Independent mobility is an important component of healthy ageing. Public transit may be an affordable way to achieve independent mobility, and yet little is known about older adults’ transition to public transit. This paper addresses this research gap by providing an exploration of older adults’ experiences transitioning to public transit use, and by comparing these experiences to those of older people who have always travelled using transit. Twenty-four older adults (65+) living in Hamilton, Canada, who use public transit completed semi-structured interviews during which they discussed their experiences when they first began to use transit. These experiences are framed herein with the concept self-efficacy, i.e. how one's belief in their ability to complete a task shapes their ability to complete said task. Results indicate that most older adults acquire skills to transition to public transit, such as trip planning, boarding, knowing where to sit and exiting the bus. These skills are developed through practice. As one gains experience, one becomes more confident in their ability to meet their daily travel needs using transit. Therefore, the transition to public transit as an older adult can be more challenging for those with little experience using public transit. This paper highlights the danger of assuming all older adults will effortlessly take up transit and stresses the importance of older adults gaining experience using public transit.

Previous research was not able to identify an effect of the COVID-19 pandemic on family care-givers' wellbeing due to cross-sectional data structures, care-giver-specific samples or non-probability sampling designs. In this article, by drawing on longitudinal data from a random and representative sample of the German population aged 40 and older, we overcome methodological limitations of previous research. We examine the impact of the COVID-19 pandemic on the wellbeing (life satisfaction, depressive symptoms, loneliness) of different groups of family care-givers (new care-givers, continuous care-givers, past care-givers) and non-care-givers in Germany. We derived a balanced sample of n = 3,875 individuals aged 43–97 (mean = 66.5 years, standard deviation = 10.2 years) from the German Ageing Survey (DEAS) to explore changes in wellbeing between 2017 (pre-pandemic) and June/July 2020 (pandemic). Using a first-difference approach, we found that the pandemic has a negative impact on both non-care-givers' and family care-givers' wellbeing, with increased levels of depressive symptoms and loneliness compared to pre-pandemic times. Changes in depressive symptoms of family care-givers did not significantly deviate from non-care-givers. However, continuous care-givers showed more pronounced increases in loneliness compared to non-care-givers. Our results suggest that family care-givers' wellbeing merits particular attention when considering the long-term consequences of the COVID-19 pandemic on individuals' wellbeing.

By the year 2030, 19–21 per cent of the population of New Zealand (NZ) is projected to be aged 65 and over. Like many countries, life expectancy in NZ differs by gender but also ethnicity: in 2019, life expectancy for Māori (indigenous) women was 77.1 years compared with 84.4 years for non-Māori women. If Māori and NZ European women are to flourish in later life, examining the factors associated with their wellbeing is paramount. The current study draws on the Life Course Perspective to explore how wellbeing is associated with age-related life events among mid- to later-life NZ women. The women in this study (N = 19,624) are participants in the 2018 wave of the New Zealand Attitudes and Values Study, a national probabilistic 20-year longitudinal study (mean age = 55.62; Māori = 10.8%, NZ European = 89.2%). We found that stressful life events were negatively associated with life satisfaction but positively associated with meaning in life. Māori women exhibited lower levels of life satisfaction but there were no ethnic differences for meaning in life; however, Māori and NZ European women showed different patterns of significant correlates associated with meaning in life. Findings highlight the necessity of an intersectional approach to the study of mid- to later-life wellbeing and the utility of measuring wellbeing in more than one way within NZ's unique cultural-historical context.

The Sociocultural Stress and Coping Model focuses on the role of cultural values in shaping the stress and coping process for family care-givers of frail older adults. The literature suggested ethnic group-specific values as influences. The current study explored care-givers’ perceptions of values influencing caring to identify values not addressed in quantitative studies of cross-cultural care-giving. Seventeen family care-givers from Australian Aboriginal, Romanian-Australian, Pacific Island and white non-immigrant Australian backgrounds participated in semi-structured interviews about their care-giving experience and the role that values played in caring for a frail older adult. Thematic analysis of the interview transcripts led to identification of themes of cultural values of familism and care for frail older adults, religious values of filial piety and religious coping, love, reciprocity and responsibility/obligation. While cultural values influenced family care versus institutional care, religion was a more clearly identified source of values. Care-givers mostly shared values of love, reciprocity and responsibility/obligation rather than endorsing culture-specific values, with potential variations in expression between individualist and collectivist cultures. These findings suggest that the focus on cross-cultural differences may have missed core values shared across cultural groups and underestimated the influence of religion on care-giving values. Future research could focus on these perceptions of care-givers themselves rather than external perceptions of researchers and service providers.

