Maintaining quality of life and wellbeing into advanced age is a major challenge to societies. Driving is one factor contributing to an ageing individual's independence. Understanding antecedents of driving-related self-regulation is important for designing interventions to preserve safe driving in old age. This paper reports on a study that investigated factors associated with two forms of self-regulation in driving (SRD) – avoidance of difficult driving conditions and voluntary cessation of driving – in a sample of 860 Israeli drivers aged 70 and over. We examined roles of health, vision, driving experience, driving-related self-efficacy (DRSE) and global self-esteem in SRD. Health and DRSE had direct effects on SRD, and effects of vision and driving experience were mediated by DRSE. Participants who had ceased driving were older, with poorer vision and health, and less driving confidence and experience than active drivers. Statistical analyses demonstrated that SRD is affected by a reduced sense of confidence due to an initial lower level of driving experience, compounded by deteriorating vision, and that older drivers are sensitive to factors affecting their ability to drive safely. Our results demonstrate that older drivers tend to self-regulate their driving. Programmes for older adults can be introduced for diagnosing driving capabilities, improving skills and confidence, and/or helping to develop self-regulation habits of avoiding driving in difficult conditions, and assisting drivers who must adjust to driving cessation.

A number of studies have explored the relationship between socio-economic status and mortality, although these have mostly been based on the working-age population, despite the fact that the burden of mortality is highest in older people. Using Poisson regression on linked New Zealand census and mortality data (2001–04, 1.3 million person years) with a comprehensive set of socio-economic indicators (education, income, car access, housing tenure, neighourhood deprivation), we examined the association of socio-economic characteristics and older adult mortality (65+ years) in New Zealand. We found that socio-economic mortality gradients persist into old age. Substantial relative risks of mortality were observed for all socio-economic factors, except housing tenure. Most relative risk associations decreased in strength with ageing [e.g. most deprived compared to least deprived rate ratio for males reducing from 1.40 (95% confidence interval (CI) 1.28–1.53) for 65–74-year-olds to 1.13 (CI 1.00–1.28) for 85 + -year-olds], except for income and education among women where the rate ratios changed little with increasing age. This suggests individual-level measures of socio-economic status are more closely related to mortality in older women than older men. Comparing across genders, the only statistically significantly different association between men and women was for a weaker association for women for car access.

Past research has documented the influences that ‘traumatic’ memories of war have on older people's mental health (e.g. Post-Traumatic Stress Disorder). However, fewer studies have explored the longer-term implications of wartime experiences for older men and women's everyday lives. This article explores the impact of Second World War experiences on older men and women living in the United Kingdom (UK), to provide an insight into how such experiences influence how they construct their daily lives. Forty UK-based participants born between 1914 and 1923 were interviewed as part of the ENABLE-AGE project that was undertaken in five European countries. The key concepts underpinning the interview schedule were: home, independence, participation, health and wellbeing, and societal supports. The data were analysed using a grounded theory approach. Participants emphasised how wartime experiences continue to hold significance within their lives and settings some 60 years later. Seven themes emerged from the analysis. Four of these reflect the way wartime experiences remain important influences on participants' present-day social worlds: comradeship, storytelling about the war, community and alienation, and long-term physical effects. A further three themes reflect how skills and personal characteristics defined by wartime experiences are embedded in the way many older people continue to negotiate and structure their practical lives: managing, resilience and adaptability, and independence.

