Showing papers in "Ageing & Society in 2004"

Quality of life from the perspectives of older people

Abstract: This paper report results from a national survey of quality of life (QoL), based on 999 people aged 65 or more years living in private households in Britain. The study produced both qualitative and quantitative interview data. The 999 survey respondents were interviewed in their own homes with a semi-structured survey instrument, and 80 were followed-up in greater depth at one and two years after the baseline interview. The material from the in-depth interviews is presented here. The main QoL themes that emerged were: having good social relationships, help and support; living in a home and neighbourhood that is perceived to give pleasure, feels safe, is neighbourly and has access to local facilities and services including transport; engaging in hobbles and leisure activities (solo) as well as maintaining social activities and retaining a role in society; having a positive psychological outlook and acceptance of circumstances which cannot be changed; having good health and mobility; and having enough money to meet basic needs, to participate in society, to enjoy life and to retain one's independence and control over life. The results have implications for public policy, and supplement the growing body of knowledge on the composition and measurement of quality of life in older age.

Ethnographic reflections on selfhood, embodiment and Alzheimer's disease

Abstract: Explicit in the current construction of Alzheimer's disease is the assumption that memory impairment caused by cognitive deficiencies leads to a steady loss of selfhood. The insistence that selfhood is the exclusive privilege of the sphere of cognition has its origins in the modern western philosophical tradition that separates mind from body, and positions the former as superior to the latter. This dichotomy suggests a fundamental passivity of the body, since it is primarily cognition that is held to be essential to selfhood. In contrast to the assumed erasure of selfhood in Alzheimer's disease, and challenging the philosophical underpinnings of this assumption, this paper presents the findings of an ethnographic study of selfhood in Alzheimer's disease in a Canadian long-term care facility. It argues and demonstrates that selfhood persists even with severe dementia, because it is an embodied dimension of human existence. Using a framework of embodiment that integrates the perspectives of Merleau-Ponty and Bourdieu, it is argued that selfhood is characterised by an observable coherence and capacity for improvisation, and sustained at a pre-reflective level by the primordial and socio-cultural significance of the body. The participants in this study interacted meaningfully with the world through their embodied way of ‘being-in-the-world’.

The diversity and welfare of older migrants in Europe

Abstract: This paper sets the scene and provides a conceptual framework for the articles in this special issue. They present the findings of research on European residents who have reached or are on the threshold of old age and whose current circum- stances have been strongly influenced by a migration across an international border. Such ' older migrants  are scattered throughout Europe and they have especially diverse characteristics. They include some of the most deprived and socially excluded, and some of the most affluent and accomplished, but all to a greater or lesser extent are disadvantaged through an interaction between social policies and their ' otherness  by living in a foreign country. Some claim attention through the severity of their unmet health and welfare needs and poor capacity to access advice and treatment, while the affluent groups are of great interest to social gerontology because of their enterprising, developmental and positive approaches to old age. They include among the most innovative of the latest generation of older people, who pursue new combinations of family responsibilities, leisure pursuits and income generation. The paper proposes that the concept ' human capital  summarises variations in preparedness for old age, that is, the resources by which people cope with demands for income, roles, treatment, care and support. A typology of the 'welfare position  of international migrants in contemporary Europe is presented.

Northern European retired residents in nine southern European areas: Characteristics, motivations and adjustment

Abstract: During the last two decades, northern European retirement residence in the southern European sunbelt has grown strongly and its forms have rapidly changed, but standard demographic and social statistical sources provide no information about the flows, the migrants or their increasingly mobile and complex residential patterns. Considerable primary research has however recently been undertaken into the causes, conditions, experiences and consequences of international retirement migration (IRM) by investigators from Germany, Spain, Switzerland and the United Kingdom. Many collaborated when designing their studies and instruments, and all have subsequently worked together in a European Science Foundation Scientific Network. This paper compares the findings of six systematic social surveys in (to be more precise than the title) eight regions of southern Europe and the Canary Islands: all have tackled similar research questions with similar methods and instruments. It presents interpretations of several comparative tables compiled from their original data, with a focus on the socio-economic backgrounds, motivations and behaviour of the various migrant groups and their relationship with the host and home countries. The paper presents new findings about the typical and variant forms of IRM, and additional understanding of the heterogeneity of the retirees of different nations and in the several regions. © 2004 Cambridge University Press.

