Increasing levels of physical activity in older adults and fall prevention are key concerns of current UK health policy. Regular physical activity has many positive benefits for older adults, for example in fall prevention. However, sedentary behaviour among older adults is common. Forty per cent of over 50s in the UK report less physical activity than is considered necessary to maintain good health. Sedentary behaviour is even more common in South Asian older people in the UK. The aim of this research was to investigate the attitudes and beliefs that drive or hinder uptake and adherence of physical activity, in general and in relation to fall prevention, among 60-70 year old Caucasian and South Asian community dwellers. An ethnographic method was chosen as the research approach as it provided the framework for facilitating the incorporation of multiple voices. Two main geographical areas were chosen to conduct the study and included eight sites of study. Data collection used multiple methods (participant observation, focus groups and semi-structured interviews). In total 60 hours of participant observation, 15 focus group discussions (n = 87; mean age = 65.74 years) and 40 semi-structured interviews (mean age = 64.83 yrs) were conducted. Data analysis and classification followed a framework approach, comparing and contrasting themes within and across groups. Findings demonstrate that older people do not recognise falls as a risk and are not motivated to perform physical activity on a regular basis purely to help prevent falls. Social support and social benefits of physical activity appear to be key motivators to initiating and maintaining physical activity. Enjoyment, increased self-confidence and developing social networks seem to be important motivators in terms of adherence. Health, although a good motivator for the initiation of physical activity, appears to be a secondary motivator in terms of adherence. Barriers to physical activity include perceived and actual poor physical health, lack of social support, specificity of physical activity messages by health professionals as well as lack of motivation, low mood, fear of harm and domestic and carer issues. These findings suggest that older adults should be assessed individually, to address physical symptoms and possible low mood, and not according to age. The importance of exercise, even in the presence of physical illness needs to be explained. There is a need to promote confidence in older people’s ability to perform an activity, as this appears to be essential in continuing with exercise. Activities that take a ‘one size fits all’ approach, serve as a de-motivating force. Variety in exercise and physical activity is important to maintain motivation in the long-term.

This mixed methods study investigates how counselling psychology perspectives can collaborate with the Sikh community in the development of Older Adult Psychology Services. 73 Sikh participants, aged 45-65 years contributed in English and Punjabi through interview, questionnaire or focus group at multiple community sites across 3 metropolitan boroughs in Sandwell. Qualitative data from validated scenarios and personal experience were analysed by a thematic approach informed by Interpretive Phenomenological Analysis. Master themes were identified for religion, quality of life and service development. The SF12v2 (Ware et al., 2005) is a measure of health and well-being which showed just below average population norms for physical and mental health components of well-being for the Sikh Community. The God Locus of Health Control Scale (Wallston et al., 1999) demonstrated religion‟s importance, and how karma is integral to Sikhs‟ understanding and management of health. 80.6% (N=31) prefer older adult service providers to account for their religious beliefs and counselling psychologists are recommended to address this request in their engagement with this community. Preferences in the modes of delivery, types of psychological intervention and aids to service uptake are provided with recommendations for clinical practice, training and future research.

Older adults increasingly face difficult decisions in life threatening contexts as they move closer to death, become more likely to be diagnosed with life threatening diseases, and encounter more death within their social network (Greenberg, 2011). The purpose of this research was to understand the effect of a life-threatening decision context centered around cancer, self-esteem, other individual difference factors and cancer experience on older adults’ decision making competence, and preferences for collaborative decision making. Study participants were recruited through online circulation of the study recruitment flyer and in-person solicitations at meetings and other events at community locations (senior centers, civic group centers, and churches, etc.). Participants age 55-90 (N=202) were randomly assigned to either a mundane or life threatening condition and asked to complete the corresponding survey packet containing a measurement questionnaire. Analyses consisted of a series of analyses of variance (ANOVA) and regressions. The dependent variables were 3 major components of the DeBruin et al. (2007) Adult Decision Making Competence Scale: (a) Resistance to Framing, (b) Resistance to Sunk Cost Bias, and (c) Over/under confidence, in addition to a measure of Maximizing Tendency (Diab et al., 2008). Analyses revealed mixed results. Decision context did have an effect on decision making competence, while self-esteem showed little effect. No main effects or interactions were found between decision context, self-esteem, and preferences for collaborative decision making. Individual difference factors did effect decision making competence, with future time perspective, risk tolerance, and ego-integrity emerging as significant predictors. Furthermore, compelling results emerged pertaining to the effect of previous cancer experience on decision making competence. Results highlight the lasting effect of context and a previous cancer diagnosis on decision making competence and have implications in health care, psycho-oncology, and treatment decision making domains.

