private arenas have been relatively widely examined, the talk of political decision makers has not been studied to any large extent. However, decision makers' understandings of older people are likely to influence the ways in which service systems are developed and services organised for older people. The parliamentary discussions examined in this study were related to the process of enacting legislation to secure services for older people. Using discourse analysis, three ways of constructing older people – as ‘the dependent’, ‘the active’ and ‘the deserving’ – are identified. Although the results are to some extent in accordance with previous findings, indicating that older people are constructed as either totally dependent and passive or extremely active, this study also breaks this dichotomous view and highlights the overlap between those constructions. Nonetheless, the picture of older people remains fairly one-dimensional. There was an absence of recognition of diversity among older people, which might inhibit the development of a customer-oriented service system.

This study examines social ties within a community of retirement residents to examine how health influences patterns of social interaction. Drawing from a social fields perspective, I anticipated that health would emerge as a key form of status. I hypothesised that this would manifest in the healthiest residents receiving a disproportionate share of social tie nominations, and that the network would be characterised by distinct patterns of health-based sorting. Exponential random graph models were used to disentangle individual, dyadic and higher-order influences on reports of interaction. Findings support the main hypotheses, pointing to the importance of health as a basis of micro-level social structure in contexts where it is a scarce and valued resource. I urge further research to trace out these implications in other unique settings.

Old age is a priori a vulnerable stage of the lifecourse. Quality of life can be expected to decline in older age due to loss, isolation, and declining cognitive and physical abilities. The purpose of this study was to investigate the distribution, prevalence and trajectory of life satisfaction (LS) as a measure of quality of life among Swiss elderly women. We also assessed the impact of different social determinants on LS within the age categories of the ‘young old’ and the ‘old old’ across different cohorts. Using the Swiss Household Panel survey data, analyses of LS distribution and trajectories were conducted for 1,402 women aged 65–84 years. About 50 per cent of elderly women in Switzerland were very satisfied with their lives. The mean LS score and the prevalence of satisfied women were lower in more recent cohorts of identical ages. However, their LS remained more stable over ageing than was the case in former cohorts. High education, satisfaction with income, social support, living with a partner and good self-perceived health were all positive and significant predictors of LS. Longitudinal analyses allowed the ageing process net of cohort and period effects to be disentangled and the assessment of the influence of both social determinants and within-individual psychological traits on the self-evaluation of LS.

It is noteworthy that while modernisation, together with population ageing, has happened in Western countries for a rather long period of time, China must confront the challenges of an ageing population before it really becomes an advanced industrial society. Facing rapid societal changes, citizens may react differently to this process. By conducting questionnaire surveys with 445 elders in Wuhan, China, this study examines Chinese older adults' individual modernity modes and reveals its socio-demographic correlates. The results show that facing rapid changes in societal modernisation, participants have reacted differently to this process, with 23.8 per cent of Chinese older participants using an accommodation mode, 27.0 per cent using a resistance mode, 13.3 per cent using a withdrawal mode and 36.2 per cent using a coping mode. In addition, socio-demographic factors such as urban–rural residence, age, gender, socio-economic status, living arrangement and daily activities have been identified as significant correlates of Chinese older participants' individual modernity modes. It is further suggested that governments at all levels should allow for options and opportunities for older people to align themselves in the modernisation process by removing the barriers that may hinder their integration and empowerment efforts. While it is important to respect older adults' different responses in the face of modernisation, their participation in societies should be encouraged and respected by the wider society in the context of modernisation.

Organisational culture of institutions providing care for older people is increasingly recognised as influential in the quality of care provided. There is little research, however, that specifically examines the processes of care home culture and how these may be associated with quality of care. In this paper we draw from an empirical study carried out in the United Kingdom (UK) investigating the relationship between care home culture and residents' experience of care. Eleven UK care homes were included in an in-depth comparative case study design using extensive observation and interviews. Our analysis indicates how organisational cultures of care homes impact on the quality of care residents receive. Seven inter-related cultural elements were of key importance to quality of care. Applying Schein's conceptualisation of organisational culture, we examine the dynamic relationship between these elements to show how organisational culture is locally produced and shifting. A particular organisational culture in a care home cannot be achieved simply by importing a set of organisational values or the ‘right’ leader or staff. Rather, it is necessary to find ways of resolving the everyday demands of practice in ways that are consistent with espoused values. It is through this everyday practice that assumptions continuously evolve, either consistent with or divergent from, espoused values. Implications for policy makers, providers and practitioners are discussed.

The share of older migrants in Dutch cities is increasing. However, only limited knowledge has been gained about the urban conditions that older migrants live in and how these compare to those of their native Dutch counterparts. This paper contributes to filling this knowledge gap using detailed information on residential patterns, housing conditions and levels of neighbourhood deprivation in the city of Amsterdam in the Netherlands, and links this information to data about housing and neighbourhood satisfaction and perceived safety. Empirical evidence demonstrates that there is strong path dependence with regard to the places in which one finds different groups of older non-Western migrants. Older non-Western migrants in Amsterdam are highly concentrated in disadvantaged neighbourhoods. The number of concentrations has increased significantly over the past decade, as well as the concentration levels. Nevertheless, we did not find indications of social isolation. With regard to housing conditions, we found better conditions for socio-economically similar groups of native Dutch and Surinamese 55+ residents, compared to Turkish and Moroccan 55+ residents. These conditions correspond with levels of housing satisfaction. Surinamese older people are more positive about their neighbourhoods. We hypothesise that this is related to the restructuring of neighbourhoods where Surinamese 55+ residents are concentrated. Although the immediate environment of older non-Western people is characterised by high levels of social deprivation, this does not translate into dissatisfaction with social relations or feelings of lack of safety. This suggests that their residential concentration in particular urban neighbourhoods may also bring significant opportunities.