Modernisation and ageing theory revisited: current explanations of recent developing world and historical Western shifts in material family support for older people

Abstract: Modernisation and ageing theory has provided the main platform for the debate on changes in family support for older people in both the industrialised and the developing worlds. Although its well-known proposition of an ‘abandonment’ of older people in individualistic society has received much attention and been solidly refuted, the modernisation model continues to be the principal and most common framework for explaining the decline in familial material support for older people – both historically in the West, or at present in developing countries. The main rival explanation is provided by materialist accounts. The ability of these explanations to provide a meaningful understanding of why material family support may diminish has however received little if any analytical attention, despite its vital policy relevance, especially for the developing world. This paper critically examines the content and basis of both explanatory models. For each it exposes fundamental conceptual and epistemological limitations that render neither able to provide a solid understanding of the nature and causes of decline in support. Building on this analysis, the paper proposes a new approach in order to develop a fuller conceptual and empirical understanding.

Quality of life and building design in residential and nursing homes for older people

Abstract: Older people living in residential and nursing care homes spend a large proportion of their time within the boundaries of the home, and may depend on the environment to compensate for their physical or cognitive frailties. Regulations and guidelines on the design of care buildings have accumulated over time with little knowledge of their impact on the quality of life of building users. The Design in Caring Environments Study (DICE ) collected cross-sectional data on building design and quality of life in 38 care homes in and near Sheffield, Yorkshire. Quality of life was assessed using methods which included all residents regardless of their frailty, and staff morale was also assessed. The physical environment was measured on 11 user-related domains using a new tool, the Sheffield Care Environment Assessment Matrix (SCEAM). Significant positive associations were found between several aspects of the built environment and the residents’ quality of life. There was evidence that a focus on safety and health requirements could be creating risk-averse environments which act against quality of life, particularly for the least frail residents. Staff morale was associated with attributes of a noninstitutional environment for residents rather than with the facilities provided for the staff. The new tool for assessing building design has potential applications in further research and for care providers.

Quality of life in the third age: key predictors of the CASP-19 measure

Abstract: This article aims to identify and analyse the lifecourse and contextual factors that influence the quality of life in early old age. We conceptualise quality of life as distinct from the factors which influence it, and employ a model of the quality of life that is derived from an explicit theory of human need. The operational measure (CASP-19) consists of 19 Likert-scaled items which cover four theoretical domains: control, autonomy, self-realisation and pleasure. A postal questionnaire was sent to 286 British people aged 65-75 years who were members of the sample for the 1930s Boyd-Orr study of health and diet and who had been followed up through retrospective interviews during the late 1990s. The 286 were broadly representative of their age group. The survey's response rate was 92 per cent. Respondents provided information on a number of contextual influences on their quality of life in early old age, notably social support and participation, the quality and quantity of social contact, feelings of trust and reciprocity about the local neighbourhood, health and financial security. In the analyses reported here, a series of conceptual and operational influences on quality of life in early old age is identified using block regression models. Finally, the relative impact of each predictor on CASP-19 is examined. The findings suggest that the legacy of the past tends to be best captured by people-Is feelings about the adequacy of their pensions and their status as owner-occupiers as well as a feeling that the area in which they live is deprived. The quality of the social contact people describe and how close they-feel to those around them will ameliorate the negative impacts of the past and the immediate environment. In addition I we must recognise that people remain vulnerable to the impact of loss: recent bereavement, and major illnesses can impact on a person's quality of life.

