This thesis contributes to understanding two demographically important phenomena: African ageing, and the ageing of the African HIV epidemic. Building on the body of interpretivist demography that privileges context and meanings, it explores older adults’ experiences of becoming old, sexuality and living with HIV in rural Malawi. The research uses a constructivist grounded theory framework. It is based primarily on data produced using repeat dependent interviews (N=135) with older men and women(N=43). These are supplemented by fieldwork observations, as well as data from a three-month multi-site pilot study, interviews with HIV support groups (N=3), and key informant interviews (N=19) and policy documents. The thesis identified sets of meanings surrounding old age and ways of discussing ageing that, taken together, formed an analytical framework. The framework is focused on the importance of maintaining an ‘adult’ identity and draws insights from sociological and psychological identity theories. The adult identity was aligned with personhood. It was situated within the body-centred livelihood system of rural Malawi, and associated with physical production. Old age was understood to limit productivity and thereby an individual’s adult identity. This thesis argues that ostensibly contradictory narratives about ageing experiences can be understood as rhetorical strategies respondents employed to maintain their adult identities. A central tenet of the thesis is that the adult identity (and its childlike counter identity) influenced older adults’ broader experiences and behaviours. This framework is used to explore ageing, as well as sex and HIV infection. The grounded understandings of older adults’ experiences developed in the thesis are presented against dominant understandings of the situation of older adults documented by the academe and in policy and programmatic arena emerging in Malawi. The findings highlight the centrality of wider experiences of ageing for older adults’ experiences of sex and HIV, as well as the broader importance of identity for understanding demographic behaviours and processes. In addition, they demonstrate how grounded theory and repeat dependent interviewing can be used within demographic studies to produce nuanced analytical accounts of the experiences that are most salient for the population of interest.

The economic wellbeing, physical and mental health of the ageing population in the United Kingdom is associated with continued participation in the labour force. Encouraging later life employment is therefore a key policy issue. Research into older person's employment trajectories is concentrated on male working patterns, and often takes an individualistic approach that does not account for the domestic context. Previous research on women's labour force participation has been informed by small scale qualitative studies that do consider the household domain but these findings cannot be generalized to the wider population. This research investigates the factors associated with the continued employment of women aged 50 to 59 using data from the English Longitudinal Study of Ageing (ELSA). Transition rates out of employment between 2001 and 2011 are modeled using multilevel discrete time event history specifications that permit the inclusion of time varying covariates. Retirement is characterized as an ageing process which allows the impact of predictors on transition rates to be assessed and measured as women approach state pension age. Alternative time structures are considered, with parameter estimates from an age baseline model compared with those from a time on study specification. Results illustrate the sensitivity of parameter estimates in discrete time event history models to the measurement of time, and emphasize the importance of adopting a time metric that is commensurate with the theoretical representation of retirement as a dynamic ageing process. The domestic context is realised as sampled women and their male partners are positionedwithin a household structure, and asymmetric effects of predictors on the transition rate of each gender are considered. Own poor health, caring responsibilities and a retired or inactive spouse accelerate labour market exit for women whilst high levels of accrued pension wealth predict earlier transitions for their male partners. The age of employment exit for females is independent of pension wealth, but pension resources do predict the retirement pathway taken following any transition that does occur. Women residing in the wealthiest households are more likely to report as voluntary retired prior to state pension age whilst those in the poorest of couples are at higher risk of following an involuntary pathway into an alternative inactive state. These findings emphasize the importance of conducting research into later life employment trajectories on a household, rather than individual, basis.

