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This qualitative narrative correspondence study investigates older adults' experiences of physical activity (PA) during the 2020 COVID-19 pandemic lockdowns in Aotearoa, New Zealand. This paper presents a reflexive thematic analysis of 501 letters received from 568 participants that discussed PA. Participants described PA as bringing joy and rhythm to daily life under stay-at-home measures. The most frequently discussed forms of PA included exercising, gardening, and housework. Four interconnected conceptual themes identified were as follows: (a) renegotiating environmental relationships, (b) social connection, (c) pleasure and PA, and (d) navigating active aging discourses. This paper emphasizes the important environmental and social motivations for becoming and remaining physically active despite restrictions on movement. Older adults' understandings and performance of PA were heavily shaped by active aging discourses. As such, we suggest that initiatives seeking to promote PA should foreground older adults' feelings of connection, productivity, and pleasure and recognize their diversity. This is contrary to current recommendations focused on duration or intensity of older adults' PA. [ABSTRACT FROM AUTHOR]

BACKGROUND: Design for All or Universal Design is a relatively new domain in Ergonomics. With globally ageing populations, it has however recently gained significant interest. OBJECTIVE: This position paper summarizes the outcomes of a workshop held at the virtual 21st Triennial Congress of the International Ergonomics Association. The paper expands the horizon of traditional Ergonomics into a domain where people are differently abled and establishes a platform for the essential needs of future ergonomic standards which are required to inform inclusive design guidelines, or Design for All, extending the range of users. METHODS: The paper includes contributions from Asian, Australian, European and US workshop participants who are accessibility design experts in their respective geographic regions. The paper summarizes issues related to anthropometry in the Design for All, based on recent work in the US (Access board) and actual developments in various national and international accessibility standardization bodies, such as the Standards Australia/Standards New Zealand, the European Standardization Organization (EN 17210:2021; EN 17161:2019) and the International Organization for Standardization (ISO 21542:2021 and BS ISO 7176-5:2008). CONCLUSIONS: The paper concludes that despite the identification of a significant gap in knowledge of the anthropometry of people with disabilities as far back as 1990, work towards bridging the gap and enabling ergonomic standardization has not progressed since then globally. The lack of standardization in anthropometric data on people with a physical disability continues to complicate provision of data for mobility and accessibility design and hampers accessibility standardization efforts. [ABSTRACT FROM AUTHOR]

Objectives: Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards. Methods: Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study. Results: Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later. Conclusion: While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age. [ABSTRACT FROM AUTHOR]

Spirituality permeates our land, our waters, and our people; it is inherent in Māori culture, often explicit for new migrants, but frequently ignored or tokenistically acknowledged in mainstream culture. Older New Zealanders are a pluralistic population, often fiercely secular, with a small but active religious population. How we now treat our elders requires work, needs careful consideration, and vision. As a country, New Zealand has embraced the notion of 'well-being', with the first 'well-being budget' announced in 2019. But well-being, or hauora as it is known for Māori, is incomplete without spirituality. This paper examines the place of spirituality, based on understandings and observations grounded in the New Zealand context, which comprises four interrelated areas: zeitgeist, scope and definitions, models, and evidence. We suggest this framework is a useful approach to examining what can be an ineffable personal experience and challenge to society's provision of aged care and healthy ageing. [ABSTRACT FROM AUTHOR]

Ageing does not reduce people's need to connect with family members, friends, and acquaintances, and neither does migration. For those older migrants living in a foreign land, connectedness with others plays a particularly important role in achieving a sense of belonging and sustaining their health and well-being. This paper explores the issues of social isolation and loneliness among older Asian migrants in New Zealand. Data were collected from in-depth semi-structured interviews with Chinese- or Korean-speaking migrants aged between 75 and 84 years (n = 10: all females), and from three focus groups consisting of Chinese- and Korean-speaking migrants (n = 10: 7 females, 3 males) and Chinese professionals (n = 5: 3 females, 2 males) between June 2016 and December 2016. The qualitative data obtained were analysed applying a thematic analysis approach using NVivo software for group analysis by a multidisciplinary research team. The findings from the study show that older Asian migrants experienced high levels of isolation and loneliness at least at some points in their migrant lives. Most participants in this study were living alone or with only their spouse, and this living arrangement was likely to provide fertile ground for isolation and loneliness to grow in the context of later-life migration. It was also observed that their lonely ageing ironically resulted from their efforts to preserve family relationships through avoiding being a burden, while allowing them a sort of space to maintain now barely connected lives. The participants revealed multiple ways of coping with lonely and isolated experiences in their limited social network, and these individual strategies allow us to make suggestions about how best to reduce older migrants' social isolation and loneliness in the New Zealand context and beyond., (© 2018 John Wiley & Sons Ltd.)