Whose empowerment and independence? A cross-national perspective on ‘cash for care’ schemes

Abstract: This paper uses qualitative data from a cross-national study of ‘cash for care’ schemes in five European countries (Austria, France, Italy, The Netherlands and the United Kingdom) to consider the concepts of empowerment and independence in relation to both care-users and care-givers. The paper locates the schemes along two axes, one of regulation/non-regulation, the other whether relatives can be paid or not. Each of the schemes has a different impact both on the care relationship and on the labour market for care. In The Netherlands where relatives can be paid, for example, a fully commodified form of informal care emerges; but in Austria and Italy with low regulation, a mix of informal and formal care-givers/workers has emerged with many international migrant workers. In the UK, direct payments allow care-users to employ local care-workers who deliver care for various lengths of time; while in France a credentialised system means that care-work is delivered by qualified workers but for very short intervals. The main conclusion is that none of these schemes have a simple outcome or advantage, and that the contexts in which they occur and the nature of their regulation has to be understood before drawing conclusions about their impact on empowerment and independence on both sides of the care relationship.

Renegotiating identity and relationships: men and women's adjustments to retirement

Abstract: Retirement is frequently a period of change, when the roles and relationships associated with individuals' previous labour market positions are transformed. It is also a time when personal relationships, including the marital relationship and relationships with friends and family, come under increased scrutiny and may be realigned. Many studies of adjustment to retirement focus primarily on individual motivation; by contrast, this paper seeks to examine the structure of resources within which such decisions are framed. The paper examines the contribution that gender roles and identities make to the overall configuration of resources available to particular individuals. It draws upon qualitative research conducted with older people in four contrasting parts of the United Kingdom, and examines the combination of labour market and non-labour-market activities in which they are involved prior to state retirement age and as they withdraw from paid work. It explores how older people invoke various gendered identities to negotiate change and continuity during this time. The paper argues that gender roles and identities are central to this process and that the reflexive deployment of gender may rank alongside financial resources and social capital in its importance to the achievement of satisfying retirement transitions. Amongst those interviewed, traditional gendered roles predominated, and these sat less comfortably with retirement for men than for women.

The portrayal of older people in prime time television series: the match with gerontological evidence

Abstract: Empirical studies in several disciplines including sociology, psychology and communications science have investigated images of older people in the mass media, but analyses to date have failed systematically to apply gerontological concepts and to compare the portrayal of old age with ‘real-world’ evidence. A model of older people's internal and external resources was used to assess the portrayal of older people in prime-time television drama series. Three hours of programmes broadcast over six weeks in 2001 of 32 prime-time television series on the four German networks with the largest market shares were examined. The age of 355 portrayed characters were estimated, and the socio-economic, health-related and psychological resources of the 30 characters rated as 60 years or older were assessed. Observational categories and rating dimensions were developed on the basis of the resource model. Older people were heavily under-represented, especially women and those of advanced old age. Furthermore, the representation of older people's social participation and financial resources was overly positive. Finally, older women and men were portrayed in traditional gender roles. The antecedents and consequences of the biased portrayals (of old and young people) are discussed from a psychological perspective.

The construction of Heimat under conditions of individualised modernity: Swiss and British elderly migrants in Spain

Abstract: The objective of this paper is to present the findings of a quantitative study of Swiss elderly residents on the Costa Blanca (in the Province of Alicante, Spain) and of an ethnographic study of their British counterparts in Fuengirola and Los Boliches on the Costa del Sol (in the Province of Malaga). We examine the German concept Heimat and its value as an organising construct for understanding the aspirations and actions of foreign retirees resident in Spain, and explore whether globalisation undermines locality to the extent that being in a particular geographical place is no longer a prerequisite for feeling at home. The paper describes the social life and patterns of association of these groups of retired people, in terms of social clubs, leisure activities, voluntary associations, charity groups and self-help groups, relations with home, and relations to Spaniards and people from other countries. It compares the results of the two studies in an analysis of the strategies that the two groups adopt for constructing social communities and for finding a new home. This paper thus provides some insights into what older people seek in later life in terms of their residence, co-resident groups, social contacts and lifestyle choices.

