The impact of residential immobility and population turnover on the support networks of older people living in rural areas: Evidence from CFAS Wales

This article addresses two questions: Are ‘stayers’ - defined as older people who were born in an area and lived there for 25 years or more prior to interview – more likely to have locally integrated or family dependent networks than other types of networks in the 21st Century? Does population turnover influence the support networks of older people more strongly than being a ‘stayer’? A sample of 1,870 participants living in rural areas is drawn from cross-sectional (Wave 1) data (version 2) from The Cognitive Function and Ageing Study (CFAS Wales). Five multinomial logistic regression models are used to establish how demographic covariates, cumulative population turnover, inflow, outflow and ‘stayer’ influence membership of Family Dependent (FD), Locally Integrated (LI), Local-Self Contained (LSC), Wider Community Focused (WCF) and Private Restricted (PR) support networks. The results reveal significant differences in the distribution of network types between stayers and non-stayers. Stayers were more likely to have LI or FD networks and were less likely to have WCF or PR networks than non-stayers. Gender, marital status, education, disability, childlessness, area deprivation, and cumulative population turnover, inflow and outflow (by age group) also influence membership of different networks. The research has implications for planning of formal services in rural places characterised by ‘ageing in place’ or as ‘ageing places’ and comprising socially engaged and socially marginalized networks. In particular, providers of social care should take into account the different types of support that may be required to bolster socially marginalized support networks

Exploring intergenerational, intra-generational and transnational patterns of family caring in minority ethnic communities: the example of England and Wales

We investigated family caring using established questions from national surveys of 1,206 adults aged 40+ from six minority ethnic communities in England and Wales. We included in our analysis factors that predisposed caring (age, sex, marital status and household composition) and enabled caring (health, material resources, education, employment and cultural values). In the general population, 15% of adults are family carers. Three groups reported lower levels of caring (Black African [12%], Chinese [11%] and Black Caribbean [9%]) and three reported higher levels of caring (Indian [23%], Pakistani [17%] and Bangladeshi [18%]). However, ethnicity predicted caring independent of other factors only for the Indian group

Improving continence management for people with dementia in the community in Aotearoa, New Zealand: Protocol for a mixed methods study

Background: The number of people living with dementia (PLWD) in Aotearoa New Zealand (NZ) was estimated at 96,713 in 2020 and it is anticipated that this number will increase to 167,483 by 2050, including an estimated 12,039 Māori (indigenous people of NZ) with dementia. Experiencing urinary incontinence (UI) or faecal incontinence (FI) is common for PLWD, particularly at the later stages of the disease. However, there is no robust estimate for either prevalence or incidence of UI or FI for PLWD in NZ. Although caregivers rate independent toilet use as the most important activity of daily living to be preserved, continence care for PLWD in the community is currently not systematised and there is no structured care pathway. The evidence to guide continence practice is limited, and more needs to be known about caregiving and promoting continence and managing incontinence for PLWD in the community. This project will seek to understand the extent of the challenge and current practices of health professionals, PLWD, caregivers and family; identify promising strategies; co-develop culturally appropriate guidelines and support materials to improve outcomes; and identify appropriate quality indicators so that good continence care can be measured in future interventions. Methods and analysis: A four-phase mixed methods study will be delivered over three years: three phases will run concurrently, followed by a fourth transformative sequential phase. Phase 1 will identify the prevalence and incidence of incontinence for PLWD in the community using a cohort study from standardised home care interRAI assessments. Phase 2 will explore continence management for PLWD in the community through a review of clinical policies and guidance from publicly funded continence services, and qualitative focus group interviews with health professionals. Phase 3 will explore experiences, strategies, impact and consequences of promoting continence and managing incontinence for PLWD in the community through secondary data analysis of an existing carers’ study, and collecting new cross-sectional and longitudinal qualitative data from Māori and non-Māori PLWD and their caregivers. In Phase 4, two adapted 3-stage Delphi processes will be used to co-produce clinical guidelines and a core outcome set, while a series of workshops will be used to co-produce caregiver resources

A Cultural Framework of Care and Social Protection for Older People in India

This article applies a cultural political economy lens within a sustainable livelihood framework and examines how cultural norms and values as well as social protection amplify or attenuate livelihood shocks leading to care-home entry. We used framework analysis and higher-level interpretive analysis of data from interviews with 30 older care-home residents from three districts in Tamil Nadu, India, to understand the practices that allow the social welfare system to function alongside the beliefs and values legitimizing these practices. Results reveal a divergence between the value orientation of social-protection policy and cultural practices which constrains the choices available for care in later life and reinforces culturally constructed inequalities rather than protecting or remediating livelihood shocks and loss of assets

Research on rural ageing: Where have we got to and where are we going in Europe?