This research explored older Slovenians’ occupations, including the ways in which the transition into a care home influenced their occupational engagement. The research encompassed three stages. Stage 1 investigated Slovenian older people’s individual experiences of occupational engagement, with a particular emphasis on their personally meaningful occupations. Stage 2 aimed to enhance understanding of the impact of transition into a care home on older Slovenians’ meaningful occupations. Finally, Stage 3 sought to provide an insight into older people’s occupational engagement in one Slovenian care home. The first two stages of this research took a phenomenological approach; focusing on the participants’ individual experiences of occupational engagement; using Interpretative Phenomenological Analysis (IPA) to approach and analyse the data. Ten older adults were interviewed in Stage 1 and six older adults were interviewed in Stage 2 at three time points: before the relocation into a care home, one month after and six months after the relocation. The final stage was ethnographic in nature; exploring occupational engagement among Slovenian care home residents as a culture-sharing group; using observations for collecting the data and analysing the resulting field notes using Thematic Analysis. The findings consistently highlighted the significance of occupations and routines in participants’ everyday lives as important parts of their identities. The first two stages highlighted the importance of a continuous experience of meaning in occupation, across participants’ lives and throughout their transition into a care home. Some of these meanings were specific to Slovenian socio-cultural, historic and geographical context. The participants especially valued productive occupations such as gardening, family-related occupations such as looking after and passing knowledge to younger generations and occupations related to particular places, such as spending time at their weekend cottages and home surroundings, walking familiar pathways or hiking Slovenian mountains. These Slovenian older adults purposefully engaged in health-promoting occupations in order to maintain their health, in turn influencing their occupational engagement. Since their everyday routines were related to particular places, Stages 2 and 3 highlighted that some of these occupations were disrupted by their new living environment. The care home residents managed this situation by trying to maintain their engagement in occupations that they perceived personally meaningful and enjoyable. This research is foundational in the Slovenian context, with the findings also being transferrable to individuals and contexts outside Slovenia. From exploring the impact of older people’s living environments on their meaningful occupational engagement, the findings contribute original knowledge to occupational science regarding the link between occupation, place, identity and the transactional perspective of occupation. This indicates the need to develop further therapeutic programmes and services for older people making the transition to care home living.

Greater life expectancy has resulted in older adults becoming more vulnerable to social isolation, with increasing numbers of British older adults reporting loneliness in recent years. This trend is of concern as it has been documented that feeling a connection to others is a fundamental need for psychological well-being. It is therefore important to support older adults to maintain connections with others, in order to help increase, and prevent deterioration of, their well-being. The social presence theory asserts that visual presence during conversations can enhance the quality of communications between individuals and thus strengthen relationships. The use of video-communication by older adults may therefore lend itself as a tool to enhance communications with others and consequently increase their psychological well-being. This research utilised a mixed-methods quasi-experimental design to explore the impact of video-communication on the psychological well-being of older adults. Participants in the intervention condition received video-communication training sessions to help them communicate with their friends or relatives remotely via video. Participants in the control conditions received either email or basic computer skills training. Self-report measures were used to investigate the effectiveness of the video-communication in enhancing psychological well-being. Semi-structured interviews were also conducted with the participants in the intervention condition in order to capture the participants’ experiences with using the video-communication and to corroborate the quantitative data. The quantitative data was subjected to statistical and clinically significant change tests, while the qualitative data was analysed using thematic analysis. Triangulation of the quantitative and qualitative data revealed that the video-communication increased some older adults’ psychological well-being and the social support they received. The findings are discussed in relation to previous research. The clinical implications of the findings and directions for future research are also discussed.

The study seeks to make two contributions. One is to participate in the development of theories and methods for the analysis of equity and efficiency in community care. The second is to yield evidence which assists policy-makers and managers to improve the effectiveness of their policies. The broad context is the évolution of the policy discourse about issues of equity and efficiency in community care of elderly people. More narrowly, the context is the implementation of the 1989 community care reforms, set out in Care in the Community: Policy Guidance (Department of Health 1990) and the government's commitment to commission research to evaluate their impact on equity and efficiency in social care. The more recent White Paper, Modernising Social Services (Department of Health 1998), is also an important element of the context. The detailed analysis in the thesis will therefore focus around two main foci: (1) the extent to which care brokered by social services departments has achieved the equity- and efficiency-related goals stated by the 1989 White Paper and developed in the 1998 White Paper; and (2) the extent to which current policies need to be adjusted in the light of understanding about how the new system produces equity and efficiency effects. 1.1 Public policy and the Holy Grail: improving efficiency in the use of public funds The Conservative administration which produced the 1989 White Paper attached a higher priority to efficiency in the use of public funds than its predecessors. However, the origins of its concerns could be traced back to the 1970s.