Mortality and morality: ageing and the ethics of care

Abstract: This paper focuses on the circumstances of death and dying in old age. It considers the ways in which social policies and social gerontology reflect the values of independence, autonomy and citizenship, and it considers the implication of these values for older people who are dependent on others for care and support at the end-of-life. It discusses the complexity of the relationship between ageing and dying, by exploring recent research from the fields of social gerontology and the sociology of death and dying. Arguing that a long-term perspective is required to understand fully the circumstances of older people's deaths, it analyses the third age/fourth age dichotomy as a conceptual model. The task of developing knowledge about the links between ageing and dying requires consideration of moral and ethical principles. The article examines the conceptual frameworks developed by feminists who argue for an ethics of care as a central analytic referent in social policy. The feminist ethics-of-care approach provides a powerful critique of the moral framework of independence and autonomy as characterised in contemporary policies and practices. Feminist ethicists argue that the inter-relatedness of human beings and the importance of the social context have been overlooked in the preoccupation with individual rights – as reflected more generally in policies and social life. It is argued in the paper that the need for care at the end-of-life highlights these shortcomings. The feminist ethics of care has considerable potential to illuminate our understanding of dependency and care, and to generate both new approaches to policy and practice in health and social care and theoretical perspectives in gerontology.

Ageing in a non-heterosexual context

Abstract: There is increasing recognition of the importance of social and cultural differences in shaping the diversity of the ageing experience in contemporary Britain. Various social and cultural factors, such as those associated with class, ethnicity, gender and disability, influence people’s living circumstances and sources of support in later life. While they have been the subject of considerable speculation, ageing in a non-heterosexual context remains remarkably under-studied. This paper examines the difference that being non-heterosexual makes to how people experience ageing and later life. It draws on quantitative and qualitative data gathered for a British study of the living circumstances of non-heterosexuals aged between the fifties and the eighties. Previous work has overwhelmingly emphasised how individuals manage their sexual identities, but this paper focuses on the factors that shape the non-heterosexual experience of ageing and later life. Particular attention is paid to the relational and community contexts in which non-heterosexuals negotiate personal ageing. This not only provides insights into the specific challenges that ageing presents for non-heterosexuals, but also offers insights into the challenges faced by ageing non-heterosexuals and heterosexuals in ‘ detraditionalised ’ settings.

Family, work and quality of life: Changing economic and social roles through the lifecourse

Abstract: This article reports research funded as part of the recent ESRC Growing Older initiative. The project ‘Family, Work and Quality of Life’ explored changes in economic and social roles across four birth cohorts passing through mid-life (45–59/64 years) in Britain. The relationship between multiple role responsibilities and a range of indicators of quality of life, including material resources, health and engagement in social activities were investigated. The research was based upon secondary analysis of four different surveys: the 2000 British Household Panel Study, the 1994–95 Family and Working Lives Survey, the 1985, 1990, 1995, and 2000 General Household Surveys, and the longitudinal Retirement Survey (1988/89 and 1994). A particularly interesting finding is that being ‘caught in the middle’, in terms of having simultaneous care-giving responsibilities to dependent children and frail parents whilst in paid work, has been atypical. Only one-in-nine British women, and one-in-ten British men, aged 45–49 years (born in 1941–45) occupy all three roles concurrently, but multiple role occupancy is increasing across cohorts, particularly the combination of caring and paid work. Role occupancy significantly affects the accumulation of pension entitlements (particularly second-tier pensions), with the effect that many women who have fulfilled the important social roles of carer and parent will face a low income in old age. Where adverse health outcomes were found, parental role in mid-life was most frequently associated with such poor health, suggesting that continued parental demands in mid-life may have negative health consequences.

Determinants of quality of life amongst older people in deprived neighbourhoods

Abstract: This article analyses the determinants of the quality of life in a sample of 600 people aged 60 or more years living in deprived areas of three English cities. Data were collected by means of a face-to-face administered questionnaire. Two standardised measures, the ‘Satisfaction With Life Scale ’ (SWLS) and the ‘Philadelphia Geriatric Center Morale Scale ’ (PGCMS), and a single-item question were used to produce outcome measures of the quality of life. Using a conceptual model of quality of life factors, 21 socio-demographic, objective and subjective variables were correlated with each of the measures. Thirteen of these variables were subsequently entered in three multiple regression models. Subjective variables correlated significantly with all three quality of life measures, but sociodemographic and objective life condition variables correlated less strongly. Regression analysis revealed perception of own health, perceived ability to cope financially, perception of poverty over time and loneliness to be important determinants of the quality of life across all three quality of life measures. Variables that described characteristics of the urban environment had limited direct influence on the quality of life. The findings support the conceptual framework and highlight the key role played by subjective variables in determining the quality of life of older people in deprived urban areas.

