There is a need for new imaginaries of care and social health for people living with dementia at home. Day programmes are one solution for care in the community that requires further theorisation to ensure an empirical base that is useful for guiding policy. In this article we contribute to the theorising of day programmes by using an ethnographic case study of one woman living with dementia at home using a day programme. Data were collected through observations, interviews and artefact analysis. Peg, whose case story is central in this article, was observed over a period of nine months for a total of 61 hours at the day programme, as well as 16 hours of observation at her home and during two community outings. We use a material semiotic approach to thinking about the day programme as a health ‘technology in practice’ to challenge the taken-for-granted ideas of day programmes as neutral, stable, bounded spaces. The case story of Peg is illustrative of how a day programme and its scripts come into relation with an arrangement of family care and life at home with dementia. At times the configuration of this arrangement works to provide a sort of stabilising distribution of care and space to allow Peg and her family to go on in the day-to-day life with dementia. At other times the arrangement creates limits to the care made possible. We argue that how we conceptualise and study day programmes and their relations to home and the broader care infrastructure matters to the possibilities of care they can enact.

‘Living well’ is an important concept across national dementia strategies. Qualitative research has contributed to understanding of living well for people with dementia. Longitudinal qualitative approaches, though fewer, can explore potential changes in accounts of living well, psychological coping and adapting to dementia, and if/how people with dementia maintain continuity in their lives. This longitudinal qualitative study aims to gauge what is important for ‘living well’ with mild-to-moderate dementia and whether this changes over time in a group of older people with mild-to-moderate dementia living at home. Semi-structured, qualitative interviews with 20 people with dementia from the IDEAL cohort study were conducted in 2017 and again one year later then thematically analysed. The overarching narrative was largely that of continuity and adaptation, with incremental not disruptive change. Continuing participation and meaningful occupation were important to maintaining living well over time; individuals pursued new as well as previous interests. As a key psychological coping strategy to support continuity in their lives, individuals emphasised their capabilities to maintain activities in spite of dementia, compartmentalising areas that had become more challenging. Maintaining social networks and accommodating changes in social relationships were also central to living well, including managing the psychological impacts of changes in spousal relationships. People in the earlier stages of dementia emphasise continuity and their capabilities, reporting change over time only in certain aspects of their lives. However, small, incremental changes in their social relationships and opportunities for meaningful occupation may still afford key areas for supporting capability to ‘live well’.

Recent debates on age-dissimilar romantic relationships have centred on newly formed relationships, asking whether they reflect shifts towards more equal and individualistic love, or more malleable and self-determined understandings of age. Yet, in a global context where age dissimilarities are shifting and populations are ageing, little attention has been paid to how these understandings of love and age might play out in couples’ futures, particularly in relation to care and gender. While median marital age differences have decreased in Australia and worldwide in recent decades, there has been a rise in larger gaps. In such cases, one partner will reach old age markedly earlier than the other. This article therefore examines how age-dissimilar couples imagine their futures together. It draws on 24 in-depth interviews with women and men in heterosexual, age-dissimilar relationships in Australia, with age differences of seven to 30 years. Talking about their love relationships, interviewees – especially those in older woman relationships – avoided discussing ageing or described age as meaningless or relative. For them, they argued, appearance, experience, personality and felt age took precedence over chronology. Conversations with older interviewees exposed gaps in this logic, however, and gendered anxieties about old age and responsibility for care. Interviewees’ discussions of their futures thus highlighted tensions in understandings about age(ing), gender, care and love. Love was thought to transcend age differences and facilitate care responsibilities for some but not others. Utilising the concepts of democratisation, responsibility and gendered double standards of ageing and care, this article complicates conceptions wherein age dissimilarities are seen to typify the growing meaninglessness of age and gendered equality of love.

In the UK, when people with dementia are regarded as a risk to themselves or others, they are usually admitted compulsorily onto a National Health Service dementia inpatient ward, under the 1983 Mental Health Act. Remarkably little is known about the experiences of informal (family) carers supporting these individuals with dementia during their stay; this study is the first to explore those experiences.

Qualitative, semi-structured interviews with 12 informal carers with a family member admitted to an NHS dementia inpatient ward in the Northwest of England were analysed. The reflexive thematic analysis identified 4 main themes – (1) Initial adjustment and transition; (2) Becoming a visitor; (3) Receiving support and sharing expertise; (4) Planning for the future – and 15 sub-themes. Some carers experienced traumatic events in the build-up to admission and felt overwhelmed, worried, guilty and stressed during the stay, whilst others felt relieved that the person with dementia was no longer at home. The ward environment was regarded as safe and practical, albeit ‘stark’. Staff care was seen as high-quality; carers appreciated support, when available, from a range of care staff and carer groups. Communication with ward staff was reported as ‘mixed’; positives were receiving information leaflets, attending ward rounds and having informal conversations with staff. Carers often felt excluded from future care planning.