Only a few studies have been conducted so far on the long-term impact of war. We investigated whether a life-long impact of the war experiences could be detected in advanced-agers who have successfully overcome all life's challenges. The participants in this study were oldest-old (80+ years) residents of retirement homes in Zagreb (Croatia), who were divided into two groups – ‘war-exposed’ and ‘not-exposed’ – according to their direct war experience (First World War, Second World War, Croatian Homeland War). Within this 1906–1928 birth cohort, a higher percentage of participants with war experiences reached extreme longevity (95+ years). We found no significant difference (p < 0.01) between the two groups concerning demographic and socio-economic characteristics, their life satisfaction, their self-rated current health and functional ability status. Despite numerous similarities, several traits related to life-history, current quality of life, attitudes and reflections distinguish the group of participants with direct war experience. The kind of war involvement – active military service, imprisonment in concentration camps or prisons, forced migration due to war and war-related death of close family members – stretched through various aspects of the life-history features, quality of life and attitudes. It differed for men and women, so it is no wonder that the significance pattern in the two genders mostly seems mutually exclusive. Socio-economic situations strongly differed by gender and according to the kind of war exposure, amplifying the differences within the ‘war-exposed’ group in terms of the life-long impact of wars on their lives. Therefore, we could claim that the war experiences were not the same for everybody, and that they had lasting consequences on the lifecourse of persons who directly faced war-related events. The results also point to the high resilience capacity as a common feature among persons who survived direct exposure to at least two wars and yet survived to exceptionally old age.

Societal change related to individualisation has likely made individual resources more important for the maintenance of social ties. This raises the question whether lower-educated adults are more disadvantaged in later-born cohorts in personal network structure and function. Observations are from 4,886 individuals aged 55 and over from the Longitudinal Aging Study Amsterdam (LASA), who are followed over a timespan of a maximum of 24 years between 1992 and 2016. Multi-level regression models are estimated to determine cohort differences. Network size is larger in later-born cohorts, and more so for the higher-educated than for the lower-educated adults. Network diversity increases across birth cohorts irrespective of educational level. Lower- and higher-educated women, and lower-educated men give more instrumental support in later-born cohorts, whereas higher-educated men do not show such a steep increase. More emotional and instrumental support is also received in later-born cohorts irrespective of educational level, but higher-educated adults receive more emotional support in all birth cohorts. Thus, lower-educated older adults are not necessarily worse off socially in later-born cohorts. Instead, they are even more likely to be active givers of support. Also, most of the gains in personal networks of older adults in later-born cohorts are independent of educational level, suggesting that the social landscape for older adults today is much richer.

The general discourse in health and social care policy purports digital technology as necessary to meet growing demands for long-term care and health care as a result of an ageing population. This needs critical investigation since public policy influences people's health and wellbeing. This study aims to interrogate critically what we call the ‘digital technology solution’ discourse in local Swedish health and social care policies. The main concern of our analysis is the discursive constructions of older people and their informal carers and how the concept of health is constructed. A discourse analysis was conducted of 61 local policy documents using the ‘What's the Problem Represented to Be’ method. Our analysis revealed that so-called ‘e-health strategies’ were rarely concerned with health. Health was often referred to as an activity and seen as a means to achieve independence among older people. The norm advocated independence, with the responsibility placed upon the older person, supported by digital technology. Informal carers were constructed as a resource within an older person's environment and largely taken for granted. We argue that the digital solution discourse ignores older people's agency and capacities as contributors to society, not least with regards to being providers of informal care.

Anecdotal evidence suggests that non-communicable diseases (NCDs) contribute substantially to mortality, morbidity and disability in Ghana. Nonetheless, no data are presently available on Ghanaians with disability from major NCDs, such as hypertension, diabetes and stroke. Using data from the 2007/2008 Ghana World Health Organization Study on Global Ageing and Adult Health (SAGE) and applying ordinary least squares techniques, the prevalence of and associations between activity limitations and participation restrictions in Ghanaians with NCDs are examined in the present study. The results show stroke is the major contributor to activity limitations and participation restrictions among the Ghanaian population with NCDs. The study results further revealed that respondents with higher education reported high levels of disability compared to those with no education. The results suggest that functioning can be restored by providing assistive technologies, such as wheelchairs, prosthetic limbs, walking aids, etc., that can enhance participation of persons with disability in society.