The effects of informal care on paid-work participation in Great Britain: a lifecourse perspective

Abstract: Several recent studies have documented a negative relationship between informal care-giving and labour market attachment in Great Britain. This paper examines the relationship from a longitudinal perspective using data from the Great Britain 1994–95 Family and Working Lives Survey. The first part of the paper studies the timing of informal care-giving to a sick, disabled or elderly person. This information is used in the second part to examine the effects of caring on employment. The results show that most carers look after only one dependant during their lives, and only around one-fifth to one-third look after a second dependant before the age of 65 years. Of all informal carers, about one-third had not been employed when they started caring for the first time in their lives, another third said that caring had no effect on their work arrangements, and about one-third reported one or several effects on their work arrangements, most commonly that they stopped working. Multivariate analyses show that semi-routine and routine manual workers report the strongest effects of care-giving. Part-time workers were more likely than full-time workers to reduce their hours of paid employment when they started caring.

Fixed laws, fluid lives: the citizenship status of post-retirement migrants in the European Union

Abstract: This paper presents key findings of a recently completed socio-legal study of international retirement migration in the European Union (EU).1 It highlights the diverse nature of retirement migration and the differential citizenship status that is formally granted to various groups of retired migrants. ‘Citizenship of the European Union’ (Articles 17–22 of the Treaty establishing the European Community) bestows important social and political rights on nationals of EU Member States (‘Community nationals ’). These rights are not, however, universal or based on nationality as such. In practice, the residency and social rights that a mobile EU national can claim in another Member State depend on the type of social contribution they have made and their personal relationships. Contributions through paid employment and/or membership of the family of a mobile EU worker gives rise to maximum social benefit. Whilst the European Union citizenship provisions extend residency rights to all EU nationals (irrespective of work status), those whose mobility is not connected to employment derive significantly inferior social entitlements when resident in a host Member State. Put simply, the rights of people (and members of their family) who move following retirement in their home country differ substantially from those who retire following a period of working in another Member State (and achieve the status of ‘community migrant worker’ prior to retirement). This formal ‘ discrimination ’ is further compounded by the diversity of the social welfare systems of the member states that results in distinct social, economic and spatial inequalities across the EU. To that extent, the ‘choice’ of retirement location significantly impacts on citizenship status. However, retired migrants are not merely passive spectators of formal rights and policies. Many show considerable skill in actively managing their rights (at both national and EU levels) and other resources to optimise personal benefit. This ability to maximise wellbeing is unevenly distributed.

Variations in subjective wellbeing: the mediating role of a psychological resource

Abstract: This study examines the mediating role of psychological resources on life satisfaction, an indicator of subjective wellbeing. The evidence identifies several life events and changing circumstances that can be potentially detrimental to the wellbeing of older adults. Based on the literature, a theoretical model was developed with the hypothesis that adaptation to potentially adverse events draws on psychological resources central to the self. The study participants were a random sample of 423 community-dwelling people aged 70 years and over. All respondents were interviewed in their own homes using a structured schedule. Quantitative data were obtained on age, gender, social support, marital status, physical functioning, bodily pain, loneliness, isolation and housing difficulties. Subjective well-being was assessed by the life satisfaction index, and the psychological mediator was conceptualised as a measure of environmental mastery. The first round of analyses found that variations in well-being were associated with housing difficulties, isolation, loneliness, physical functioning, pain, support networks and marital status. The full model established perfect mediation by environmental mastery occurred for the variables housing problems and physical functioning, and partial mediation occurred for the variable loneliness – supporting the original hypothesis. The results add to the evidence from an increasing number of studies that demonstrates how psychological resources underlie the processes of adaptation to the changing situations that accompany increasing age and prevent negative outcomes.

