Some foundations are laid for a social-psychological theory of dementia care. Central to this is a conceptualisation of personhood, in which both subjectivity and intersubjectivity are fully recognised. Evidence is brought forward concerning relative well-being even in those who are, from a cognitive standpoint, severely demented. In the light of this it is argued that the key psychological task in dementia care is that of keeping the sufferer's personhood in being. This requires us to see personhood in social rather than individual terms.

Preventing and alleviating social isolation and loneliness among older people is an important area for policy and practice, but the effectiveness of many interventions has been questioned because of the lack of evidence. A systematic review was conducted to determine the effectiveness of health promotion interventions that target social isolation and loneliness among older people. Quantitative outcome studies between 1970 and 2002 in any language were included. Articles were identified by searching electronic databases, journals and abstracts, and contacting key informants. Information was extracted and synthesised using a standard form. Thirty studies were identified and categorised as ‘group’ (n=17); ‘one-to-one’ (n=10); ‘service provision’ (n=3); and ‘community development’ (n=1). Most were conducted in the USA and Canada, and their design, methods, quality and transferability varied considerably. Nine of the 10 effective interventions were group activities with an educational or support input. Six of the eight ineffective interventions provided one-to-one social support, advice and information, or health-needs assessment. The review suggests that educational and social activity group interventions that target specific groups can alleviate social isolation and loneliness among older people. The effectiveness of home visiting and befriending schemes remains unclear.

An engaged lifestyle is seen as an important component of successful ageing. Many older adults with high participation in social and leisure activities report positive wellbeing, a fact that fuelled the original activity theory and that continues to influence researchers, theorists and practitioners. This study's purpose is to review the conceptualisation and measurement of activity among older adults and the associations reported in the gerontological literature between specific dimensions of activity and wellbeing. We searched published studies that focused on social and leisure activity and wellbeing, and found 42 studies in 44 articles published between 1995 and 2009. They reported from one to 13 activity domains, the majority reporting two or three, such as informal, formal and solitary, or productive versus leisure. Domains associated with subjective wellbeing, health or survival included social, leisure, productive, physical, intellectual, service and solitary activities. Informal social activity has accumulated the most evidence of an influence on wellbeing. Individual descriptors such as gender or physical functioning sometimes moderate these associations, while contextual variables such as choice, meaning or perceived quality play intervening roles. Differences in definitions and measurement make it difficult to draw inferences about this body of evidence on the associations between activity and wellbeing. Activity theory serves as shorthand for these associations, but gerontology must better integrate developmental and psychological constructs into a refined, comprehensive activity theory.

As increasingly more people experience old age as a time of growth and productivity, theoretical attention to successful ageing is needed. In this paper, we overview historical, societal and philosophical evidence for a deep, long-standing ambivalence about human ageing that has influenced even scientific views of old age. In recent years, however, discussion of the psychological and behavioural processes people use to maintain and reach new goals in late life has gained momentum. We contribute to this discussion the metamodel of selective optimisation with compensation, developed by Baltes and Baltes. The model is a metamodel that attempts to represent scientific knowledge about the nature of development and ageing with the focus on successful adaptation. The model takes gains and losses jointly into account, pays attention to the great heterogeneity in ageing and successful ageing, and views successful mastery of goals in the face of losses endemic to advanced age as the result of the interplay of the three processes, selection, compensation, and optimisation. We review evidence from the biological and social science literatures for each component and discuss new research avenues to study the interaction of the three processes.

This paper report results from a national survey of quality of life (QoL), based on 999 people aged 65 or more years living in private households in Britain. The study produced both qualitative and quantitative interview data. The 999 survey respondents were interviewed in their own homes with a semi-structured survey instrument, and 80 were followed-up in greater depth at one and two years after the baseline interview. The material from the in-depth interviews is presented here. The main QoL themes that emerged were: having good social relationships, help and support; living in a home and neighbourhood that is perceived to give pleasure, feels safe, is neighbourly and has access to local facilities and services including transport; engaging in hobbies and leisure activities (solo) as well as maintaining social activities and retaining a role in society; having a positive psychological outlook and acceptance of circumstances which cannot be changed; having good health and mobility; and having enough money to meet basic needs, to participate in society, to enjoy life and to retain one's independence and control over life. The results have implications for public policy, and supplement the growing body of knowledge on the composition and measurement of quality of life in older age.

The loss of self in Aizeheimer's Disease is examined from a social constructionist view of the nature of the self. Empirical evidence derived from the structure of the discourse and behaviour of three Alzheimer's sufferers is presented to show that self1, the self of personal identity, persists far into the end stage of the disease. Self2, the multiple personae that are projected into the public arena, and which require the cooperation of others in order to come into being, can be lost, but only indirectly as a result of the disease. The primary cause of the loss of self2 is the ways in which others view and treat the Alzheimer's sufferer. Recommendations are made regarding interactions between Alzheimer's sufferers and caregivers.