It is well established that older adults show a deficit in episodic memory. The associative deficit hypothesis (ADH) (Naveh-Benjamin, 2000) suggests that an age-related reduced ability to create links between units of information is a major contributor to the episodic deficit. It has been a robust finding that older adults show a disproportionate decline in associative memory relative to item memory when compared to young adults. Previous researchers have investigated the role of the frontal lobes (FL) by studying the effect of reduced attentional resources in the associative deficit. However, they have not found that divided attention in young adults produces the disproportionate associative decline seen in aging and it is thought that some cognitive process other than the allocation of attentional resources may contribute to the associative deficit. The present study intended to use a divided attention (DA) task that also engages medial temporal brain regions (MTL) in order to tax additional parts of the network involved in creating associations and provide indirect support for the role of the MTL in the associative deficit. However, the associative memory deficit in older adults was not replicated due to unique poor associative memory performance of some young adults in the study. Analyses excluding these participants show support for the role of the MTL in the associative deficit. However, the young poor performers may provide support for the role of FL function in the associative deficit and show that poor associative memory may not be limited to the older adult cohort.

This qualitative research study addressed the gap in the literature and lack of clinical guidelines and frameworks for health professionals as they assess and manage risk when balancing the safety and autonomy of community-dwelling older adults. Twelve health professionals were asked in individual interviews how they perceive, identify, assess and treat risk and how they negotiate the safety and autonomy of their clients. Informed by grounded theory methodology, the findings revealed what kinds of decisions health professionals made and how they made them within this clinical context. These findings from the perspective of the health professional contributed to the development of a definition of living at risk, a safety continuum and a conceptual/practice framework to help health professionals, including occupational therapists, make sound clinical decisions as they balance the autonomy and safety of their community-dwelling older adult clients.

Background: attachment theory provides an account of human behaviour across the lifespan, has a strong theoretical foundation and is clinical applicable. It is particularly relevant to older adults, who are often exposed to a greater number of losses. Despite a growing awareness of increasing life expectancy worldwide, services for older adults in the NHS remains under-resourced. However, increased exposure to death and loss in the work might result in clinical psychologists being more reluctant to choose this specialism and may raise issues about their own early attachment experiences. Therefore, it is important to understand how clinical psychologists approach the complexities of their work in light of their own early attachment experiences. Qualitative research of the lived experiences of clinical psychologists is sparse and to date there are no studies addressing this specific issue. Aims: this is an exploratory study which addresses a gap in the literature. The aims are to capture the early attachment experiences of clinical psychologists specialising in working with older adults. It is hoped that the outcome of the study will shed some light on the characteristics of this under-researched group and how they manage the challenges of the work. Methodology: a semi-structured interview schedule was developed to explore how clinical psychologists make sense of their work with older adults in light of their early attachment experiences. Interviews were carried out with five clinical psychologists working in specialist older adult services. The transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: the analysis of the five interviews yielded five main themes – “Making sense of early attachment relationships”, “Developing identity in childhood and adolescence”, “Understanding of decision to work with older adults”, “Work with older adults as both challenging and rewarding” and “The person within the professional”. Each of the main themes and their subthemes were supported by excerpts from narratives of participants experiences. Implications: this study highlighted several research and clinical implications. First, the role of non-parental childhood attachments in the development of internal working models is currently an under-researched area which may provide important insights into resilience factors in the face of childhood adversity. Second, clinical implications suggest that access to older adult work early on in the career of clinical psychologists may increase desirability of working in specialist services. Third, the study supports attachment theory as a useful approach to understanding the work with older adults and as a valuable area for the professional development of clinical psychologists. Finally, systemic working with older adults remains an important part of the work which would benefit from further research in this area.

Since households and businesses alike obtained the high-speed Internet service of broadband, the Internet has become integral to daily life in the 21st century. Advancements in information and Internet technology has led to the conception of novel internet- enabled applications such as, Online Social Networks (OSNs). Since the turn of the twenty first century fast-developing OSNs such as, Twitter and Facebook have become essential communication channels that people are using to develop their online personal and professional networks online. A recent phenomenon that is worrying countries around the globe is an ageing population. Due to recent improvements in the quality of life and advances in medicine, individuals are achieving longer life spans. Given the fact that older adults are also experiencing loneliness and depression, a recent solution to reduce this problem is the use of OSNs. Using these reasons as motivation, the aim of this research is to identify and understand the factors driving or inhibiting the adoption, use and diffusion of OSNs within the older population (50+) in UK households. In order to achieve this aim the Model of Online Social Networking (MOSN) was conceptually developed. Drawing upon the attitudinal, normative and control constructs from the leading Information Systems (IS) theories of the Diffusion of Innovations theory (DOI), Theory of Planned Behavior (TPB), Model of Adoption of Technology in Households (MATH) and the E-Services Adoption Model selected constructs were identified and formed. To achieve the aim, the conceptual framework (MOSN – Model of Online Social Networking) was initially empirically validated using primary data. A quantitative approach involving a small-scale online pilot survey (n-252) and a wide-scale online survey (n-1080) were used for this purpose. Findings revealed that that older individuals will adopt Internet technologies if technology-facilitating conditions such as ‘anytime access’ to Internet capable devices and a fast reliable Internet connection had significant positive effects on OSN intention. In terms of influences of peers, it was revealed that older individuals do consider and act upon the views of members in one’s social circle. Most significantly, the consequences of older adults efforts to preserve their own privacy enforces a vast majority of non-adopters from not taking part in the OSN uptake. In terms of diffusion it was found that messages about OSNs conveyed through media channels: TV, newspapers and magazines are having a negative impact on older adults intention to adopt OSNs. As little is known of the underlying factors effecting older individuals adoption or non-adoption and diffusion of OSNs this research contributes to an emerging body of knowledge through the identification of empirically supported factors found to be significantly influencing UK older adults decision making regarding OSN technology adoption. For those participants currently using OSNs an in-depth understanding of usage behavior is presented. Importantly this research addresses a gap in research relating to the household adoption of OSNs in older adults in the UK. Due to the limitations of time, finance and manpower research findings could not be nationally representative of the UK are only representative of a single group of society residing in an affluent area of the UK.