Preliminary suggestions for practice and policy recommendations include enhanced informal carer support during the admission, improved communication with ward staff, making the ward environment accessible and ‘homely’, and explaining staffing levels prior to admission.

With society’s growing diversity, it is increasingly crucial to comprehend the care needs of older migrants with dementia and their informal carers. This study explores the experiences of informal carers of older migrants with dementia using professional care, focusing on the participants’ perceptions of whether the delivered professional care meets the needs of the informal carer and their family member with dementia. Purposive sampling identified 17 informal carers living in Belgium and caring for older first-generation labour migrants from Italian and Turkish backgrounds. In-depth interviews were conducted and inductive data were analysed using the Qualitative Analysis Guide of Leuven, a method inspired by the constant comparative method. The findings are presented through composite narrative vignettes. The data analysis revealed six predominant themes: (1) Informal carers are hoping for engagement from professional care providers, to create together a care alliance for the older person with dementia; (2) Informal carers experience cold substandard care provision from professional care providers towards their loved ones; (3) Informal carers need to feel a sense of home to be able to trust the professional care providers; (4) Informal carers experience culturally insensitive care practices by professional care providers; (5) Informal carers struggle with the responsibility of informal care-giving in the context of today’s world; (6) Informal carers experience the cumulative mental load of care-giving. Informal carers of older migrants with dementia face a cumulative mental burden through limited adapted-care options, cultural insensitivity in services, care-giving duties and additional tasks to bridge the professional care gaps.

Involuntary retirement has negative effects on an individual’s health and satisfaction with life. However, it remains unknown whether the recent European policy shift from early retirement towards extending working lives has impacted retirement voluntariness.

This study examines how socio-demographic factors affect retirement voluntariness, which is classified as ‘involuntary’ (e.g. being laid off), ‘voluntary’ (e.g. wanting to spend more time with family) or ‘regular’ (e.g. reaching the state pension age). The analysis is based on SHARE data (Survey of Health, Ageing and Retirement in Europe), covers ten European countries and differentiates between two retirement cohorts (1994–2004 and 2005–2015) during which the policy shift took place.

At the individual level, we find that gender and socio-economic status correlate with retirement voluntariness. At the company level, the sector of employment and job tenure also show an association with retirement voluntariness. The results indicate that, between the two cohorts, the share of those who experience their retirement as ‘regular’ has increased, while the share with ‘involuntary’ retirement has decreased. However, these shifts differ by educational groups, with a stronger increase of voluntary retirement for those with high education, suggesting a rise in social inequalities in retirement-transitions, likely owing to an accumulation of (dis)advantages over the lifecourse.

Average lifespans for people with physical disabilities are increasing; yet there is limited knowledge about their perceptions of what it means to age well. The criteria for Rowe and Kahn’s influential model of successful ageing effectively preclude people ageing with a long-term disability. Several authors have attempted to develop more-inclusive models of successful ageing. The aim of this study was to explore what successful ageing means for people ageing with either spinal cord injury (SCI) or post-polio syndrome (PPS). We used an emic-based methodology, and recruited from Australia 17 participants aged 40–78 years. Nine participants (one male, eight female) had acquired poliomyelitis in childhood and experienced PPS, and eight participants (seven male, one female) had acquired an SCI 15 or more years ago. We used semi-structured interviews to elicit participants’ views on the dimensions important to ageing successfully with a disability, and analysed the transcripts using inductive thematic analysis. We identified eight themes, which related to: (1) maintaining physical health, (2) retaining cognitive abilities, (3) a sense of safety and security, (4) being treated with fairness and respect, (5) positive psychological resources, (6) independence and autonomy, (7) social engagement and participation in community and (8) a sense of purpose. We used the findings to construct a multi-dimensional successful ageing model for those ageing with SCI or PPS. The model includes insights from lay perspectives that further illustrate the role broader society plays in supporting or hindering individuals to age successfully, and has implications for health-care and government services.