Social commentators in countries such as the United Kingdom and the United States are beginning to recognise that encouraging older adults' use of information and communication technologies (ICTs) is essential for the creation of bona fide information societies. To date, however, few studies have examined in detail older adults' access to and use of ICTs. This important aspect of the interaction between population ageing and societal change is more complex than the published literature's portrayal of a dichotomy between ‘successful users’ and ‘unsuccessful non-users’. The paper examines the extent and nature of ICT access and use by older adults in their everyday lives. Information was collected from a sub-sample of 352 adults aged 60 or more years taken from a large household survey of ICT use in England and Wales among 1,001 people. The findings suggest that using a computer is not only a minority activity amongst older adults but also highly stratified by gender, age, marital status and educational background. Conversely, non-use of computers can be attributed to their low relevance and ‘relative advantage’ to older people. The paper concludes by considering how political and academic assumptions about older people and ICTs might be refocused, away from trying to ‘change’ older adults, and towards involving them in changing ICT.

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

The relationship between age and loneliness is intriguing. While loneliness has been widely perceived as a problem of old age, there is evidence suggesting that adolescence is the peak age for experiencing loneliness and there are demonstrable variations between nations in reported rates of loneliness. However, comparative data for examining both the prevalence of loneliness across age groups and across nations are sparse. As the first phase of a larger project, we explore the prevalence of loneliness across different age groups in 25 European nations, with a focus on people of an advanced age. After discussing issues of comparability, we present our empirical findings employing data collected in the third round (2006–07) of the European Social Survey (total sample size 47,099, age range 15–101) which included a ‘self-rating’ loneliness scale. Our results suggest that the prevalence of loneliness does increase with age for the combined sample. However, the nation in which one lives shows a greater impact than age on reported levels of loneliness, with Russia and Eastern European nations having the highest proportions of lonely people (about 10–34% for different age groups) and Northern European nations the lowest (mostly below 6%). Possible explanatory factors are identified and discussed, which provides the groundwork of a subsequent and formal study.

A new theory of the dementing process in old age is presented in outline. Its main focus is on the dialectical interplay between neurological and social-psychological factors, with special emphasis on aspects of the latter which deprive a neurologically impaired individual of his or her personhood. The account of dementia so derived is more comprehensive and less deterministic than those which are based on the simpler versions of a ‘medical model’. Also, it opens up the way for a more personal and optimistic view of caregiving.

If we are to develop better methods of integrating elderly people into society then above all we need a better sociology of the ageing and the aged. In this paper I wish to put forward the thesis that the dependency of the elderly in the twentieth century is being manufactured socially and that its severity is unnecessary. The process can therefore be revised or at least modified. Certain major influences, which will be discussed below, are steadily deepening, or widening that dependency. There is the imposition, and acceptance, of earlier retirement; the legitimation of low income; the denial of rights to self-determination in institutions; and the construction of community services for recipients assumed to be predominantly passive.

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.

Research and theory on ‘dependency’ and ‘care-giving’ have to date proceeded along largely separate lines, with little sense that they are exploring and explaining different aspects of the same phenomenon. Research on ‘care’, initially linked to feminism during the early 1980s, has revealed and exposed to public gaze what was hitherto assumed to be a ‘natural’ female activity. Conversely, disability activists and writers who have promoted a social model of disability have seen the language of and the policy focus upon ‘care’ as oppressive and objectifying. ‘Dependency’ is an equally contested concept: sociologists have scrutinised the social construction of dependency; politicians have ascribed negative connotations of passivity; while medical and social policy discourse employs the term in a positivist sense as a measure of physical need for professional intervention. Autonomy and independence, in contrast, are promoted as universal and largely unproblematic goals. These contrasting perspectives have led social theory, research and policies to separate and segregate the worlds of ‘carers’ from those for whom they ‘care’. Drawing on the work of Kittay and others, this paper explores the ways in which sociological perspectives can develop new understanding of the social contexts of ‘care’ and ‘dependence’.

This paper reviews the empirical literature on social isolation and loneliness and identifies a wide range of published correlates. Using data from a study conducted in North Wales, which included many of the same correlated variables, a statistical modelling technique is used to refine models of isolation and loneliness by controlling for co-variance. The resulting models indicate that the critical factors for isolation are: marital status, network type and social class; and, for loneliness: network type, household composition and health.

