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BackgroundPeople with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as ‘clinically vulnerable’ (CV) to COVID-19, that is, at higher risk of severe illness and mortality from COVID-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people.MethodsWe used data from wave 9 (2018/2019) and the first COVID-19 substudy (June/July 2020) of the English Longitudinal Study of Ageing. Using logistic and linear regression models, we investigated associations between being CV and health and social well-being during the pandemic, while controlling for prepandemic levels of the outcome variables. We also explored the interactions between CV and age group (50s, 60s, 70s, 80+), and between CV and shielding.ResultsCV people were more likely to report worse health and social well-being outcomes during the pandemic, even taking into account prepandemic differences. However, changes in health were not uniform across different age groups, and CV respondents were generally at greater risks of deterioration in health and social well-being compared with those not CV in the same age group. CV respondents who were shielding reported worse outcomes compared with those not CV and not shielding.ConclusionsWhile policies focusing on shielding CV older people reduce rates of hospitalisation and death from COVID-19, policymakers should also pay attention to understanding and addressing the wider needs of this group if their long-term health and social well-being are not to be compromised.

Background How quality of care in homecare for older people is understood is important, because it influences how quality in homecare is delivered, improved, regulated and measured. We conducted a scoping review to summarise the meanings of homecare quality for key stakeholders and identify measures of homecare quality. Methods We searched four databases (CINAHL, PsycINFO, ASSIA and Social Care Online) for peer-reviewed literature from high-income countries, and websites of major UK organisations for grey literature, published between 2016 and 2023. Articles were included if they reported views of any stakeholder on quality of care in the context of homecare for older people (aged 65 and above). Data were summarised using a qualitative content analysis approach to identify key dimensions of quality. Results Overall, 93 articles from 16 countries were included. Research focussed on understanding the views of four groups: older people, family carers, care workers and service providers. Homecare quality is understood as a multi-dimensional concept. We identified four dimensions: (1) relationships and continuity of care; (2) bespoke care; (3) organisational and structural aspects of care; and (4) understanding of quality as a measurable construct. Notable gaps in the literature include a lack of evidence on how older people form and articulate their preferences for homecare; a lack of consensus on care quality measurement; and a lack of focus on optimal models of care provision within existing budgets. Many crucial perspectives were absent, including owners of homecare organisations, inspectors and assessors involved in regulation of homecare services, and the legal or advocacy professions. Conclusions There is a wealth of evidence about how homecare quality for older people is understood. These understandings are largely consistent across different constituencies and countries. It is less clear how this shared vision of high quality homecare might be realised within existing systems.

Background Given the current policy emphasis in many Western societies on extending working lives, we investigated the health effects of being in paid work beyond state pension age (SPA). Until now, work has largely focused on the health of those who exit the labour force early. Methods Our data come from waves 2–4 of the English Longitudinal Study of Ageing, including the life history interview at wave 3. Using logistic and linear regression models, we assessed the longitudinal associations between being in paid work beyond SPA and 3 measures of health (depression, a latent measure of somatic health and sleep disturbance) among men aged 65–74 and women aged 60–69. Our analyses controlled for baseline health and socioeconomic characteristics, as well as for work histories and health in adulthood and childhood. Results Approximately a quarter of women and 15% of men were in paid work beyond SPA. Descriptive bivariate analyses suggested that men and women in paid work were more likely to report better health at follow-up. However, once baseline socioeconomic characteristics as well as adulthood and baseline health and labour market histories were accounted for, the health benefits of working beyond SPA were no longer significant. Conclusions Potential health benefits of working beyond SPA need to be considered in the light of the fact that those who report good health and are more socioeconomically advantaged are more likely to be working beyond SPA to begin with.