Background: Increasing numbers of older people are requiring residential care and there are high levels of depression in such settings. Existing literature suggests that social support can help maintain psychological wellbeing. This study aimed to examine perceived changes in social support following a move into residential care. The key theories drawn upon were socioemotional selectivity theory (Carstensen et al., 1999) and the convoy model (Kahn & Antonucci, 1980). Method: Forty care home residents were interviewed using a structured interview. A hierarchical network mapping technique was used to measure perceptions of total network, inner network and peripheral network size. Functional support from a key significant other was measured using the Significant Others Scale. Contact with network members, depression and demographic information were also examined. Retrospective ratings were obtained by asking participants to think back to before they moved into care. Current and retrospective ratings on all measures were compared using Wilcoxon signed rank tests. Results: Total network size was perceived to have decreased following a move into residential care. There was no significant difference between current and retrospective ratings of inner network size. Peripheral network size decreased but this difference was not statistically significant. There was no perceived change in emotional and practical social support received from a key significant other following the move. Discussion: The results suggest that an individual‟s social network is compacted following a move into care but that membership of the inner network remains stable. These findings are discussed in terms of socioemotional selectivity theory (Carstensen et al., 1999) and the convoy model (Kahn & Antonucci, 1980). Strengths and weaknesses of the study are discussed and clinical implications of the findings explored.

This thesis introduces the innovative idea of the use of computer games and interactive entertainment by second-and third-age adults, specifically in the area of game content and interaction. This form of entertainment and technologies has become varied recently, with increased and widening participation of groups such as older adults of differing ages. The purposes of using technology involve well-being, intergenerational relationships and learning; these are some aspects primarily associated with the study of gerontology and game studies. This investigation encompassed two phases. Phase One examined the type of computer games older adults would like to play relating to hobbies, dreams and interests. Qualitative and quantitative data was collected in a step-by-step approach enabling participants to design their own game idea in an informal, jargon-free environment allowing for ease of understanding and coherence. Phase Two of the investigation involved older adults playing one of two consoles (Wii and PS-2). The games chosen were from the sports genre (golf, tennis and boxing) and were required to play for 15 minutes each. Results from Phase One indicated that participants were able to devise and design a number of game genres, and having prior knowledge of gaming did not necessarily aid when trying to design a game concept. Results from Phase Two indicated participants’ playing on the Wii was easier due to the nature of the console pad, rather than the traditional game pad used on the PS-2. Qualitative and quantitative data analysis interaction mechanism was far more influential on participants’ experience of flow than content. Extensive technological developments have enabled audiences in recent years to interact with gaming platforms easier than before, using motion sensor and natural body movement during game play. Preliminary design guidelines established from this investigation stipulate a multitude of aspects relating to interaction and content to enhance the experience of gaming for older adults.

To explore the influence that variations in projective stimuli might have on the respondent's ability to identify with pictorial representations of hands derived from the Hand Test (Wagner, 1961, 1983), 61 young adults (M age = 23) and 60 older adults (M age = 73) were presented with four alternate versions of hand stimuli (young male, young female, old male, and old female) in addition to the original Hand Test. Results indicated main effects for age and gender of respondent, which were primarily consistent with previous Hand Test research. Main effects for gender and age of hand stimuli (p < .05) were also found. Significant interaction effects were revealed for age of respondent by age of hand stimuli and for age of respondent by gender of hand stimuli (p < .05). These interactions resulted in the elicitation of a variety of responses to a differentiated manner than a standard set of Hand Test stimuli. A gender of respondent by gender of hand stimuli interaction effect was also found (p &lt; .05), suggesting that gender alterations of the card may also be beneficial for increasing respondent identification for some individuals. Overall, the results of variations in Hand Test stimuli, as they interact with respondent personal characteristics, indicate the utility of alternate versions of the Hand Test. This is based on the assumption that the respondent will identify with the hand that best resembles his/her hands, resulting in the stimulus performing its projective function to a greater extent.