‘Active ageing’ is a topic of increasing attention in scientific and policy discussions on ageing, yet there is no consensus on its actual meaning. The current paper proposes a detailed classification of various definitions that have been used since its introduction. These definitions are subjected to critical investigation, and subtle differences with regard to such terms as ‘healthy ageing’ and ‘productive ageing’ are clarified. Bearing the hazards of previous definitions in mind, a comprehensive strategy is initiated. Given that earlier definitions have tended to exclude frail older adults, this strategy pays particular attention to the translation of the active-ageing concept to situations of dependency by centring on three key principles: fostering adaptability, supporting the maintenance of emotionally close relationships and removing structural barriers related to age or dependency.

The ‘sandwich generation’ has been conceptualised as those mid-life adults who simultaneously raise dependent children and care for frail elderly parents. Such a combination of dependants is in fact very unusual, and the more common situation is when adults in late mid-life or early old age have one or more surviving parents and adult but still partly dependent children. It can be hypothesised that for parents in this pivotal position, the demands from adult children and from elderly parents compete, with the result that those who provide help to one are less likely to provide help to the other. An alternative hypothesis, however, is that family solidarity has an important influence but is not universal, so that some pivotal-generation parents engage in intergenerational exchange in both directions, and there is a positive association between helping parents and helping children. To investigate this question, the paper presents an analysis of data from two broadly comparable national surveys, in Great Britain and the United States, on the care provided by women aged 55–69 years to their descendent and ascendent relatives. The results show that around one-third of the women reported providing help to members of both generations, and that around one-fifth provided support to neither. They broadly support the solidarity hypothesis, but provide some evidence that having three or more children is associated with a reduced likelihood of providing help to a parent.

The paper argues for the importance of recognising carework as a form of bodywork. It discusses why this central dimension has been neglected in accounts of carework, pointing to the ways in which community care has traditionally been analysed, the resistance of social gerontology to an overly bodily emphasis, and the conceptual dominance of the debate on care. Drawing on a study of the provision of help with bathing and washing for older people at home, it explores the body dimension of the activity, looking at how careworkers negotiate nakedness and touch, manage dirt and disgust, balance intimacy and distance. Finally, the paper draws together some of the key themes of this bodywork: its designation as ‘dirty work’, its hidden, silenced character, the low occupational esteem in which it is held and its gendered nature.

This qualitative study examines meanings and experiences of ageism for older Australians. While the concept is widely applied in academic social analysis, the term is not understood or used by many of the informants. They talk freely, however, about negative experiences in ‘being seen as old’ and ‘being treated as old’. Active ageing is viewed as a positive way of presenting and interpreting oneself as separate from the ‘old’ group. Informants recognise that older people as a group experience negative treatment in terms of poor access to transport and housing, low incomes, forced retirement and inadequate nursing home care. While few have experienced overt or brutal ageism, interaction in everyday life involves some negative treatment, occasional positive ‘sageism’, and others ‘keeping watch’ for one's vulnerabilities. Health professionals are a major source of ageist treatment. Some older people limit their lives by accommodating ageism, while others actively negotiate new images of ageing for themselves and those who will be old in the future.

Assistive technology (AT) is defined in this paper as ‘any device or system that allows an individual to perform a task that they would otherwise be unable to do, or increases the ease and safety with which the task can be performed’ (Cowan and Turner-Smith 1999). Its importance in contributing to older people's independence and autonomy is increasingly recognised, but there has been little research into the viability of extensive installations of AT. This paper focuses on the acceptability of AT to older people, and reports one component of a multi-disciplinary research project that examined the feasibility, acceptability, costs and outcomes of introducing AT into their homes. Sixty-seven people aged 70 or more years were interviewed in-depth during 2001 to find out about their use and experience of a wide range of assistive technologies. The findings suggest a complex model of acceptability, in which a ‘felt need’ for assistance combines with ‘product quality’. The paper concludes by considering the tensions that may arise in the delivery of acceptable assistive technology.

In the literature on Alzheimer's disease (AD), scholars have noted how both the disease and the people who are diagnosed as having it have been stigmatised. I argue here that the AD stigma is of a specific sort – it is dehumanisation based on disgust and terror. Although the blame for negative perceptions of people with AD has been placed on the biomedical understanding of dementia, I argue that strong negative emotional responses to AD are also buttressed by the social construction of people with AD as zombies. To illustrate this point, this paper identifies seven specific ways that the zombie metaphor is referenced in both the scholarly and popular literature on AD. This common referencing of zombies is significant as it infuses the social discourse about AD with a politics of revulsion and fear that separates and marginalises those with AD. It is in recognising the power of this zombie trope that its negative impact can be actively resisted through an emphasis of connectedness, commonality, and inter-dependency.