This study explores retirement processes. State pension age is gradually increasing in many countries, including the Netherlands. The traditional retirement pathway where individuals have a cliff-edge transition from a full-time job with a permanent contract to full retirement appears to be applicable to an ever-smaller group of employees. Hence, more recently, ‘retirement’ is viewed not as a single transition out of the labour force but rather as a process determined by several intertwined contractual and financial aspects of the labour market. Research has hardly ever combined labour market aspects such as employment security (type of employment contract), financial security (income), work-time arrangements (hours worked) and social protection (receipt of pension and other benefits). This study aims to address this knowledge gap using register data from Statistics Netherlands and treating the status of individuals before and immediately after retirement as a latent variable (late employment quality [LEQ]) measured by several indicators: contract type, contractual working hours, self-employment, income and different types of benefits including pension. We follow older workers between 2008 and 2019 for at least four years before and two years after state pension age and derive trajectories of LEQ using a mixture hidden Markov model. The results indicate several avenues: ‘retirement with medium/high pension’, ‘from non-employment to low pension’, ‘eventually partial retirement’, ‘steps from employment to low pension’ and ‘alternating work and non-work’. It seems to be the case that most older workers in the Netherlands cannot simply be categorised as having either cliff-edge transitions or atypical retirement.

Next of kin play a vital role in the informal care of older relatives in long-term-care facilities (LTCFs). However, finding a sustainable balance between everyday commitments and caring for their loved ones can be demanding, and there is a need to explore new ways to support their caregiving efforts while prioritising their wellbeing. Digital communication technologies have shown promise in enabling meaningful social interactions between older adults and their families, yet their potential to foster connections in LTCFs remains understudied. This study explores the efficacy of a communication technology called Komp in facilitating meaningful connections between next of kin and older relatives in LTCFs. It utilises Norwegian data from all public nursing homes in Oslo municipality to assess whether Komp can facilitate social contact between nursing home residents and their next of kin, and if the use of Komp impacts the next of kin’s experience of satisfaction with this contact. Based on 238 next of kin, this study uses two data sources: (1) survey data collected from all next of kin, in three waves, and (2) a highly detailed weekly data stream from each Komp device. These sources are combined and analysed using multiple regression analysis. The results generally show a positive and significant relationship between use of Komp and increased social satisfaction, indicating that Komp can serve as a valuable tool to help next of kin maintain social bonds with older relatives in LTCFs.

Social determinants of health (SDH) impact older adults’ ability to age in place, including their access to primary and community care services. Yet, older service users are infrequently consulted on the design and delivery of health services; when they are consulted, there is scant recruitment of those who are Indigenous, racialized and/or rural. This study aimed to identify SDH for socially and culturally diverse community-dwelling older adults and to understand their views on how primary and community care restructuring might address these SDH. We recruited a diverse group of 83 older adults (mean = 75 years) in Western Canada and compared quantitative and qualitive data. The majority resided rurally, identified as women, lived with complex chronic disease (CCD), had low income and/or lived alone; nearly a quarter were Indigenous or Sikh. Indigenous status correlated with income; gender correlated with income and living situation. Thematic analysis determined that income, living situation, living rurally, Indigenous ancestry, ethno-racial minority status, gender and transportation were the main SDH for our sample. Income was the most predominant SDH and intersected with more SDH than others. Indigenous ancestry and ethno-racial minority status – as SDH – manifested differently, underscoring the importance of disaggregating data and/or considering the uniqueness of ‘BIPOC’ groups. Our study suggests that SDH models should better reflect ageing and living rurally, that policy/decision makers should prioritize low-income and ethno-racial minority populations and that service providers should work with service users to ensure that primary and community care (restructuring) addresses their priorities and mitigates SDH.

Despite the recognized importance of older adults ageing in their own homes, the role of public financing in mitigating unmet and under-met home care needs remains under-explored. This study addresses this gap by examining the impact of public financing on home care adequacy among English adults aged over 50, utilizing data from waves 6–9 (2013–2019) of the English Longitudinal Study of Ageing. Longitudinal fixed effects and pooled cross-sectional modelling are used to explore the impact of public financing of home care on the unmet and under-met needs of older people. Findings show that individuals with greater limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), as well as those experiencing cognitive decline, are more likely to receive home care. Importantly, while receipt of publicly financed care is associated with a reduction in unmet needs, it does not necessarily translate to fully met needs, resulting in under-met need and highlighting a crucial distinction between access to and adequacy of care. Comparatively, transitioning from use of publicly financed home care to exclusively informal care is linked with lower odds of reporting under-met needs, suggesting variance in the quality of care provided across funding types. This study not only enriches the existing literature by describing the specific impact of different home care financing mechanisms (publicly financed care versus other types of care) on the unmet and under-met needs of older adults but also underscores the need for policies that ensure care adequacy, not just accessibility.