Dementia, a global health priority, poses a disproportionately high risk to lesbian, gay, bisexual and trans plus (LGBT+)/gender and sexuality diverse people. Despite this, little research has explored the lived experience of LGBT+ people with dementia or their care partners. This scoping review aims to understand what the literature reveals about their experiences, the ways in which their lives have been investigated, to inform future research, policy and practice. Using an established scoping review methodology, we identified seven papers that reported empirical research on the lived experience of LGBT+ people with dementia and their care partners. Only a single study reported on in two of the papers included people who were trans. This in itself reveals how rarely LGBT+ people are asked to speak about how dementia has shaped their lives in academic research. Our reflexive thematic analysis indicates that LGBT+ people with dementia and their care partners endure overlapping forms of disadvantage. This results in heightened experiences of fear and discrimination, lack of services and compounded social isolation. Importantly, while dementia was embodied as interference and loss by LGBT+ people, it was their gender and sexuality differences that provided solace, even in the face of disadvantage. Importantly, people's relationships with LGBT+ identities were framed as fundamental for safety, resilience and wellbeing, rather than a complicating or confounding factor in living with dementia.

Although the older adult population faces a higher risk of poverty compared to others, there is no clear picture of their poverty in Iran. The aim of this study was to measure multidimensional poverty and its related factors among Iranian older adults. This cross-sectional study was conducted from July to November 2019 and collected data by interviewing 1,280 participants in Tehran, Iran. To compute multidimensional poverty, four dimensions were used: health (disabilities), education, housing and standard of living. Single and multidimensional poverty and the joint distribution of deprivation were calculated. Multilevel logistic regression models were used to determine the relationship between predictor variables and outcome (multidimensional poverty). Multidimensional poverty among Tehran's older people was 59.0 per cent. The prevalence of health, housing, education and standard of living deprivations were 15.4, 25.3, 29.5 and 29.9 per cent, respectively. Furthermore, multivariate analysis shows that living with a spouse, being employed, and having health and social insurance coverage were protective factors, while being female was a risk factor for multidimensional poverty. Approximately 21 per cent of multidimensional poverty variance was attributed to the district level and the remaining was assigned to individual-level factors. This study showed that the older adults living in different areas of Tehran experience different aspects of poverty. So paying attention to the dimensions of multidimensional poverty can play an important role in customising the policies of each district. Also, the findings of this study on risk and protective factors of multidimensional poverty can be effective in designing and implementing interventions to mitigate poverty among the older adults.

During the past decades, childless old age has attracted a considerable amount of scholarly interest. However, few studies address this phenomenon in Southern European familistic welfare states, where there is a pervading expectation that family members, especially spouses and children, care for their older relatives. The present cross-sectional study aims to analyse the relationship between childlessness, social networks and wellbeing in a sample of 612 Portuguese individuals aged 65 and over, comprising two sub-samples: parents (N = 540) and childless (N = 72). Data were collected through a research protocol that included a sociodemographic questionnaire, a personal social network assessment inventory, and several validated psychometric measures of psychological wellbeing focusing on mental health, loneliness, depression and satisfaction with life. Childless older adults' social networks are smaller but more diverse, including a more significant proportion of friends and neighbours. No differences were found in perceived support from significant others, but network reciprocity was lower among non-parents. The childless subsample also reported more feelings of loneliness and less life satisfaction, but regression analysis showed that parenthood status, per se, is not significantly related to any outcome measures. Besides the central role of sociodemographic characteristics and personal functioning measures in explaining psychological wellbeing variance, several network factors were also identified as influential predictors. Implications for micro-level network intervention and macro-level social policy making are discussed.

Little is known about risk management in homecare for people with dementia. We aimed to gain an understanding of the ways in which homecare workers assess and manage risk whilst caring for people with dementia in their own homes. We conducted a qualitative interview study with 17 homecare workers assisting people with dementia with their personal care. Interviews were face-to-face, semi-structured, recorded and transcribed verbatim. Analysis was inductive and thematic. A key theme of risk was identified, with three main sources: the client as a source of risk to the homecare worker, the clients' home and behaviours as a risk to the client, and the wider health and social care system as a risk to both clients and homecare workers. Three interrelated aspects of risk were found to influence homecare workers' decision making and actions: homecare workers' perception of the level of risk, their perceived ability to control the risk and their tolerability of risk. The higher the perceived risk, the stronger the action taken by the worker or agency to mitigate it and the greater the impact on the client. To support effective development of this workforce there is a need to devise training that incorporates the use of tacit knowledge and experiential learning. Risk management policies for homecare should acknowledge and utilise the expertise, experiences and values of homecare workers.

