This paper seeks to understand the engagement of people with dementia in creative and arts-based activities by applying a relational model of citizenship and incorporating concepts of contextual and embodied learning from adult learning theory. A theoretically driven secondary analysis of observational and interview data focuses on the engagement of staff, volunteers and people with dementia during an arts-based intervention in a day centre and care home. The processes through which learning is co-constructed between the person with dementia, staff/volunteer facilitators and peers in the group to co-produce a creative engaged experience involves: increasing confidence for learning, facilitating social and physical connections, and affirming creative self-expression. The role of facilitator is central to the process of creative engagement to reinforce a sense of agency amongst participants and recognise people's prior experiences of learning and engagement in creative activities. People with dementia continue to learn and grow through engagement in creative activities to produce positive outcomes for the individual participants and for the care staff who observe and participate in this creativity. Facilitating creativity requires attention to lifelong experiences of learning in addition to the immediate interactional context to integrate arts-based interventions in dementia care successfully.

In recent years, several authors have drawn attention to signs of growing inequalities in the ageing populations of the developed economies. Such formulations have employed the concept of precariousness to suggest that a ‘new’ precarity has emerged in old age. Questioning this position and drawing on data reported over the last two decades on income and health inequalities between and within retired and working-age households, the present paper argues that evidence of this ‘precarity’ is speculative at most and relates more to imagined futures than to empirically observed trends in the present. The ageing of ageing societies – that is the growing agedness of the older population – might imply an increase in precarity or vulnerability at older ages, but this is not a result of changes in the underlying economic and social relations of society. Instead, we would contend that it is the corporeal consequences of living longer. By conflating the various meanings of ‘precarity’ there is a corresponding danger that the very real changes brought about by population ageing will be underplayed, which may be to the detriment of the most vulnerable. The idea of a new precarity in later life may thus not serve the ends to which it is intended.

The aim of this study was to gain an understanding of the experiences of extended longevity as perceived by centenarians. Centenarians (people over 100 years of age) are the fastest growing group of the ageing population in developed countries. Ten centenarians aged between 100 and 106 years, living in the Lower North Island of New Zealand, participated in the study. The biographical narrative interpretive method of inquiry guided data collection through face-to-face interviews, and thematic analysis was subsequently undertaken. Four themes were identified: (a) ‘becoming a centenarian: ‘Just another day’; (b) ‘growing up in a privileged environment’ that revealed four sub-themes: ‘having freedom and choice’, ‘being loved and nurtured’, ‘living healthy lifestyles’ and having ‘good education prospects’; (c) ‘unique opportunities in adult life’; and (d) ‘positive ageing and celebration of longevity’. The centenarians spoke nonchalantly about their experience of turning 100 and positive personalities were prominent features of the participants, who all expressed a sense of acceptance and satisfaction with life and contentment with living in the present, a feature throughout their lives that was ongoing and at an intergenerational level. This study has provided further insights into the existing literature on longevity and through the narratives of the centenarians has demonstrated the value of Erikson's psycho-social stages of development and Tornstam's theory of gerotranscendence when considering positive ageing.

Rapid fertility declines in Latin American and Caribbean countries since the 1960s have contributed to smaller family sizes among the current cohorts of older adults. This may have mental health implications in these societies as the family unit is highly valued as a source of social support. Utilising data from the 2000 Survey of Health, Well-being and Aging in Latin America and the Caribbean (SABE), this study examines the association between parental status, marital status and the likelihood of experiencing depressive symptoms among adults 60 years and older in seven cities within Latin America and the Caribbean (N = 9,756): Buenos Aires, Bridgetown, São Paulo, Santiago, Havana, Mexico City and Montevideo. Results from multivariate logistic regressions indicate that parental status is not significantly associated with depressive symptoms. Nonetheless, unmarried older adults, both those living alone and those living with others, are more vulnerable to experiencing depressive symptoms than their married counterparts. Marriage is especially protective for older adults in Havana and Montevideo. Older adults’ perceived income adequacy significantly moderates the relationship between marital status and depressive symptoms. Other significant covariates, such as experiencing disability and comorbidity, showed positive associations with depressive symptoms. While families may still represent a critical component for the mental health of older adults, broader investments in health across the lifespan are needed to improve individual psychological wellbeing.

