Identifying the Third Agers: An Analysis of British Retirees' Leisure Pursuits

Despite the recent theoretical focus on the emergence of the Third Age as a period of fulfilment and an ongoing engagement with an active leisure lifestyle, there is a dearth of quantitative studies on how older people spend their time. Few studies of later life capitalise on time-use surveys, which constitute the most widely employed and accurate methodology for collecting data on everyday life. This article analyses data from the 2000 UK Time Use Survey in order to operationalise the concept of the Third Age and test theoretical propositions regarding the irrelevance of social divisions in the formation of an active leisure lifestyle after retirement. The analysis focuses on a subsample of 1615 people over the age of 64. An index of active leisure activities is constructed in order to estimate the proportion of third agers amongst British retirees. Logistic regression models are specified to examine the relative influence of socio-demographic characteristics on the probability of a person being a third ager. Strong effects of structural factors and health are found, which do not support arguments suggesting a minor influence of social context in lifestyle choices after retirement. 'Active' ageing appears to be the province of those who are culturally and materially advantaged, and it is the healthy, educated, upper-class and middle-class men that are more likely to engage in a Third Age leisure lifestyle.Active Leisure; Retirement; Time-Use Research; Third Age; Successful Ageing; UK

The influence of patient's age on clinical decision-making about coronary heart disease in the USA and the UK

This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of ‘knowledge structures’ when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests

Caring for a loved one with a malignant fungating wound

Purpose: Caring for a loved one with a malignant fungating wound is very challenging and causes extreme physical and psychological distress. The aim of this study was to explore the experiences of carers who care for a loved one with a fungating breast wound. Method: To explore the lived experiences of carers, a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Seven carers were interviewed from January until November 2009. Results: Having to deal with a situation of a loved one with a visible cancer was hard for all the carers. The visibility of the cancer was one of the most shocking aspects to deal with from the perspective of the patient and the carer. The presence of the visible wound and a cancer at an advanced stage contributed to a change in the relationship and extreme suffering for both the patient and the carer. Despite many problems such as wound odour and copious discharge from the wound, which was difficult to control, carers did their best to help their loved one with the wound. Gradually, the wound became the centre of the patient and carer's life, and a great deal of time was spent trying to control the wound symptoms. All carers managed the wound on their own without help and advice from health care practitioners. For all of them, it was a major burden and they felt isolated. Conclusion: This study contributes to an understanding that the care of women and their carers needs strategies that are integrated in palliative wound care that takes a holistic and empathic approach that responds to patients' and carers' psychosocial and emotional needs and a practical need for information to help carers assist in managing the wound-related symptom

Women and men with coronary heart disease in three countries : are they treated differently?

Non-medical determinants of medical decision making were investigated in an international research project in the US, in the UK and in Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by the patients' gender. A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different sex, age, race and socio-economic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, a CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Moreover, results indicate that gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the US. Although patients with identical symptoms were presented, primary care doctors’ behavior differed by patients' gender in all three countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men

Unen sosiologia: hoiva, sukupuoli ja uniongelmat

Tämän artikkelin tarkoituksena on kuvata, miten sosiologinen tutkimus voi lisätä ymmärrystämme unesta. Korostamme kvalitatiivisen unitutkimuksen merkitystä luomalla katsauksen viimeisimpiin tutkimustuloksiin, joissa on tarkasteltu sukupuolen, yhdessä nukkumisen ja yöaikaisen hoivaamisen vaikutuksia uneen. Artikkelissa tarkastellaan myös kvantitatiivisia unitutkimuksia. Aineistona käytetään Britanniaa koskevaa “Understanding Society 2009” -tutkimusta (n = 14 746). Osoitamme, miten ikääntyneen tai sairastuneen sukulaisen hoivaaminen kotona on yhteydessä uniongelmiin ja että matala sosioekonominen asema ja huono terveydentila vaikuttavat hoivan ja unen yhteyteen vain vähän

Long-term care at night: understanding sleep in care homes

Introduction: Sleep plays a significant role in the lives of older people experiencing institutional long-term care. It relates to their well being yet may also indicate a lack of stimulus and motivation to stay alert and participate in everyday life. However, to date the importance of sleep in this context has not been widely addressed. Research: This research identifies the determinants of poor sleep in care homes as part of a four year New Dynamics of Ageing Collaborative Research Project, SomnIA (Sleep in Ageing), which addresses practice and policy relevant issues arising from the nature, impact and management of the sleep-wake balance in later life. Using multi-methods data was collected in ten care homes. Over a two-week period, sleep and activity diaries are collected from 140 residents, supported by 275 h observational studies, and interviews with residents (n=40) and staff (n=78). Results: A conflict between meeting care needs and the facilitation of sleep has been identified and the findings aim to inform the future development of the care home environment and provide an evidence base from which practitioners can reconfigure the delivery of care to enhance the sleep of older people living in care homes

Work-life imbalance: informal care and paid employment

In the United Kingdom informal carers are people who look after relatives or friends who need extra support because of age, physical or learning disability or illness. The majority of informal carers are women and female carers also care for longer hours and for longer durations than men. Thus women and older women in particular, shoulder the burden of informal care. We consider the costs of caring in terms of the impact that these kinds of caring responsibilities have on employment. The research is based on the responses of informal carers to a dedicated questionnaire and in-depth interviews with a smaller sub-sample of carers. Our results indicate that the duration of a caring episode as well as the hours carers commit to caring impact on their employment participation. In addition carers’ employment is affected by financial considerations, the needs of the person they care for, carers’ beliefs about the compatibility of informal care and paid work and employers’ willingness to accommodate carers’ needs. Overall, the research confirms that informal carers continue to face difficulties when they try to combine employment and care in spite of recent policy initiatives designed to help them

Country differences in the diagnosis and management of coronary heart disease : a comparison between the US, the UK and Germany

Background The way patients with coronary heart disease (CHD) are treated is partly determined by non-medical factors. There is a solid body of evidence that patient and physician characteristics influence doctors' management decisions. Relatively little is known about the role of structural issues in the decision making process. This study focuses on the question whether doctors' diagnostic and therapeutic decisions are influenced by the health care system in which they take place. This non-medical determinant of medical decision-making was investigated in an international research project in the US, the UK and Germany. Methods Videotaped patients within an experimental study design were used. Experienced actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patients of different sex, age and social status. The videotapes were shown to 384 randomly selected primary care physicians in the three countries under study. The sample was stratified on gender and duration of professional experience. Physicians were asked how they would diagnose and manage the patient after watching the video vignette using a questionnaire with standardised and open-ended questions. Results Results show only small differences in decision making between British and American physicians in essential aspects of care. About 90% of the UK and US doctors identified CHD as one of the possible diagnoses. Further similarities were found in test ordering and lifestyle advice. Some differences between the US and UK were found in the certainty of the diagnoses, prescribed medications and referral behaviour. There are numerous significant differences between Germany and the other two countries. German physicians would ask fewer questions, they would order fewer tests, prescribe fewer medications and give less lifestyle advice. Conclusion Although all physicians in the three countries under study were presented exactly the same patient, some disparities in the diagnostic and patient management decisions were evident. Since other possible influences on doctors treatment decisions are controlled within the experimental design, characteristics of the health care system seem to be a crucial factor within the decision making process