The aim of this article was to ascertain nursing home residents' preconceptions about institutionalisation and analyse the causes and circumstances of and the justification for their admission. Grounded theory was used to design and analyse a qualitative study based on in-depth interviews in a theoretical sampling of 20 persons aged over 65 years with no cognitive impairment, and eight proxy informants of residents with cognitive impairment, institutionalised at a public nursing home in Spain. Our analysis revealed that preconceptions about nursing homes differ between residents and relatives, and are strongly influenced by the views held by society about such centres and by previous experiences. Regarding the causes and circumstances underlying nursing home placement, while the principal cause of institutionalisation among residents with cognitive impairment was the ineffectiveness of informal care systems, in the case of residents without cognitive impairment reasons tended to revolve around two main themes: social causes (loneliness, not be a burden to the others, household-related, comfort and absence of relatives in the vicinity), and limitations in physical functioning, with the former predominating. This study shows society's perception of such centres and the circumstances surrounding admission. These points of view are useful for analysing why informal care systems prove inadequate, and are crucial for designing programmes targeted at acceptance and successful adaptation to institutionalisation when this becomes necessary.

This study examines how intergenerational exchanges affect elders' choice of preferred care-givers in the case of sickness among adult children in rural China. The sample derived from a four-wave longitudinal study in Anhui Province, China, based on which we constructed three time intervals (i.e. 2001–2003, 2003–2006 and 2006–2009) and stacked them. Our working sample included 10,181 observations from these three stacked intervals, representing 4,927 children with 1,170 elder parents. We used fixed-effects logistic regression to predict elders' favouritism among their children. Results show that those children who received more help with grandchild care from parents, who provided instrumental support to parents and whose spouses provided instrumental support to parents were more likely to be named the preferred care-givers. On average, parents favoured sons. For mothers, this favouritism was completely explained by proximity and intergenerational exchanges, and even reversed under certain circumstances. For fathers, this favouritism of sons was partially explained by proximity and intergenerational exchanges. Migrant children were less likely to be preferred care-givers. This effect was moderated by elder parents' help with caring for grandchildren. Particularly, mothers favoured daughters over sons if the above moderation effect was considered. We discuss these findings in the context of social changes including increased importance of daughters in elder parents' support networks and the large-scale rural to urban migration.

The fourth age remains a poorly understood phenomenon and there is a lack of understanding of the perceptions of those who might be considered to be living in it. This article draws on findings from a study of dignity in later life which examined the day-to-day experiences of participants who were in need of support and care because of failing health. It discusses their accounts of the changes to their sense of self and their identity that came about as a result of their ageing and health problems and looks also at the ways in which the support and care they received helped to shape their adjustment to those changes. The accounts given by participants reveal a great deal about the physical, mental and emotional effort entailed in maintaining a sense of self and highlight the essential role played by social relationships in the maintenance of identity. These findings are analysed by reference to emerging theories of the fourth age.

Primary carers provide much of the day-to-day care for community-dwelling people living with dementia (PWD). Maintaining that contribution will require a more in-depth understanding of the primary carer role and the support needs that flow from that role. This study explored patterns of formal and informal support utilisation by people caring for a PWD in a rural-regional context. In-depth semi-structured interviews were conducted with 18 rural primary carers of a PWD and thematically analysed. Participant primary carers' almost total commitment to, and absorption in their role and their assumption of ultimate responsibility for the PWD's wellbeing meant that external social context, such as rurality, became less relevant. Carer networks effectively contracted to those key individuals who were central to supporting them in their caring task. External sources of support were tightly managed with strong boundaries around the provision of direct care to the PWD largely excluding all but professional providers. Primary carers are generally categorised along with other family and friends as informal care. However, in assuming primary responsible for the care and wellbeing for the PWD they effectively become the key care provider, suggesting that it would be productive in both research and practice to treat primary carers as key members of a care partnership alongside professional carers, rather than as adjuncts to formal care and/or another client.