Inter-generational family support provided by older people in Indonesia.

Abstract: Most social research on ageing in Asia has focused on the support provided by adult children to their parents, and thereby suggests that as a matter of course older people are in need of support. This paper offers a different perspective. Drawing on ethnographic and quantitative data from a village in East Java, it examines the extent of older people’s dependence on others and highlights the material and practical contributions that they make to their families. It is shown that only a minority of older people are reliant on children or grandchildren for their daily survival. In the majority of cases, the net flow of inter-generational support is either downwards – from old to young – or balanced. Far from merely assisting with childcare and domestic tasks, older people are often the economic pillars of multi-generational families. Pension and agricultural incomes serve to secure the livelihoods of whole family networks, and the accumulated wealth of older parents is crucial for launching children into economic independence and underwriting their risks. Parental generosity does not generally elicit commensurate reciprocal support when it is needed, leaving many people vulnerable towards the end of their lives.

Older labour migrants' well being in Europe: the case of Switzerland.

Abstract: This paper examines several aspects of the social situation of the older immigrant population in Switzerland. It reviews their demographic history and characteristics and provides profiles of their health and well being, their material standard of life and access to social security and related benefits. It reports selected findings from an original survey of older Italian and Spanish citizens who are resident in the country, which show relatively high rates of disadvantage and poverty. The determination of a large proportion of the immigrant population to remain in Switzerland after they have ceased work demonstrates that the minorities who entered the country as labour migrants will become a permanent element of the Swiss population and its society. Neither the politicians nor the general public in Switzerland have yet accepted the reality of this new diversity. Given the continuation and indeed growth of international labour migration, the paper concludes by discussing the social policy and attitudinal options that face the governments and the population of Switzerland and many other European countries.

The communication and psychosocial perceptions of older adults with sensory loss: a qualitative study

Abstract: Sensory loss (visual and/or hearing loss) is prevalent in older adults. Decreased vision and/or hearing acuity often result in poor communication and psychosocial functioning. This qualitative study explores the communication and psychosocial perceptions of a group of older adults with single or dual sensory loss. The aims were to identify the communication difficulties and conversational strategies used by the subjects, and to explore their perceptions of their social adjustment, quality of life and physical and mental well-being. The participants were all older adults with sensory loss who attended the Vision Australia Foundation. In-depth interviews revealed that the participants experienced frequent communication difficulties. They identified the personal, situational and environmental triggers responsible for communication breakdown, and they described the compensation and avoidance strategies that they used. The participants acknowledged that frequent communication breakdown resulted in decreased socialisation. The problems of adjusting to sensory loss, depression, anxiety, lethargy and social dissatisfaction were cited as factors that affected their physical and mental well-being, while being optimistic, coping with their sensory loss, and maintaining social contact contributed to an improved quality of life. All participants expressed interest in being involved in further communication intervention programmes.

Quality of life perceptions and social comparisons in healthy old age

Abstract: This paper reports a study of the influence of healthy older people's type of residence and social comparison strategies on their quality of life perceptions. Data were collected from 190 participants aged 65 or more years resident in one London Borough. Participants were classified by their type of residence, and their quality of life was assessed by the Schedule for Evaluation of Individual Quality of Life: Direct Weighting (SEIQoL-DW). Among the reported social comparison judgements, the dominant strategy was ‘Downward Contrast’. It was the sole strategy for 78 per cent of those studied, and was significantly associated with a higher perceived quality of life. Among other statistically significant findings, it was found that positive orientation, optimistic orientation, and the use of Contrast rather than Identification comparisons associated with a better reported quality of life. The over-riding influence of Downward Contrast comparisons was also confirmed: this strategy appears to be adaptive and functional in enhancing perceived quality of life. The effect is not mediated by depression, although differences in comparison strategy were observed among groups with different residential status. The possibility of an intervention to enhance the perceived quality of life is discussed.