This exploratory descriptive study investigated barriers and enablers to the provision of leisure activities for people living in three Australian residential aged care facilities (RACFs) that operated under a household model of care. This research is unique in the international context, as few studies have explored the understandings and experiences of personal care attendants' (PCAs) perceptions of what impacts leisure provision for people living in RACFs. Qualitative data were collected from 17 PCAs via four focus groups. Barriers to leisure provision were identified as PCA–resident ratios, competing demands of the PCA role and a prioritisation of physical care tasks over leisure-related activities. The severity of residents' dementia (cognitive and functional deficits) as well as behavioural and psychological symptoms of dementia were also framed as barriers to participation in and the provision of leisure. Participants identified enablers of leisure provision as related to perceptions of leisure, the experiential knowledge of staff, organisational support and resourcing. The study findings suggest that enhancing leisure provision for people living with dementia will require attention to system issues (i.e. staffing levels, ratios, PCA role demands) as well as PCA knowledge and capability to facilitate person-centred leisure.

Despite theoretical accounts asserting the importance of children for the wellbeing of individuals as they age, research evidence suggests that children may be inconsequential when it comes to loneliness. Yet, there is reason to expect some subgroups may be more vulnerable to the impact of childlessness than others and this may also differ depending on the type of loneliness being assessed. This paper addresses the relationship between childlessness and social and emotional loneliness in middle and later life, including differential vulnerability associated with age, gender and marital/partner status. The study drew on data from three waves (2007, 2012 and 2018) of the Canadian General Social Survey for a nationally representative sample of adults aged 45 and older (N = 49,892). In general, childlessness assumed greater importance with regard to social than emotional loneliness. Women reported lower levels of social loneliness in conjunction with childlessness than men. Further, childlessness was associated with higher levels of overall and social loneliness among older than middle-aged adults. Fewer interactions were evident between marital/partner status and childlessness. Among women specifically, those who were co-habiting, separated/divorced or never married reported lower levels of social loneliness than their married counterparts. In contrast, childlessness was linked to greater emotional loneliness only among separated/divorced men and widowed women. Overall, our results suggest that having children available does matter for feelings of loneliness in middle and later life but that the relationship varies and is contingent on the social contexts (age, gender, marital/partner status) and the type of loneliness (social, emotional) involved.

For older persons, age discrimination can undermine equal participation in modern service and consumer societies. One way to tackle age discrimination is to implement anti-discrimination policy and legislation. However, age discrimination is an ambiguous concept that can be interpreted in different ways and differences in the interpretation can impact the scope and application of related policy and legislation. Hence, to understand how policy, legislation and their central constructs operate within society, it is necessary to look beyond the letter of the law or policy text and explore the interpretations of age discrimination employed by actors in the field. We interviewed experts from Austria and Ireland, who by virtue of their professional or representative position co-structure the conditions for people to claim they have experienced age discrimination. Based on 12 expert interviews and two focus groups, each involving six representatives of the major national advocacy and interest organisations on ageing, we reconstructed four interpretation patterns of age discrimination: age discrimination as the ‘denial of dignity’, as the ‘denial of recognition of contribution’, as the ‘denial of participation’ and as the ‘lack of consideration of need’. The findings are discussed with reference to the concepts of recognition and representation, and considerations are provided on possible legal and political implications of this research.

Stigma and discrimination in relation to dementia has a range of implications for people living with dementia and their families worldwide, including help-seeking, quality of life, social rejection and isolation. Few studies consider the perceptions and stigma towards dementia from multiple perspectives, such as people living with dementia, carers, general public and health-care workers. South Africa has limited evidence on the stigmatisation of people living with dementia, with responses to people living with dementia being driven by poor understanding of the condition, cultural beliefs about causes and social interaction problems associated with memory and cognitive impairment. This study explored the experiences of stigma among people living with dementia and their carers through understanding their own knowledge, attitudes and beliefs as well as those of the public and health-care workers. Qualitative data (N = 52) were collected across two provinces and in four languages (English, Afrikaans, Sesotho and isiZulu), with semi-structured interviews and focus groups with the following stakeholder groups: people living with dementia and their carers, the general public and health-care workers. Inductive thematic analysis generated themes across stakeholder groups. The study shows that people living with dementia and carers experienced high levels of internalised stigma, related to negative public attitudes, which were associated with high levels of isolation, health system unpreparedness and limited access to support. The study contributes to the evidence base needed in South Africa but also extends its relevance by contributing to a growing global evidence base on stigma and dementia in low- and middle-income contexts.