The provision of physical care is a sensitive matter in all cultures and is circumscribed by moral injunctions and personal preferences. Research on Western cultures has shown care networks to be narrow subsets of people's wider networks and revealed dependence to be deeply undermining of full personhood. In non-Western societies these issues have received little attention, although it is sometimes assumed that care provision and dependence are much less problematic. This paper uses longitudinal ethnographic data from two ethnic groups in rural Indonesia to compare care preferences and practices in old age and to examine the implications of care dependence. The groups manifest varying degrees of daughter preference in care and differ in the extent to which notions of shame and avoidance prohibit cross-gender intimate care and care by ‘non-blood’ relatives. Demographic and social constraints often necessitate compromises in actual care arrangements (e.g. dependence on in-laws, neighbours or paid carers), not all of which are compatible with quality care and a valued identity. We argue that by probing the norms and practices surrounding care provision in different socio-cultural settings, it becomes possible to arrive at a deeper understanding of kinship, personhood and sociality. These insights are not only of sociological interest but have implications for people's vulnerability to poor quality care in old age.

Despite sociological understanding that bodies are social and morphological, material and discursive, there is a persistent, prevailing tendency within sociology to approach the old body – particularly in ‘deep old age’ – as non-social. No longer amenable either to reflexive (consumerist) choice, or expressive of the self, it is viewed rather through a biomedical explanatory framework in which it is held to succumb to ‘natural’ physiological processes of decline that lie outside culture. This paper critically questions such assumptions which it links to sociology's acquiescing in modernity's age ideology rather than taking it as a starting point for critique. This means that sociology's sensitivity towards ageing is displayed not in challenging models of the older body but in diverting attention away from the body altogether and focusing on structural and cultural determinants which are not considered to encompass physiology. Arguing, however, that biology and society do not exist on separate plains, and that the body in deep old age is, like other bodies, first and foremost a social body, the paper draws upon feminist methodology and epistemology for the purpose of dismantling such essentialism. It suggests that the sociological imagination will benefit from the eradication of age ideology through a clearer understanding not just of ageing but of embodiment at all stages of the lifecourse.

Mealtimes in residential care homes are fundamentally social occasions, providing temporal structure to the day and opportunities for conversation and companionship. Food and drink are imbued with social meanings and used to express and create relationships between people. There is a dearth of research exploring care home residents' mealtime experiences in the United Kingdom. This paper reports on particular findings from a qualitative study which investigated factors influencing nutritional care provided to residents in two different types of residential care settings in South Wales, UK. Data were generated through focus group interviews with relevant staff members (N = 15), individual interviews with managers (N = 4) and residents (N = 16) of the care homes and their informal carers (N = 10), observation of food preparation and mealtimes throughout the day, and analysis of appropriate documents. Data were analysed using thematic analysis. This paper's focus is on the ways in which care home residents' experiences and understandings of mealtimes were influenced by various environmental factors, such as the home's geographical location, physical lay-out and ambience. Moreover, the shared meaning of mealtimes for residents, informal carers and staff was constructed from each group's socio-cultural background, family experiences and memories, and was integral to residents' sense of normality, community and identity.

In many sub-Saharan African communities, caring for vulnerable children in the era of HIV/AIDS appears to be creating deep financial, physical and psychological strains for care-givers, the great majority of whom are ageing women or ‘grandmothers’. Yet, limited primary research has been carried out with older women in specific communities, and therefore grandmothers' collective responses, sources of support, complex lived experiences, and diverse family situations are not well understood. This paper presents the findings of research undertaken in four communities in KwaZulu-Natal, South Africa, between 2006 and 2010. The purpose was to understand the daily stresses, collective responses and mobilisations of older women in these communities. The research involved repeated focus groups, interviews and participant observation involving approximately 100 older women. In the analysis, attention is given to the diversities among participants, the ways in which HIV/AIDS intermingles with other stresses in their lives to drive their mobilisations, and their collective responses, even amidst highly constrained conditions. Through these lenses, the paper illuminates how older women in these communities are organising in response to the combined, devastating and diverse effects of HIV/AIDS, poverty, violence and illness. It also suggests that, counter to some stereotyping of ‘African grandmothers’ as frail or passive, these women are forming associations in order to generate incomes, resist stigma, connect with broader support networks and provide care to hundreds in their communities.