This paper examines the extent to which rural studies conducted in the countries of the Global North have addressed the phenomenon of rural ageing. Through a review of the literature published on rural ageing research in the last decade, it compares the research goals identified by the International Rural Ageing Project (IRAP) in 1998 with progress in this area. In addition to the key themes for rural ageing research identified by IRAP, the authors believe that there are others topics that will emerge and impact on rural ageing in the coming decade. These have been highlighted consistently in futures studies  as ‘global challenges’ and can be grouped as social, economic and political, technological, relating to climate change, or related to agriculture and food security. In addition to the literature review, the authors undertook a consultation exercise with more than 50 eminent academics and directors of key organisations who were interested in rural issues, ‘global challenges’ or rural ageing. Their feedback is included within a framework for future rural research. The article concludes with a discussion of emerging areas for rural ageing in the European context and the challenges that the EU may potentially face over the coming decades.</p

Transitions in loneliness in later life: the role of social comparisons and coping strategies

This study explored the coping strategies and social comparisons used by older adults on different loneliness trajectories (decreased loneliness, stable loneliness and degenerating loneliness). The adaptive consequences of social comparison in later life are recognised as an important strategy for preserving life satisfaction regardless of age-related losses. Coping strategies are also important in managing loneliness. Narrative interviews were conducted with lonely older adults (N = 11) who had participated in Wave One of the Maintaining Function and Well-being in Later Life Study Wales (CFAS Wales). The study found key differences in the coping strategies employed by older adults on different loneliness trajectories. Differences in coping styles between those who reported decreased loneliness and those who were chronically lonely stemmed from perceptions as to whether loneliness was modifiable or not. Different types of social comparison were also found to modulate the loneliness experience. The findings indicate that higher-order strategies (problem, emotional and meaning focused) are not distinct entities but are part of a dynamic process. The management of loneliness in later life may be dependent on several factors, including older adults’ interpretations of the cause of loneliness. These interpretations will have implications for interventions aimed at alleviating chronic loneliness, where the focus may have to be on changing older adult's perceptions of unmodifiable loneliness

A support network typology for application in older populations with a preponderance of multigenerational households

This paper considers the support networks of older people in populations with a preponderance of multigenerational households and examines the most vulnerable network types in terms of loneliness and isolation. Current common typologies of support networks may not be sensitive to differences within and between different cultures. This paper uses cross-sectional data drawn from 590 elders (Gujaratis, Punjabis and Sylhetis) living in the United Kingdom and South Asia. Six variables were used in K-means cluster analysis to establish a new network typology. Two logistic regression models using loneliness and isolation as dependent variables assessed the contribution of the new network type to well-being. Four support networks were identified: ‘Multigenerational Households: Older Integrated Networks’, ‘Multigenerational Households: Younger Family Networks’, ‘Family And Friends Integrated Networks’, and ‘Non-Kin Restricted Networks’. Older South Asians with ‘Non-Kin Restricted Networks’ were more likely to be lonely and isolated compared to others. Using network typologies developed with individualistically-oriented cultures distributions are skewed towards more robust network types and could underestimate the support needs of older people from familistic cultures, who may be isolated and lonely and with limited informal sources of help. The new typology identifies different network types within multigenerational households, identifies a greater proportion of older people with vulnerable networks and could positively contribute to service planning

Rural Ageing and Equality

This chapter draws on data from the ESRC funded research programme Grey and Pleasant Land? An Interdisciplinary Exploration of the Connectivity of Older People in Rural Civic Society (GaPL). It examines ageing and inequality in rural areas of the United Kingdom and explores the intersectionality of rural area with age, gender, marital status, health, and socio-economic status in relation to distribution of resources, recognition, and representation of rural older people. Rural areas are typologized in terms of their population density and nearness to urban locations; level of deprivation; resource dependency; and population turnover/stability. We explore the roles of rural areas are in relation to the distribution of material resources of older people. We capture recognition through social status by the extent one can meet certain lifestyle expectations, thereby examining the relationship between rural area, and participation in the social life of communities. We capture representation by examining civic engagement in the community, but also the degree to which elected officials represent the voices of rural elders which we operationalize as trust in local officials and the strength of local concerns. Overall, we observed that participants living in the most remote and deprived areas had fewer material resources, greater levels of poverty, lower levels of social participation and resources, lower levels of civic participation, and trust in local official, but more local concerns than those in the more affluent and accessible areas. We conclude that the most rural and remote areas are misrecognized in popular, media and policy conceptions of the countrysid

The welsh Welsh – Y Cymry cymreig: A study of cultural exclusion among ruraldwelling older people using a critical human ecological framework

Research on cultural exclusion has not kept apace with transformations to rural populations, economy, family structures and community relationships. Cultural exclusion refers to the extent to which people are able or willing to conform to cultural norms and values. We theorise cultural exclusion using the critical human ecological framework and social comparison theory, taking into account period effects, area effects and cohort and/or lifecourse effects. Qualitative case studies in three rural areas of South Wales (United Kingdom) synthesise data from life-history interviews, life-history calendars, documentary sources and focus groups (n = 56). Our findings suggest that cultural exclusion is an issue for rural-dwelling older people, which they describe by temporal self-comparison and group comparisons. The critical human ecological framework provides new insight into the drivers (industrial decline, policy and population change, a shift from collectivism to individualism), and outcomes (sense of belonging, community cohesion) of cultural exclusion experienced by rural-dwelling older people