Little is known about the experiences of informal family care-giving for persons with ADRD in the context of Arab and Muslim communities. This paper offers fresh insight into the less-studied private sphere of the home, showing how families respond to the onset and long-term care of persons with Alzheimer's disease and related dementias (ADRD). It considers the extent to which sociocultural and religious influences are appropriated by family care-givers as coping mechanisms and motivators for care. Drawing upon interviews with 32 family care-givers for older persons living with ADRD in Qatar, findings reveal the intersectionality of the care-giving experience with various sociocultural, religious and emotional influences through seven emergent themes: (a) reasons and motivations for care-giving; (b) role of the extended family; (c) socio-demographic attributes of care-givers, their allocated responsibilities and how these intersect; (d) socio-religious attitudes towards care-giving of older persons; (e) social stigma; (f) personal knowledge of ADRD; and (g) coping mechanisms. The paper is concluded with key implications of these sociocultural insights for theory, policy and practice, which could inform Qatar's health and social care provision sector as well as other Arab and Muslim communities that share similar cultural and religious belief systems.

Age-related changes shape social connectedness, isolation and loneliness among older adults. Ageing often accompanies decisions about ageing in place or moving (i.e. senior living facility). Scant research compares these two living arrangements and even sparser research focuses on older women. This study, thus, poses the following questions: How do older women (aged 75+ years) experience social connectedness and perceived isolation? How does this experience vary between older women living alone in private homes and those living in assisted living facilities? Data include semi-structured interviews with women aged 75+ years who live alone in a private home or in an assisted living facility (N = 16). Findings revealed differences in three aspects of social connectedness: interactions, relationships and belonging. Private home participants' interactions underscored intentionality, with minimal investment in forging new or deeper relationships and an emphasis on belonging to the world through awareness, contribution and cognitive ability. The experiences of participants living in assisted living were characterised by availability of interactions and casual relationships. They emphasised belonging to the facility community, while positioning themselves between the status of resident and staff. Surprisingly, most participants in both groups did not express feelings of perceived isolation. Both had adapted their social connectedness expectations to reflect their current situation.

Risk is an innate and integral part of everyday life and is present in simple, everyday occupations and complex actions. Age-related stereotypes can mean older people have little opportunity to engage in activities that present some degree of risk. The present study explores the discourse around risk and older people in the context of the COVID-19 pandemic. We investigated news media as a reflection of the dominant public discourse around older people's behaviour to identify how risk is represented in relation to occupational engagement. Texts relating to older people and COVID-19 were sourced from the West Australian newspaper for a period of two months. Seventy texts were subject to Foucauldian discourse analysis to identify subject positions, location of risk and discursive features. Findings indicate that older people were segregated from the rest of society, with their behaviours framed in mostly negative ways. We identified three areas of discourse: vulnerable, and in need of protection; recalcitrant, and in need of management; and resilient, deserving of respect. While we recognise competing representations, implicit within the dominant discourse was the premise that older people were not capable of mediating risks and required ‘management’. These findings highlight the role of surveillance in restricting occupational engagement for older people and carry implications for older people, the public and therapists.

Loneliness is linked to many negative health outcomes and places strain on the economy and the National Health Service in the United Kingdom. To combat these issues, the determinants of loneliness need to be fully understood. Although friendships have been shown to be particularly important in relation to loneliness in older adults, this association has thus far not been explored more closely. Our exploratory study examines the relationship between number of friends and loneliness, depression, anxiety and stress in older adults. Data were obtained from 335 older adults via completion of an online survey. Measures included loneliness (UCLA Loneliness Scale version 3), depression, anxiety and stress (Depression Anxiety Stress Scales DASS-21). Participants also reported their number of close friends. Regression analyses revealed an inverse curvilinear relationship between number of friends and each of the measures tested. Breakpoint analyses demonstrated a threshold for the effect of number of friends on each of the measures (loneliness = 4, depression = 2, anxiety = 3, stress = 2). The results suggest that there is a limit to the benefit of increasing the number of friends in older adults for each of these measures. The elucidation of these optimal thresholds can inform the practice of those involved in loneliness interventions for older adults. These interventions can become more targeted; focusing on either establishing four close friendships, increasing the emotional closeness of existing friendships or concentrating resources on other determinants of loneliness in this population.