Much contemporary theory suggests that, unlike works of biography or autobiography, human life itself is fundamentally comprised of disconnected moments and is thus devoid of literary form. People may seek to bind these moments together as narratives in the course of their efforts at self-understanding; but these narratives, it is often held, are little more than fictions or myths, impositions of form and order upon the flux of experience. In Tolstoy's Death of Ivan Ilych, we find a powerful refutation of this view. For what we see in Tolstoy's story are the grave consequences of a life lived moment to moment, without any sense of the whole. Only in the face of death could Ivan Ilych gain the requisite distance to behold the true meaning of his dismal life and only upon beholding this meaning could he see the contours of the life well-lived, that is, the life possessed of narrative integrity. By exploring the relationship between death, narrative integrity, and the radical challenge of self-understanding via the story of Ivan Ilych, the present essay seeks ultimately to identify ways in which the study of ageing might contribute to our identifying the good and virtuous life.

The aim of the study was to examine Scottish private sector employers' policies with regard to flexible working arrangements for carers of physically and mentally impaired older people. The questions addressed by this study were as follows : (1) Are employers aware of the needs of carers? (2) To what extent do they view carers' needs or responsibilities as problematic? (3) What proportion of companies have specific policies regarding flexible working arrangements to accommodate carers' responsibilities? (4) What is the ‘nature’ of these policies? (5) Are flexible policies with regard to caregiving responsibilities viewed by companies as part of ‘health promotion’ in the workplace? (6) In what ways do company characteristics influence policy on carers' responsibilities?, and (7) What, if any, initiatives have been adopted to help employees plan for caregiving responsibilities? One thousand questionnaires were sent to companies drawn from the Scottish Chamber of Commerce National Directory 1993; 32 per cent were returned completed and in time for analysis. The majority (92 per cent) of companies had never previously considered the issue of employees' elder care responsibilities. Although expressing considerable sympathy, as well as some responsiveness and flexibility with regard to working arrangements for caregiving employees, the results of the survey indicate that Scottish companies in the private sector are providing little in the way of direct or indirect support to the UK community care reforms. However, informal contacts during the project indicated that the public and voluntary sectors may be more flexible and have begun to develop specific policies with regard to the needs of caregiving employees.

Employing a political economy analysis of need as it relates to the ageing of the population in the context of the postmodern welfare state, this paper attempts to go beyond the narrow confines of the apocalyptic demography argument that an increasing dependent older population represents social and fiscal catastrophe. Older people are caught between a social ethic which values independence on the one hand, and, on the other, a service ethic which constructs them as dependent. This paper argues that this dichotomy between dependence and independence results from a depoliticisation of need, in part the legacy of a radical individualism combined with a postmodern therapeutic ethic. The deeper issues which lie at the heart of the apocalyptic demography argument have to do with issues of need, reciprocity, and community. This paper argues further that a moral economy of interdependence, based on the notion of reciprocity, transcends the dependency/independency dichotomy, repoliticises need, and thereby creates the possibility of a revitalisation of civil society.

Over thirty years ago geriatric nursing, as it was then called, was at the forefront of nursing research in the United Kingdom. Concurrent with the emergence of geriatric medicine as a distinct speciality, the pioneering study of Doreen Norton and colleagues (Norton et al. 1962) served to highlight both the deficits that existed in the hospital care of older people and the enormous potential of nursing to improve the situation, particularly for the ‘irremediable’ patient (Norton 1965). Caring for those who could not be cured but required on-going support was seen to constitute ‘true nursing’ and was identified as an area of practice in which nurses should excel (Norton 1965, Wells 1980). Such potential went largely unrealised, however, as nursing focused on acute, hospital-based care (Nolan 1994). As a consequence, those working in continuing care struggled to find value in their work and patients were subjected to ‘aimless residual care’ (Evers 1991), a situation exacerbated by the continued application of the biomedical model (Reed and Watson 1994). Despite claims that nurses working with older people have ‘special skills’ (Royal College of Nursing 1993), the nature of such skills has therefore never fully been explicated. Indeed, Armstrong-Esther et al. (1994) asked what nurses currently contribute to the well-being of elderly people and, following their study, suggested that nurses must take the initiative and expand their role if ‘we are going to avoid simply warehousing the elderly until they die’. The need to act is particularly pressing at present as the spectre of ‘bed-blockers’ emerges once more and there is growing professional concern that older people may soon be denied the right to receive care from a qualified nurse (Nursing Times 1996).

In Africa, AIDS is called the grandmothers' disease because the burden of caring for the sick and the survivors falls on older women. The two abstracts which follow report an overview of research on the social and economic effects of the HIV/AIDS epidemic in Southern Africa and a case study of an intervention among older women in a Botswanan village.

During the past year depression has remained an important theme of debate in Britain because of its continued high prevalence and association with suicide. Nonetheless patients are often inadequately assessed, the diagnosis is frequently missed, and treatment is commonly inadequate. Depression also has a complex aetiology and physical causes including several medical conditions are often causally related. The condition has a devastating effect on an individual's life and without adequate treatment can be disabling. The following papers examine some of these issues in detail.