Ageing-in-place for persons with dementia and informal care-givers is encouraged by governments and society. However, individuals with non-Western migration backgrounds are at higher risk of dementia yet underrepresented in research and care. This study aims to identify ageing-in-place care preferences of persons with dementia and their informal care-givers in the Netherlands. Semi-structured interviews (n = 8 participants with dementia, n = 20 informal care-givers) were analyzed using reflexive thematic analysis. Findings reveal that informal care-givers feel a strong duty to care, assisting with various daily tasks. While they desire shared care with professionals, identifying concrete care needs is challenging, highlighting the need for proactive professional support. Participants also emphasized the importance of culturally sensitive in-home care, home adaptations, social care and accessible dementia information. Additionally, the emotional impact of dementia on care recipients and care-givers underscores the need for emotional support. These insights enhance understanding of the care preferences of persons with dementia and their informal care-givers, aiding more efficient and culturally responsive health service planning.

People from different ethnic minorities in the UK are experiencing a steeper increase in dementia diagnosis compared to their white counterparts but are more likely to have a higher risk of dementia, to be diagnosed at a younger age and to die earlier from the condition. These disparities suggest the need for urgent interventions to prevent and reduce dementia risk. Despite the significant presence of Chinese people in the UK, there has been little dementia research involving them, so this study is the first in the UK to focus on Chinese communities living in five major cities. Using a cultural adaptation theoretical framework, we adapted Alzheimer’s Research UK’s virtual dementia prevention campaign Think Brain Health to meet the needs of Chinese people. We used a mixed methods approach to evaluate knowledge of dementia and brain health activities, and intention regarding help-seeking. We performed descriptive, chi-square and thematic analysis; 54 Chinese people completed the intervention, with 85 per cent aged over 60 years. Over half (56%) could not speak, read or write in English. Our results showed significant improvements in knowledge of dementia and brain health, and an improved intention to seek help and information. All participants reported a positive experience of the culturally tailored intervention and valued working with dementia researchers who were able to deliver the intervention in Chinese languages. Future work involving Chinese communities in the UK will need to identify an appropriate but non-stigmatizing Chinese term for dementia.

Despite consensus that quality of life (QoL) in later adulthood is multi-dimensional, scholars’ perceptions of the dimensions the construct comprises differ. Under the premise that models and measures of QoL should correspond with lay perspectives to have relevance to the targeted population, we investigated the constituents of QoL in later adulthood as perceived by middle-aged and older laypersons. We fielded a factorial design vignette experiment among 2,544 respondents aged 50+ participating in the Dutch Longitudinal Internet studies for the Social Sciences panel to assess how 11 dimensions identified from four established QoL instruments designed for older people (WHOQOL-OLD, CASP-19, OPQOL, ICECAP-O) influence QoL evaluations. The study extends prior work on lay perspectives on QoL by combining the internal validity of an experiment with the external validity of a true population sample. All dimensions considered significantly impacted the QoL ratings in the expected direction. Enjoyment and social participation had a significantly larger contribution than the other dimensions. Models stratified by age group showed a strong degree of similarity, suggesting a high level of consensus across age groups about the constituents of QoL in later adulthood. The study highlights the necessity of capturing a broad range of dimensions when conceptualizing QoL in later adulthood. Our finding that dimensions that were omitted in selected established instruments still contributed substantially to QoL evaluations arguably implies that these instruments may have suboptimal content validity. The insights gained from this study are important for developing and evaluating policies aimed at improving QoL for the ageing population.

The global population is ageing rapidly, emphasising the need to understand the decision-making processes of older adults regarding potential care transitions. Gerontological research has focused on healthcare decisions, with less information on living situation choices of older adults. This review explored older adults’ experiences with their involvement in decision-making processes related to transitioning into care facilities in the United Kingdom. From a systematic search of articles, nine were reviewed using thematic narrative synthesis. Four themes with nine subthemes were identified: Involvement in decision-making (Exclusion of older adults, Usefulness of involvement), The necessity of moving (Triggers for moves, The role of family), Timely planning (Helpfulness of planning, Planning avoidance), and Factors for choosing a care home (Non-quality factors, Quality factors, Continuity of life). These themes highlighted the issue of inadequate involvement of older adults in decision-making, often resulting in negative consequences like regret and difficulty settling into new care settings. The necessity of moving arose from sudden events or increased support needs. Some older adults acknowledged the necessity due to declining health or to spare family burden, while relatives grappled emotionally, postponing the choice. Timely planning was found to be beneficial practically and emotionally, facilitating smoother transitions. However, participants would rarely plan and discuss such matters early. Older adults focused on personal experiences and trusted sources rather than publicly available information when considering Factors for choosing a care home. The findings show the need for greater inclusion of older adults in decisions related to their care and the importance of early planning and providing preferred types and formats of information to aid decisions. Future research should focus on a better understanding of older adults’ preferences for successful involvement in care decisions, with support and guidance for others involved in the decisions.