As policy makers in the United Kingdom and many other countries grapple with financing the needs of an ageing population, financial planning for social care in later life is high on political agendas. We draw on qualitative research with older couples in the United Kingdom about their intimate money practices to analyse the day-to-day meanings attributed to money, saving and consumption in the context of financial planning for later life and death. We find that expenditure on funerals and home adaptations is discussed, negotiated and planned, as is ‘downsizing’ to release capital from the home for financing day-to-day expenses and leisure expenses. These outcomes are within easy contemplation and indeed money practice of older couples. In contrast, end-of-life planning for domiciliary or residential care was virtually non-existent across all socio-economic groups, and couples employed a range of techniques to avoid making these discussions ‘real’. Costs (while well known) are seen as astronomical, details are scarce, intensive domiciliary care is never discussed, and death is seen as preferable to residential care. We theorise antipathy to care planning as a product of social and psychological construction of the ‘fourth age’ as a period of abjection, and therefore ‘wasted’ expenditure. Exhortations by policy makers for individuals to consider care costs will be ineffective without recognition of the cultural transformation of later life.

The delivery of personalised support to vulnerable older people is largely contingent on those staff who provide direct care. These care workers play an invaluable role in supporting vulnerable older people that may have increasingly complex needs either at home or in care homes. Internationally, concern has been raised both about the recruitment and retention of care workers; and their skills and competencies because of their importance in the delivery of quality care services. Using both primary and secondary data, this paper explores commissioning and contracting arrangements for domiciliary care and care home provision in England and their influence on the recruitment and retention of staff in these services. The implications of the findings are discussed in the context of two factors which influence continuity of care, a proxy for quality services for older people: training opportunities for staff and factors affecting the supply of labour from which direct carers are traditionally recruited. It is suggested that some of the drivers of quality in the provision of care may not be susceptible to the influence of commissioners and providers. Nevertheless, training may aid the recruitment and retention of care workers and provide one way in which they can promote a higher standard of care for older people.

Dignity is a universally important issue for all people, and particularly vital for older adults who face multiple losses associated with ageing. In the United States of America and beyond, the maintenance of dignity is a key aim of policy and service provision for older people. Yet surprisingly little research has been conducted into the meaning of dignity to community-based older adults in the context of everyday life. As life expectancy continues to increase worldwide, unprecedented numbers of people are living longer than ever before. The majority of older adults will face declining health and other factors that may impact dignity in the course of ageing in their communities. This paper reports on a study that explored older people's understandings and experiences of dignity through focus groups and a survey. Three key components of dignity are identified: autonomy, relational and self-identity. In addition, the paper discusses a range of factors that can facilitate or inhibit a sense of dignity for older people, including long-term health issues, sensory deficits and resilience to life events. Finally, the implications of these findings for policy and practice are considered in the context of American social structures and values.

This paper examines how older adults living in rural Malawi explain and understand their sex lives. We present sex in this setting as a field in which broader understandings of ageing, aged identities, and conceptions of person- or adulthood in older age are played out and constructed. Qualitative data were collected from men (N=20) and women (N=23) aged 50 to around 90 using in-depth multiple dependent interviews (N=135) between 2008 and 2010. The giving and receipt of sexual pleasure was considered natural and God-given. Primarily understood as a matter of ‘power’, sex was on the one hand, beneficial to older bodies, but on the other, not accessible to such bodies. Declining sexual frequency was associated with declining desire for sex, or frustration stemming from continued desire for sex. These discourses emerged from the way the ageing body was constructed as a weakened body, incompatible with understandings of adulthood based on physical productivity. Older men and women used sex to discursively respond to these challenges to their adulthood in two ways. Firstly, sex was used to confirm strength, physical productivity, and therefore, identity as an ‘adult’. Secondly, adulthood itself was redefined as being based on moral, rather than physical productivity, and refraining from sex was used to demonstrate wisdom, self-control and therefore their ‘adult’ identity. Our results provide in-depth understanding of the ways constructions of ageing and sex can influence complex experiences of marital and non-marital sex in older age. We contribute to debates on sexuality in the gerontological literature by moving discussion beyond the presentation of continued sexuality as somehow exceptional or an indicator of successful ageing. Finally, in a setting of considerable HIV prevalence at older ages, our results challenge a preoccupation with fertility and chronological age in the collection of sexual health data in Africa.