In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015-16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Access to nature is important for wellbeing at all ages with significant benefits for older adults. This paper explores the impacts of older adults' age-related health conditions on nature connection, their responses to the changes and identifies the types of nature connections and greenspaces available to and prioritised by older adults. It is based on the experiences of 72 New Zealand older adults aged 65-99, living in family homes, down-sized homes and rest homes. Data were gathered through interviews, photographs and assessments of the natural features of their home environment. Nearly all participants experienced age-related changes in their ways of connecting with nature as living accommodation and especially health and mobility changed. Reduced mobility was the primary factor limiting nature experiences especially for frailer adults. In contrast, for 'younger' older adults, retirement can provide more time and opportunities to engage with nature. Nature connection opportunities are valued by nearly all adults irrespective of age and health. Accessible nature opportunities in the nearby and home environment should be available to all adults irrespective of health and accommodation type. Dedicated resources need to be provided to ensure these opportunities are present for the frailest whose opportunities to have direct contact with nature are frequently absent., (Copyright © 2019. Published by Elsevier Ltd.)

Evidence shows population ageing to be historically a product of economic development, closely associated with high living standards and national affluence. Nonetheless, fears that an aged population leads to economic stagnation and public bankruptcy are widespread. In justification for cuts to public programs and the transfer of costs and risks from the state to individuals and families, the projections of social expenditures, in particular those based on ageing, are frequently identified as overgenerous and unsustainable in many G20 countries such as Australia and New Zealand. Claims based on intergenerational research methodologies and frameworks, a relatively new and innovative approach to using data projections, have proven to be important in these policy debates. This paper explores the application of these new technologies to understanding the impact of ageing on the economy in the globalised world of the 21st century. [ABSTRACT FROM AUTHOR]

Access to economic resources influences the material conditions of life for older people, as well as the freedoms and capacities of older people to achieve the kind of lives they value. Security is one aspect of later life valued by older people. Ontological security provides a sense of order and continuity and needs to be understood in terms of the situated life experiences and circumstances of older people. The study reported in this paper analysed 145 qualitative interviews with New Zealanders aged 63–93 in order to explore how participants understand ontological security. Varying levels of access to economic resources were associated with differing abilities of participants to manage the unpredictability of everyday life. Among the wealthy, security was strongly connected to the freedoms provided by ample financial resources. Contrary to what might be expected, those with the lowest levels of economic resources did not express higher levels of insecurity, but instead drew upon life experiences of managing and making do to construct a trajectory of security. Those with mid-range levels of economic resources expressed most insecurity, including anxiety over changing economic conditions and concerns over their ability to manage reductions in economic resources. In discussing the implications of this, the paper highlights the need to recognise ways in which access to economic resources intersect with life circumstances, past experiences and future social expectations to provide opportunities for all older people to pursue security as they strive to age well. [ABSTRACT FROM PUBLISHER]

Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could ‘death conversations’ early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand. Five exemplars are discussed, drawn from a sample of 21 semi-structured interviews with young older adults (54–65 years old) not receiving palliative care or diagnosed with a terminal illness. Together, these narratives indicate that further community consultation is required to determine culturally appropriate ways to initiate productive conversations around aging, death and dying and how to build patient/practitioner/family relationships which allow these conversations to happen safely. There is a need to acknowledge the important factor of culture related to age, generation, sex, faith and ethnicity when engaging in conversations about aging, death and dying. By doing so, health professionals will be best equipped to assist their patients to live well into death. [ABSTRACT FROM PUBLISHER]

In New Zealand in 2006, a professional photographer undertook a photo essay of residents and staff in an aged care residential setting. The photographer captured the 'lifeworld' of the institution through photographing the images of daily life. The resulting photo essay, which included some photographs of older people naked and in semi-dress, was published in New Zealand's principal nursing journal in May 2006. There ensued an unprecedented reaction that divided New Zealand's nursing world. In this paper, I explore possible meanings of the 'photo furore', through discourse analysis of the numerous letters to the nursing journal editors. These letters reveal reactions and opinions from both 'sides'- rejection and disapproval, acceptance and approval - as the situation developed into dichotomy. In this paper, the further aim is to address the issue of attitudes and reactions of the exposed ageing body from theoretical perspectives. Results reveal conflicting discourses and attitudes within nursing towards photographs of the ageing body and underlying this, how nurses believe older people should be thought about and cared for. These attitudes are wide-ranging and, on the one hand, include ageism and a desire to protect and supervise older people versus a greater tolerance and acceptance of older people as competent, autonomous beings. [ABSTRACT FROM AUTHOR]

Implementing community services can be a very complex process where people end up “not seeing the wood for the trees” and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management-control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there. [ABSTRACT FROM AUTHOR]