This dissertation addresses the question of to what extent growing numbers of older people who might have similar preferences regarding public intergenerational transfers (family and pension policies) will limit the scope of future social policy reforms in Germany. We are interested in to what extent the shift in the country's demography will trigger a so-called "gerontocracy." As a theoretical framework, we combine Mannheim's concept of political generations with a demographic life-course approach. According to Mannheim, growing numbers of a societal group, combine with unified preferences within the group, enhance the group's political power. To empirically test this hypothesis, we use three analytical steps: First, we analyse the future age composition of the German population, including familial characteristics, using a micro-simulation approach. The results suggest that the number of older people will grow substantially over the coming decades, particularly the share of older people who will remain childless and who will not be married. Second, we analyse preferences regarding redistributive social policies according to age, parity, and marital status, based on recent survey data. Generalised Linear Models and Generalised Additive Models are applied to examine what the effects of fdemographic indicators are on these preferences. Results show that older people are less in favour of transfers ot the younger generation than their younger counterparts. This is particularly true of childless interviewees. Third, we explore the extent to which these developments are likely to have an impact on the political sphere. How do policy makers perceive ageing and the preferences structures found? How do elderly interest groups define their roles in light of these results? In-depth interviews with these stakeholders provide a mixed picture: whereas most interviewees are convinced that older people have gained more power due to their bigger population share, there is little awareness of differences in policy preferences between various demographic groups. The biggest challenge for social policy makers is, therefore, to find ways to mediate between these two interesrs. if they fail to do so, a conflict of generations might become a realistic scenario for Germany.

Informal carers provide the majority of care for older people living in the community. The provision of care can be very stressful and is said to have an adverse affect on caregivers’ health. Policy has recognised the need to support carers and a key objective has been to improve service provision for them. Research has shown that service intervention can prevent the breakdown of care and admission to long term care. However, relatively few carers and older people use formal services. While the low uptake of support services is documented, it is not fully understood. The aim of this study was to explore the experiences of informal carers of older people who received no support services. It focused particularly on the question: why when caregiving is portrayed as being stressful, do carers continue without support from formal service providers? Purposive sampling was used to obtain a sample of unsupported carers of older people, who were interviewed three times over a period of two years. For this longitudinal study a predominantly qualitative approach underpinned by the principles of grounded theory was chosen with a quantitative component included in the second stage. The study used a range of methods including focus groups, interviews and self-completion questionnaires. The main source of data was individual in-depth interviews, while self-completion questionnaires and literature provided secondary and tertiary sources of data. Data were analysed according to the principles of grounded theory. The study found that carers were motivated by a strong sense of duty and a desire to maintain their independence and control over their lives and the caregiving situation. They regarded formal services as authoritarian and intrusive. Acceptance of support was associated with feelings of failure and a potential loss of control.

In the past, Chinese normative values deprived daughters of education, choice and autonomy, relegating them to a dependent domestic role within a rigid family hierarchy. This is no longer the norm. Today, Chinese daughters are widely educated and many are working outside the home, becoming financial assets to their families. Despite this, gendered expectations concerning filial obligation have not abated, and perhaps surprisingly given their modern lifestyles and financial contributions, Chinese daughters continue to accept this responsibility, including caregiving for ageing parents. The aim of this thesis is to explore the nature of the current caregiving paradigm between Chinese daughters, their parents and parents-in-law. It seeks to understand why Chinese daughters continue to undertake filial obligation when they are no longer dependent on the family; how they manage the practical discharge of filial obligation; and the ways in which traditional filial obligation have shifted. In furtherance of this exploration, in 2011 and 2012, 58 Chinese women and 6 Filipina domestic helpers were interviewed in Hong Kong and Singapore. Thematic analysis was performed on the transcribed data. Symbolic interactionism, caregiving motivation models, and Hochschild's (1983) theory of emotion management provided the conceptual and theoretical framework for the research. Drawing from the data, a support and care typology was developed reflecting the varying levels of daughters' filial support and their motivations for providing this support. Among these respondents, the core belief in "duty" has not fundamentally changed from that of their parents' generation. However, feelings of affection and gratitude, the strength of traditional or contemporary norms, and one’s self-image together with emotion work, moderated the duration and quality of care daughters were willing to provide. These factors may also determine whether caregiving is outsourced to foreign domestic helpers, or whether parents and in-laws are placed in nursing homes, and the nature of care provided thereafter.