Vision impairment is prevalent and it is strongly associated with depressive symptoms in older adults. This study aimed to investigate the mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. This study used data from a probability-based sample of 1,093 adults aged 60 and older in Shanghai, China. Structural equation models were used to examine the structural relationships among sets of variables simultaneously, including vision impairment, activities of daily living ADLs, instrumental ADLs (IADLs), friends support, family support, relatives support and depressive symptoms. The bootstrapping method and the program PRODCLIN were used to test the indirect effects of these variables. This study found that vision impairment was directly associated with a higher level of depressive symptoms, and the association was partially mediated by functional limitations (IADLs) and social support (friends support). The study demonstrates that improving social support from friends and enhancing social participation for visually impaired older adults can reduce depressive symptoms. More importantly, this study contributes to the knowledge of mediating mechanisms between vision impairment and depressive symptoms.

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts’ suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore.

The experiences of police officers who have retired from the police service have rarely comprised the focus of empirical studies in England and Wales. Drawing on the findings of a survey of former police officers, this article examines the circumstances within which officers leave the service and aspects of the transition to retirement. We find that that certain individual, role and organisational factors come together to explain how the transition to retirement is experienced by police officers. We conceptualise police retirement as a multi-dimensional process during which a number of factors may come into play and have different effects depending on the circumstances in which retirement occurs. Findings are considered in light of wider conceptualisations of the process of retirement and implications are discussed.

Given an ageing population and increased participation by women in the labour force, the relationship between unpaid care and the availability of women to the labour force is gaining in importance as an issue. This article assesses the impact of unpaid care on transitions into employment by women aged between 45 and 59 years. It uses the German Socio-Economic Panel (SOEP) from the years 2001–2014 to estimate Cox regression models for 6,201 employed women. The results indicate that women with higher caring responsibilities and women with lower caring responsibilities are heterogeneous in terms of the socio-economic characteristics that they exhibit: higher-intensity care providers tend to have a lower level of educational attainment and a weaker attachment to the labour force than women with less-intensive caring responsibilities. Furthermore, while women with more-intensive caring roles are highly likely to exit the labour market altogether, female carers with less-intensive roles seem to be able to combine work and care better. These results highlight the importance of providing more affordable institutional and professional care services, especially for low- and medium-income families.

This paper investigates the association between accumulated major lifecourse adversities and later-life depressive symptoms among older people in England, both at a single point in time (prevalence) and the onset over time during later life (incidence), using data from the English Longitudinal Study of Ageing. Using retrospective data on the experience of major life adversities from childhood onwards, five latent classes were identified: no/few lifecourse adversities (58.6%), lost relationship (27.0%), chained adversities (2.4%), childhood adversities (6.3%) and war-related adversities (5.7%). Older people who had experienced ‘chained adversities’, ‘childhood adversities’ and ‘a lost relationship’ had higher odds of presenting current depressive symptoms in 2006, even after controlling for socio-demographic characteristics, health-risk behaviours and social resources. Longitudinal analysis indicated that amongst respondents who were clear of depression in 2006, those older people who had experienced childhood adversities, a lost relationship and war-related adversities experienced a higher risk of having a new case of depressive symptoms. Results further indicate that women's mental health in later life is more sensitive to earlier life adversities than men's. The study shows that intervention earlier in the lifecourse may have benefits for the individual both contemporaneously and over the longer term.

The development of social gerontology has led to the emergence of its own terminology and conceptual armoury. ‘Ageism’ has been a key concept in articulating the mission of gerontology and was deliberately intended to act as an equivalent to the concepts of racism and sexism. As a term, it has established itself as a lodestone for thinking about the de-valued and residualised social status of older people in contemporary society. Given this background, ageism has often been used to describe an overarching ideology that operates in society to the detriment of older people and which in large part explains their economic, social and cultural marginality. This paper critiques this approach and suggests an alternative based upon the idea of the social imaginary of the fourth age. It argues that not only is the idea of ageism too totalising and contradictory but that it fails to address key aspects of the corporeality of old age. Adopting the idea of a social imaginary offers a more nuanced theoretical approach to the tensions that are present in later life without reducing them to a single external cause or explanation. In so doing, this leaves the term free to serve, in a purely descriptive manner, as a marker of prejudice.

