Elders have long been recognised as among the most vulnerable people in disaster events. This paper reports a qualitative study of the self-perceived needs of older people in the aftermath of the Bam earthquake in Iran in 2003. A total of 56 people aged from 65 to 88 years were recruited to the study using purposive sampling, including 29 men and 27 women. Six focus group discussions and ten semi-structured individual interviews were conducted. Each focus group involved six to ten people from the cities of Bam and Baravat and their rural suburbs. Content analysis was used to analyse the transcribed data. The analysis identified four major themes among the informants' concerns: inappropriate service delivery, affronts to dignity, feeling insecure and emotional distress. A disaster-prone country like Iran needs to be appropriately prepared with culturally sensitive plans to meet the needs of those who suffer from their effects, not least older people. Emergency relief managers should note that for many older people in a disaster zone, customary forms of relief are neither required nor appropriate, and that their distinctive immediate and long-term needs should be assessed and met. Relief agencies need to be trained to be age-sensitive and should mainstream older people's rights in the planning and implementation of both the response and recovery phases of assistance.

This paper examines the association between being in paid work and depression among older adults in three poor urban communities in Beirut, Lebanon. In view of the rapid ageing of Lebanon's population and the growing number of older persons, the deteriorating economic conditions and the lack of pension systems, paid work is an important source of income for older people and deserves special attention. The sample was 328 men aged 65 or more years. Depression was assessed using the 15-item Geriatric Depression Scale. The exposure variable was working for pay at the time of the survey, and the covariates included socio-demographic measures, health characteristics, financial resources and social capital. Around one-third of the men were working, and approximately the same fraction were depressed. Adjusted data showed a protective effect of work on depression (odds ratio 0.50, 95 per cent confidence interval 0.25–0.96). This study is an eye opener on the circumstances of disadvantaged older people in a relatively low-income Eastern Mediterranean Region country, a topic rarely addressed in this area of the world. Old age is viewed as a decline in abilities while in reality many older adults are still able and ready to work. Social policies for older people should promote opportunities to work, not only pension schemes.

A review of several studies examining the lay concept of successful ageing and related concepts leads to the conclusion that elders from different cultures appear to agree on most of the components identified in the literature. From the research emerges a multidimensional conceptualisation of ‘successful ageing’ that is described on the basis of physical, emotional, cognitive and social domains, and which coincides with most theoretical and empirical definitions. The main goal of the present research is to study similarities and differences between concepts of ‘successful ageing’ in several Latin American and European countries and in two different age groups, and also to examine whether a similar structure of the lay concept can be found across both continents. The results show minor differences at item levels among countries, continents and age groups, and a similar internal structure across them.

This paper reports a qualitative study that used narrative analysis to explore how social support helps many armed-services veterans cope with traumatic memories. The analysis was carried out on two levels, that of narrative form (level of narrative coherence), argued to be indicative of reconciliation, and narrative content (themes of social support), which allowed exploration of the types of social support experienced by veterans with coherent, reconciled and incoherent narratives. Ten British male Second World War veterans were interviewed regarding their war experiences, presence of traumatic memories, and experiences of social support from comrades, family and society. Different patterns of support were qualitatively related to coherent, reconciled and incoherent narratives. Veterans with coherent narratives were no less likely to have experienced traumatic events than those with reconciled or incoherent narratives, but they reported more positive perceptions of their war experience and of the war's outcomes, more positive experiences of communication with family in later life, and more positive perceptions of societal opinion. The results are discussed in relation to how veterans can be supported by family and friends to reconcile their traumatic memories, thus to lessen the burden in later life when vital support resources may be unavailable.

The aim of this study was to document the perceptions of elders in six Caribbean countries about ‘active ageing’ and on the basis of their reports to make recommendations to improve their situation. Data were collected principally through 31 focus group discussions conducted in both urban and rural areas. Comparative analysis was carried out of the qualitative information, focusing on three components of ‘active ageing’: health and social services access and use, social support, and economic circumstances. Most of the participants were women, aged 60–79 years, of lower socio-economic status and from urban areas. Large disparities in the responses of Caribbean societies to population ageing were indicated, as well as unequal opportunities to obtain health care and social services, public transport, income and food by both socio-economic status and location. Home-care services are either insufficient or non-existent. Some elders receive social and financial support from relatives while others fear isolation and face deprivation. Social participation varies by place, physical condition, financial situation, association membership, and transport opportunities. Social protection benefits do not provide adequate income and some older people face food insecurity. It was concluded that a comprehensive and multi-sectoral approach using the ‘active ageing’ framework should be implemented to ensure a healthy ageing process.

This paper reports findings from a three-year study which integrated Kitwood's (1997) person-centred and Sabat's (2001) selfhood approaches in the design, fieldwork and analysis of a multi-method observational study that explored the social worlds of 14 people with dementia in continuing-care. The types of interactions that participants experienced in everyday ward life and during creative sessions were identified by observing, video-recording and engaging with them and by Dementia Care Mapping. The participants' responses to such interactions in terms of their well- or ill-being and expressions of self were identified and documented. The findings indicate that in the wards, staff interactions were often limited and sometimes abusive and that participants experienced ill-being, whereas during creative sessions, interactions were generally facilitatory and celebratory with the participants experiencing wellbeing. By developing the selfhood approach and integrating it with the person-centred approach, I argue that recognising and supporting selfhood (or not) during interactions can lead to qualitatively different staff behaviours, with consequences for the well- or ill-being of people with dementia. There is scope for incorporating this developed selfhood framework into staff training, for it has the potential to transform practice and the experiences of people with dementia in receipt of care.

This paper presents a structured literature review that focused on comprehensive case management by nurses for adults with long-term conditions living in the community. The emphases of the review are the implementation of case-management approaches, including its roles, core tasks and components, and the coverage and quality of the reported implementation data. Twenty-nine studies were included: the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. On the basis of the reviewed evidence, three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice, incorporating matters relating to the continuity of care, the intensity and breadth of involvement, and control over resources. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.

Self-reported altruistic activity and social capital were examined as predictors of perceived happiness and life satisfaction among a sample of 4,486 Canadians aged 65 or more years from the 2003 Canadian General Social Services Survey, Cycle 17. Altruistic behaviour was measured by number of volunteer hours per month and helping others (not including family and friends). Social capital was measured using dimensions of belonging to one's community, community and neighbour trust, and group activities. Drawing on generativity and role-identity theories, it was hypothesised that altruistic behaviour and social capital are positively associated with well-being (using perceived happiness and life satisfaction), and that social capital mediates the relationship. For both perceived happiness and life satisfaction, after controlling for demographic, health status, and social support variables, measures of altruistic behaviour demonstrated statistically significant associations. Once measures of social capital were entered into the analysis in the final block, however, the altruistic behaviour variables were no longer statistically significant. Robust associations were found for social capital and the two measures of well-being, particularly between sense of belonging, trust in neighbours, and perceived happiness and life satisfaction. The findings suggest that altruistic behaviour is mediated by social capital. The implications of these findings are discussed with respect to understanding the well-being of older Canadians.