This paper examines differences in work restrictions of midlife family carers of older people in terms of prevalence, gender and explanatory variables, in six European countries: Germany, Greece, Italy, Poland, Sweden and the United Kingdom. A sample of 2,897 carers aged 45–64 was extracted from the EUROFAMCARE (Services for Supporting Family Carers of Older People in Europe: Characteristics, Coverage and Usage) European project database, in order to analyse four possible work restrictions experienced in connection with the activity of care-giving: the reduction of working hours; giving up working; difficulties in career developments and forced occasional work. The results show that work restrictions are experienced differently between countries especially by women: they are reported to a higher degree in the United Kingdom, Germany and Greece, less so in Italy, and seldom in Poland and Sweden. Gender differences within countries are not so marked. Country differences are explained in the light of the different welfare regimes characterising the countries under investigation, in order to elucidate how policy makers may act to improve working carers' conditions through appropriate policies.

Centres for seniors offering leisure-time activities currently represent significant actors that translate the idea of active ageing into a particular approach to seniors. Despite the fact that active ageing is now represented by the state and providers of social services as the universally desirable way of ageing, the significantly smaller numbers of male clients was identified as a marked feature of such organisations. A three-year ethnographic study was conducted at two centres in the Czech Republic which offer seniors-only leisure-time activities strongly grounded in the idea of active ageing. The method of participant observation was used, and 47 in-depth interviews were conducted with the centres' clients and employees. The higher participation by women in the centres and the role they attribute to such organisations in their lives is analysed in the context of their previous gendered biographies. Gender patterns embedded in the way daily activities at the senior centres are organised, as well as in the idea of active ageing itself, are highlighted. Despite the seeming invisibility of gender as a principle that structures the way these centres are run, they are in fact gendered organisations, where gender emerges as a basic principle affecting the chances of participating in active ageing as presented by the centres.

The long-term care sector is generally characterised by low pay and difficult working conditions. Understanding pay structures and differentials within this sector is important in enhancing recruitment, retention, quality of care and productivity. This article uses new national data on the long-term care workforce in England to investigate employer and individual effects on pay levels and differentials, using mixed-effects modelling controlling for region, sector and employer hierarchical factors. We further examine whether gender and ethnic pay gaps exist among different groups of workers. The results indicate a significant relationship between sector and pay across different job roles. The analysis further identifies ethnic and gender pay differences even after controlling for the effects of sector and individual employers. The implications of this are discussed in relation to sustaining the care workforce in the context of an ageing society and the potential for structural employment marginalisation to reflect the marginalisation of older people receiving care.

During the early 1960s, Norbert Elias led a research project on the adjustment of young workers to work situations and adult roles. The data from this project, which consisted of 851 interviews with young people, were recently rediscovered and the participants, now approaching retirement, were re-interviewed as part of a restudy. In this paper we argue, that, in the context of the dramatic changes to the transition to retirement that have taken place in the United Kingdom, it is possible to use Elias's unpublished work on the transition to work as a theoretical framework for understanding of the transition from work and to retirement. In particular, we focus on the themes of fantasy and reality in the perception of retirement; changing interdependencies in the transition to retirement and the extent and impact of retirement preparation on the perception of the change in status from full-time worker to retiree. We conclude by suggesting that the implied advantages of being the ‘baby-boomer’ generation are far from the reality, with the experiences of this group being similar to those who have gone before and face an adjustment to retirement marked by uncertainty and anxiety.