Social exclusion amongst rural-dwelling older adults and the role of the diversity of people and places in mediating the construction of that exclusion has not been adequately investigated or conceptualised in the international literature. Consequently, how ageing in a rural community can function to disadvantage or protect older people remains poorly understood. With the aim of advancing conceptual understanding on rural old-age social exclusion, this article explores how exclusion is manifest in the lifecourse experiences of rural-dwelling older adults and the role of mediating factors in the construction of exclusion in different kinds of rural places. The analysis draws on ten rural case-study sites across Ireland and Northern Ireland, encompassing five kinds of rural communities: dispersed rural; remote rural; island rural; village rural; and near-urban rural. Data come from 106 interviews with older people ranging in age from 59 to 93 years. Rural old-age social exclusion is confirmed as a multi-dimensional construct, involving: social relations; service infrastructure; transport and mobility; safety, security and crime; and financial and material resources. This analysis demonstrates that social exclusion for rural-dwelling older people is multi-layered, and its prevalence and form is shaped by four mediating factors: individual capacities; lifecourse trajectories; place; and macro-economic forces. The findings are used to present a conceptual framework that emphasises the role of mediating forces on rural old-age social exclusion.

Caring for one's grandchildren has become a more common experience for individuals partly as a result of a longer overlap between the lives of grandparents and their grandchildren. Existing research shows that around 50 per cent of grandparents engage in some grandparental child care in most European countries, however, this proportion is higher among older people with a migrant background, partly due to greater economic necessity among migrant families. Research has also highlighted ethnic differences in parents’ child-care selection, even after controlling for their socio-economic status. Building on these strands of work, this paper investigates the differences in the use of (grandparental) child care among parents from different Black and Minority Ethnic (BME) groups in the United Kingdom, using data from Understanding Society. The results show that parents from Other White, Indian, Pakistani, Bangladeshi and African communities are less likely to use child care than White British parents, while the opposite is true for Caribbean parents. However, among parents using child care, individuals from the Other White, Caribbean and African groups are less likely than the White British majority to be using grandparental child care as a supplement to other child-care types, or on its own. Ethnic differentials in the use of child care per se and grandparental child care in particular, have significant policy implications, and may mask other kinds of ethnic differences.

The ageing population of Turkey has brought later-life care into question. Family care remains most prevalent, but institutional, paid and professional care are increasing. Literature in Turkey has focused on the medical or social policy aspects but not care-givers’ experiences, nor how the care is performed. This study aims to illuminate care-givers’ experiences using qualitative methods, through in-depth interviews in Ankara with 19 care-givers providing home care for people aged 65 and over. Commonalities and differences were revealed among unpaid family care-givers, paid care-givers and professional care-givers. First, whether paid or unpaid, the bodily and emotional aspects of care work are intertwined. To cope with the ‘negativities’ involved in the work, nurses usually medicalised bodily tasks, unpaid care-givers cited traditional responsibilities and employed infantilisation, while paid care-givers mostly informalised the relationship, infantilised the person cared for and underlined their asexuality. Secondly, care work is gendered; silenced, invisible and ambivalent; related to intimacy with older bodies; and performed in the home space, which blurs the distinction between the private and public field for paid care. Finally, it involves emotional work regarding managing the bodily aspects and navigating the relationships surrounding the older person; and it is labour-intensive with an exploitative character.

Little is known about the dynamic relationship between the different funding sources of community-based social care in England. Using Waves 2–6 (2004–2013) of the English Longitudinal Study of Ageing survey, I estimated dynamic multi-level cross-classified mixed-effects logistic regression models to investigate whether receiving services by one source is more or less likely if an older person was already receiving services funded by the same source or another in the previous period. Four hypotheses between formal privately and publicly funded help and informal help are tested: substitution, complementarity, compensation and task-specificity. I also report evidence that older people on low incomes residing in local authorities that reduce social care spending are especially affected.

The Chinese government encourages the promotion of community-based older people centres as a way to use space rationally, improve social inclusion and support older residents’ everyday lives. This exploratory study is the first to examine in depth the contradictory and consistent attitudes and suggestions of residents of different age groups for the design of an inclusive community-based centre for older and younger people in China. An integrative mixed-methods approach was used. In the quantitative phase, 270 older adults (⩾60 years) and 250 younger adults (<60 years) from Harbin were asked to complete questionnaires (older adults’ response rate = 87.0%; younger adults’ response rate = 87.2%). In the qualitative phase, seven focus group discussions (four groups of older adults, three groups of younger adults) were conducted. The findings indicate that older adults have a higher acceptance level of inclusive design and prefer to share spaces to improve intergenerational interactions than younger adults. Residents of all ages are more likely to share functional spaces related to health services, living services and physical exercise. Moreover, the study reveals some design suggestions: the location of the centre should be away from the residential area and integrated into a public community building; comprehensive services should be provided to older people and be accessible to the whole family; design should be barrier-free, and the climate and nearby spaces should be considered.