Age-segregation in later life: an examination of personal networks

Abstract: In a rapidly changing society, young adults may play an important role in teaching older adults about social, cultural and technological changes. Thus older people who lack regular contact with younger people are at risk of being excluded from contemporary social developments. But how age-segregated are older people? The level of age-segregation of older people can be studied by examining the age-composition of personal social networks. Using NESTOR-LSN survey data from The Netherlands, we are able to determine the number of younger adults that people aged 55–89 years identify as members of their social networks, and to examine the factors that are associated with segregation or integration. The findings show that there is a large deficit of young adults in the networks of older people, and that few older people have regular contact with younger non-kin. If age were not a factor in the selection of network members, one would expect the age distribution of adult network members to be the same as the age distribution of the entire adult population, but the ratio of actual to expected non-kin network members aged under 35 years for those aged 65–74 years is only 0.10. And only 15 per cent of the population aged 80 or more years has weekly contact with any non-kin aged less than 65 years. The number of children is strongly related to the total number of younger network members, because most younger network members are adult children. Further, participating in organisations (work and volunteer settings) that include people of diverse ages increases the likelihood of an older person having significant cross-age interactions with non-kin.

Linkages between migration and the care of frail older people : observations from Greece, Ghana and The Netherlands

Abstract: There are at least four ways in which old age and migration cross each other's paths. First of all, there are people who migrated for economic reasons, usually at a relatively young age, and who have grown old in a foreign country. Secondly, there are older people who migrate when (or because) they are old: in Europe, they are mostly from the affluent northern countries and travel southward. Thirdly, there is increasing employment of, and demand for, immigrant workers in old-age institutions in the northern countries. Finally, there is the out-migration of young people, mainly from rural areas, that results in older people being left behind without children to look after them. In all these cases, migration has a profound effect on the wellbeing and care of older people. The authors of this article explore a fifth linkage between migration and old age, by focusing on the (mainly illegal) immigrants who take on roles as private carers and, in effect, replace the children who have emigrated. Two cases, from Greece and Ghana, are presented and viewed in the two countries' political, cultural and economic contexts, and are then compared to conditions in The Netherlands. In both cases, involving a ‘stranger’ in the care of an older parent is regarded as a good and respectable solution to the problem of absent children and grandchildren: it follows rules of reciprocity and normally provides a good quality of care. Ironically, hiring full-time private care for older people is feasible in low-income countries but a rare luxury in high-income societies.

Ethnic differences in influences on quality of life at older ages: a quantitative analysis

Abstract: This article sets out to examine ethnic differences in the key influences on quality of life for older people in the context of the increasing health and wealth of British older people generally and the ageing of the post-1945 migrants. It is based on secondary multivariate analysis of the Fourth National Survey of Ethnic Minorities of England and Wales. Respondents aged 45–74 years belonging to four ethnic groups (1,068 white, 514 Caribbean, 581 Indian and East African Asian, and 199 Pakistani) were included in the analysis, which focuses on differences between ethnic groups by age and gender, using the white population as the reference group. Four dimensions (incorporating seven factors) that influence the quality of life were determined among this age group : quality of neighbourhood (availability of local amenities, and problems with crime and the physical environment) ; social networks and community participation (strength of family networks, and community participation) ; material conditions (income, wealth and housing conditions) and health. The relative position of the four ethnic groups on the seven factors illustrated two contrasting patterns. For the factors based on conventional indicators of social inequalities – such as material circumstances, health, participation in formal social networks, and quality of the physical environment – the white group ranked highest, the Pakistanis lowest, and the Indian and Caribbean groups ranked second and third. But factors that capture more immediate and subjective elements, such as frequency of family contact and the desirability of the residential neighbourhood, displayed a diametrically opposite rank-order, with the Pakistani group ranked first and the white group fourth. The study highlights the value of examining separately the various influences on quality of life. Contradictory patterns are revealed in key influences that are hidden by global measures. The study also reveals the difficulty of identifying culturally-neutral measures of quality of locality, with ethnic minority groups having a more positive perception of their area than rated by conventional measures of area deprivation such as the Index of Deprivation.