The majority of dependent older people rely on informal care to meet their long-term care needs. The activity of care-giving can place informal carers at risk of experiencing financial poverty and welfare loss, including poor health, injuries and time poverty. This thesis argues that states should recognise and treat the informal care of older people as a social risk by providing informal carers and the older people they care for with adequate statutory protection against the risks which they face. A qualitative case study was conducted to analyse the extent to which care policies in England protect informal carers and the older people they care for against care-related risks. A policy simulation technique, the model care relationship matrix, was employed as a data collection and analysis tool. The matrices incorporated thirteen care relationship types and all of the care policy mechanisms in England, including cash benefits, care services, and employment-related support. Government documents and semi-structured interviews with practitioners and managers from a range of public sector and third sector agencies were used to determine the statutory support each care relationship would be entitled to receive. The way in which institutional structures, processes and actors within the policy environment can affect the level of statutory protection provided to care relationships was also analysed. The study’s findings reveal that the English state recognises but does not treat informal care as a social risk. The state’s treatment of informal care-givers and their care-related risks is inconsistent, unpredictable and inadequate. Some informal care-givers have access to inadequate levels of statutory protection, while the risks experienced by other groups of informal carers are left unprotected and privatised. Moreover the policy environment, itself, is revealed to produce risks due to being complex, fragmented, and adversarial in nature. Overall informal carers are found to occupy a marginalised and devalued position in the English care policy system.

Pendant près d’un siècle, la France construit une politique de la vieillesse résultant de la progressive mise sur l’agenda politique de la question du vieillissement de la population dont la prise en charge se tournera récemment vers la problématique de sa prévention dans l'objectif d’un « vieillissement actif », en santé et/ou d’un « bien-vieillir ». Dans cette perspective, nourrie des avancées scientifiques et des transformations sociales, la prévention du vieillissement va intégrer dans les différents textes et dispositifs les activités physiques et sportives (APS) comme outil fondamental. On observe ainsi au détour des années 2000 en France, l’inscription des APS au sein des politiques publiques de prévention. Notre travail se propose de tracer la place des APS dans les différents textes de politique de la vieillesse au niveau international et national pour comprendre quand, comment et pourquoi celles-ci apparaissent incontournables. Nous plaçons aussi la focale sur les différents dispositifs de prévention du vieillissement mobilisant les APS aux différentes échelles des politiques publiques en France. Nous mettons alors au jour la présence d’une multitude d’acteurs publics et privés issus de secteurs d’activités différents et une forte fragmentation des dispositifs ainsi qu’une pluralité de modèles d’interventions dont les formes de coordination restent partielles. / For nearly a century, France has been gradually building its policy on ageing, as the topic took a larger and larger part in the political agenda. It has recently concentrated on prevention, to aim for active ageing, healthy ageing or ageing well. As a result, in a backdrop of scientific progress and social transformations, sports and physical activities have become the main tool of ageing prevention strategies.It was in the 2000’s that sports and physical activities became fully part of the French public policy for prevention. Our research is especially concerned with the international and national ageing policies, which use sports and physical activities as a privileged tool to keep seniors healthy. The aim is to understand when, how and why sports and physical activities became the cornerstone of these policies.We will also focus on the various schemes which rely on sports and physical activities and which are currently implemented across the country at each level of public policy making.We will show that there are a huge number of private and public actors, with all kinds of expertise, who take part in these schemes. The programmes of action are numerous and varied, but appear fragmented and sometimes lacking in coordination.