Although life-story work is an established form of support for people with dementia and their carers, culturally Deaf people who are sign language users have been excluded from this practice. There is no evidence base for the cultural coherence of this approach with Deaf people who sign, nor any prior investigation of the linguistic and cultural adaptation that might be required for life-story work to be effective for sign language users with dementia. Given the lack of empirical work, this conceptual thematic literature review approaches the topic by first investigating the significance of storytelling practices amongst Deaf communities across the lifespan before using the findings to draw out key implications for the development of life-story work with culturally Deaf people who experience dementia and their formal and informal carers (whether Deaf or hearing). The reviewed work is presented in three themes: (a) the cultural positioning of self and others, (b) learning to be Deaf and (c) resistance narratives and narratives of resistance. The article concludes that life-story work has the potential to build on lifelong storying practices by Deaf people, the functions of which have included the (re)forming of cultural identity, the combating of ontological insecurity, knowledge transmission, the resistance of false identity attribution, and the celebration of language and culture.

Faced with the dramatic pace of population ageing, the Shanghai municipal government launched a pilot programme in 2013 designed to address this and to strengthen ageing-in-place arrangements by providing basic in-home medical services for residents above the age of 80. Yet after a two-year trial run, the ‘Home-Based Medical Care Scheme for the Oldest-Old’ (HBMCSOO) policy remained significantly under-utilised despite the increasing demand for medical services. Our multi-disciplinary research team of social workers and anthropologists identified two key factors impeding the implementation of home-based medical care services: (a) the distortion of policy implementation and (b) the inadequate professionalisation of community-based elder-care workers. Based on our evaluation of the pilot programme, the Shanghai municipal government made several practical adjustments to improve the subsequent city-wide policy implemented in 2016. While these changes mostly focused on minor adjustments to improve in-home medical services for the oldest-old, they represent an encouraging first step towards our call for a holistic integrated care system whose design and delivery takes into account local political and social contexts, including existing institutional infrastructure and cultural expectations about care-giving responsibilities. The challenges of implementing Shanghai's HBMCSOO policy ultimately provide instructive lessons on best practices for integrating medical and social services in order to improve ageing-in-place measures in diverse local settings around the world.

Pakistan is a lower middle-income country, which to date has had very little research and policy making to address the challenge of dementia. This study aims to explore the perceptions of dementia in a group of Pakistani adults. A series of focus group discussions were completed during 2017 with men and women in two metropolitan centres in Pakistan (Lahore and Karachi) (N = 40). Two vignettes, depicting someone with mild dementia and someone with severe dementia, were used to facilitate discussions. An induction-led thematic analysis was completed. Five themes were identified, reflecting (a) dementia awareness, (b) responsibility, (c) barriers to health care, (d) identified support needs, and (e) religion. Most participants had little awareness and knowledge about dementia, commonly understood to be a disease of forgetting or just normal ageing. Thus, there is an urgent need of a nation-wide campaign to raise dementia awareness in Pakistan, though this needs to be accompanied by improved, accessible health and social care services.

As a response to demographic ageing, various governments have been promoting social policies that promote older people's participation in productive activities, including those outside the formal labour market. Nevertheless, older people's behaviours do not simply reflect government policies and intentions. This paper explores how older people themselves interpret their social roles within a policy context that seeks to position them as providers of welfare through their participation in community activities. For this purpose, this paper draws on a qualitative case study of older people in Japan engaging in health promotion and mutual aid among local residents. By employing Hannah Arendt's distinction between the human activities of labour, work and action as a conceptual framework, it finds that although the purported purpose of community activities was to substitute decreasing pensions and family care or to create a better community, participants in this study valued their activities as a process of creating new relations and new realities through action. The paper argues that while labour has occupied a predominant position in the post-war welfare paradigm, community activities by an expanding population of older people may offer opportunities for action, which were not always available through paid work or care-giving in the household.