The effects of pre-retirement factors and retirement route on circumstances in retirement: findings from the Whitehall II study

Abstract: Retirement has traditionally been seen as the beginning of old age. It has been depicted as mandatory expulsion from the workforce and seen to mark the transition to a period of ill health and poverty. Such ideas and associations are however being challenged in the developed world by socio-demographic changes in retirement and old age. People in the United Kingdom as elsewhere are living longer and healthier lives, and many older people have access to non-state incomes that afford them a reasonable standard of living in retirement. There is however still concern that inequalities persist into old age. Data from two waves of the British Whitehall II study have been used to assess the relative effects of occupational grade, psychological and general health during working life, and retirement patterns or pathways on activities, attitudes to health and income in retirement. The results show that the majority of the sample reported good health, financial security and overall satisfaction with life, but with observable inequalities. Regression analyses demonstrate that pre-retirement circumstances generally had a greater effect on later life than the retirement route or pathway. Retirement no longer represents a drastic break between working and post-work life but rather, the results suggest, there are continuities between the two periods. It is concluded that the main causes of inequalities in retirement are work-based rather than in retirement itself.

Inequalities in quality of life among older people from different ethnic groups

Abstract: British research on the quality of life in old age has neglected the increasing ethnic diversity of the older population, and although studies of health and income inequalities have highlighted the contribution played by racism, analyses of the factors influencing the quality of life have rarely considered its effects. This paper discusses inequalities in quality of life among older people from different ethnic groups using data from a cross-sectional survey of 203 White British, Asian, Black Caribbean, Black African and Chinese people aged 55 and more years living in England and Scotland. They were interviewed face-to-face in the language of their choice using a semi-structured schedule. Consistent with the existing literature, the study found differences in health, income and social support among the ethnic groups. The paper suggests, however, that future work should examine disparities in health and income within as well as between minority ethnic groups, and that a greater appreciation is required of the way in which such disparities may be accentuated by variations in health expectations, in the distribution of income within households, and in the willingness to discuss financial difficulties. The cumulative effects of health and material disadvantage and the experience of racism have implications both for future quality of life research and for government policies that aim to raise social inclusion and reduce inequalities.

Urbanisation and ageing: towards a new environmental gerontology

Abstract: Mike Davis. Dead Cities: A Natural History. New Press, New York, 2002. 288 pp., pbk $29.95 ISBN 1 56584 615 X.The environmental context of ageing, and issues relating to place and location in particular, has re-surfaced as a major theme within gerontology (Kendig 2003; Wahl, Schiedt and Windley 2003; Wahl and Weisman 2003). Drawing on classic studies from Rosow (1967), Rowles (1978), Lawton (1980) and others, the mission of environmental gerontology has been viewed as understanding a number of key tasks facing older adults in diverse physical and ecological settings. These include: ‘preserving as-independent-as-possible everyday life in the face of physical and mental impairments by using environmental resources outside the home environment (‘ageing in place’), initiating processes of relocation if desired or necessary, and adapting to new living environment settings (such as nursing homes or other planned housing) after relocation' (Wahl and Lang 2003: 7).

The Madrid International Plan of Action on Ageing : from conception to implementation

Abstract: The Madrid International Plan of Action on Ageing is the most important United Nations (UN) document on population ageing for 20 years and sets the context for global policies on ageing for the current century. Drawing from the authors' active participation in the preparation of the draft that formed the basis of the Madrid Plan, the primary purpose of this article is to describe the two-year process of development of the Plan. Then the main features of the Plan are outlined, including the pivotal role of the society for all ages concept and its thematic foundations. The Madrid Plan is contrasted with its Vienna predecessor of 20 years earlier – the priority given to developing countries in the former is identified as one of the key differences between them. Following a brief outline of the implementation and monitoring processes for the Madrid Plan, a model is presented as a potential template for use in evaluating the impact of the Plan and, especially, its effectiveness in improving the conditions of older people's lives. It is argued that a systematic process of monitoring and evaluation is required if the Plan is not to suffer the fate of being regarded as yet another worthy ‘wish list’.