During the COVID-19 pandemic, older and clinically vulnerable people were instructed to shield or stay at home. Policies restricting social contact and human interaction pose a risk to mental health, but we know very little about the impact of shielding and stay-at-home orders on the mental health of older people. To understand the extent to which shielding contributes to poorer mental health. We used longitudinal data from wave 9 (2018/2019) and two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing, and constructed logistic and linear regression models to investigate associations between patterns of shielding during the pandemic and mental health, controlling for sociodemographic characteristics, pre-pandemic physical and mental health, and social isolation measures. By December 2020, 70% of older people were still shielding or staying at home, with 5% shielding throughout the first 9 months of the pandemic. Respondents who shielded experienced worse mental health. Although prior characteristics and lack of social interactions explain some of this association, even controlling for all covariates, those shielding throughout had higher odds of reporting elevated depressive symptoms (odds ratio 1.87, 95% CI 1.22-2.87) and lower quality of life (β = -1.28, 95% CI -2.04 to -0.52) than those who neither shielded nor stayed at home. Shielding was also associated with increased anxiety. Shielding seems associated with worse mental health among older people, highlighting the need for policy makers to address the mental health needs of those who shielded, both in the current pandemic and for the future.

Research from the United States has shown significant increases in the prevalence of three-generation households and in households consisting solely of grandparents and grandchildren. Such shifts in household composition, which are associated with socio-economic disadvantage, may reflect the activation of grandparents as a latent network of support in response to social and demographic changes such as rising partnership disruption. However, to date, little is known in Europe about trends in grandparent households or whether these households are also likely to be disadvantaged. Moreover, we know little about how the familistic and defamilised policy environments in Europe may affect the activation of such latent kin networks. Employing the Integrated Public Use Microdata Series—International and the Office for National Statistics’ Longitudinal Study for England and Wales, we used multivariate techniques to investigate changes in prevalence over time in co-residence with a grandchild across Austria, England and Wales, France, Greece, Portugal, Romania, and the United States. We expected increases in grandparent households in Portugal and Greece, familistic societies with few public alternatives to family support. However, only Romania (like the US) showed an increase in the percentage of people aged 40 and over co-residing with their grandchildren in three-generation households between the late 1970s and 2002. Given rises in poverty and limited support for low-income families in Romania, rises in grandparent coresidence may reflect a coping strategy among poorer families to increasing financial hardship. Regardless of the trends, grandparent households in all the countries studied remained associated with socio-economic disadvantage.

The second report of the Pensions Commission sought to establish a framework for a sustainable pension system for future generations of pensioners in the UK. The framework has been largely accepted by government in their recent White Paper, Security in Retirement: Towards a New Pension System (2006). Legislation will follow. The Commission and the government have made a number of claims about how their proposals will benefit women. Reforms have been welcomed by women's lobby groups. This article presents a gendered analysis of the Pensions Commission proposals using unpublished data generated by Pensim2, a pensions' simulator developed by the Department for Work and Pensions. Substantial improvements for women will be in the long term only, and will depend heavily on the extent to which gendered patterns of work and family life change in future. For women who follow traditional paths of combining part-time work with looking after children and kin, outcomes will depend on partnering arrangements. If they are married or cohabiting, they will be better off; but if they live alone in later life, the principal advantage of the proposals will be a reduction in means testing rather than an improvement in levels of income.

In this study of older migrants living in informal settlements in Harare, we seek to understand what care and caring means for older people ageing far from their place of origin in conditions of informality in a country with no formal care infrastructure. We find that care relations derive from histories of migration, community, kinship, aspiration, displacement and disenfranchisement, with the provision of security within insecure systems core to the very idea of care. Further action is needed at all levels to foreground how older migrants are living on Zimbabwean society’s margins and to facilitate their daily practices of care.

Despite the complexity of the retirement process, most research treats it as an abrupt and one-way transition. Our study takes a different approach by examining retirement reversals (unretirement) and their predictors. Using the British Household Panel Survey (1991–2008), and following participants into Understanding Society (2010–2015), we undertake a survival analysis to investigate retirement reversals among Britons aged 50–69 years who were born in 1920–1959 (N = 2,046). Unretirement was defined as: (a) reporting being retired and subsequently recommencing paid employment, or (b) beginning full-time work following partial retirement (the latter defined here as reporting being retired and working fewer than 30 hours per week). A cumulative proportion of around 25 per cent of participants experienced a retirement reversal after reporting being retired; about half of these reversals occurred within the first five years of retirement. Unretirement was more common for participants who were male, more educated, in better health, owned a house with a mortgage (compared to owning it outright) and whose partner was in paid work. However, unretirement rates were not higher for participants in greater financial need, whether measured as subjective assessment of finances or household income quintiles. These results suggest that unretirement is a strategy more often used by those who are already advantaged and that it has the potential to exacerbate income inequalities in later life.