This paper examines age-related differences in voice quality between 15 young and 15 old speakers, using electroglottographic (EGG) recordings of three elicitation types: sustained vowels, hVd word lists, and readings of the Rainbow Passage. For each elicitation type, fundamental frequency (F0), contact quotient (Qx), and their standard deviations are analysed. Results found, for all three elicitations, that Qx was significantly lower for older speakers. F0 was higher for the older speakers, but this was only significant for the hVd word lists. Sustained vowels were used to examine the effect of target pitch and loudness on F0 and Qx. Both Qx and F0 were raised with increased target loudness. The hVd word lists were used to examine the phonetic effects of different vowels. Lip rounded vowels had higher Qx than non-lip rounded vowels. Readings of the Rainbow Passage encompassed prosodic and phonetic variations in F0 and Qx, in addition to voice quality. F0 and Qx contours of the hVd word lists and the vowel/ei/taken from the Rainbow Passage were analysed using the discrete cosine transform. The hVd frame produced coarticulation effects on the Qx contour, but no such effects were evident for the vowel /ei/. The study concluded that using multiple elicitation types is beneficial in the study of the effect of age on the voice, and that analysing contour tracks for F0 and Qx will allow further examination of how prosodic and phonetic effects interact with age-related changes in voice quality. [ABSTRACT FROM PUBLISHER]

Living with human immunodeficiency virus (HIV) in the industrialised world has for over a decade been conceptualised as living with a chronic illness. People living with HIV now are amongst the first to live and age with the virus. Drawing on a qualitative longitudinal study in a low-incidence area in a low-incidence country, this paper investigates the nuanced ways that people negotiate this condition. While it has been argued that HIV is a condition like any other chronic disease, our thematic analysis reveals some similarities and particularities around living with the condition. In comparing themselves to others with the condition, high levels of diversity of experience were identified that extended well beyond length of time from diagnosis. In comparing their illness with other illnesses, the location, for example, of their specialist service within a clinic for those with acute sexually transmitted diseases was identified as problematic. The work involved in maintaining a coherent sense of self in the face of existing and shifting challenges as a result of their infection was a second strong theme. The final theme involved flux and flex work in the ways people sought to gain and maintain control over various aspects of their lives. All of these experiences are mediated by place; that is the experience is not the same as that of those who live where there is a much higher incidence of infection. The work involved in negotiating this condition in low-incidence environments deserves more attention, but aspects of these findings are significant in higher incidence contexts as well; in particular, passivity in face of infection as one ages and the potential for medication refusal as a means of maintaining control over life and death. [ABSTRACT FROM PUBLISHER]

This paper outlines the development of culturally safe services for older lesbian, gay, bisexual, transgender and intersex people. It draws on a framework for cultural safety, developed in New Zealand which incorporates an understanding of how history, culture and power imbalances influence the relationship between service providers and Maori people. This has been adapted to the needs of older lesbian, gay, bisexual, transgender and intersex Australians., (© 2015 AJA Inc.)

Contemporary Western social policy encourages older adults to maintain independence in the community. Socio-cultural norms of independence have recently become associated with successful ageing. Personal autonomy and self-responsibility are cultural markers by which older adults increasingly define their lives and identity. Many older adults seek to remain independent within their communities, while coping with age-related decline, and living alone with decreased social connectedness. These characteristics have also been associated with personal and social vulnerability and explain why older adults are at higher risk of experiencing disproportionate negative outcomes during disasters. This paper describes findings from narrative interviews with a sample of independent community-dwelling New Zealand older adults. The interviews sought to explore their views about disaster preparedness. However, within their accounts was a collective and bigger story about personal preparedness, and social relationships in later life, which extended beyond the context of preparing for a future disaster event. Older adults identified age-specific preparedness as a way to maintain independence in the everyday context of their lives. Concerns about health influenced their choices and actions as they evaluated and prioritised goals and strategies to maintain independence and wellbeing. Social relationships were also considered an important resource to support independence. Understanding the role of preparedness in the everyday lives of older adults has implications for improving the disproportionate negative outcomes this vulnerable age group can experience during a disaster. Therefore, health, gerontology and emergency management have much in common when considering older adults' preparedness during non-disaster times. [ABSTRACT FROM PUBLISHER]

Worldwide, populations are ageing and consequently so are the consumer profiles for most organisations. Understanding how best to ensure satisfaction in interactions with older customers, patients, members of organisations, and so on is therefore increasingly important. This paper examines two research questions: (a) How satisfied or dissatisfied are older people with their customer service experience, and what are the factors associated with dissatisfaction? and (b) What prompts older people to want to change service providers? The research questions are addressed using a mixed-methods approach – quantitative analysis of observation logs, supported by illustrative quotes from focus groups. We find that on the whole older people are generally satisfied with their interactions with organisations, although a substantial minority of interactions lead to dissatisfaction or lower-than-expected satisfaction. Dissatisfaction with interactions is mostly associated with impersonal communications, including interactions that are not conducted face to face, and those that are one-off interactions rather than repeated interactions. Media and communications firms prompted the greatest levels of dissatisfaction among older consumers. Dissatisfied older consumers from our sample are more than 12 times more likely to report an intention to switch providers than satisfied consumers. This highlights the potential costs to organisations of poor customer interactions with older people. [ABSTRACT FROM PUBLISHER]

The impact of disparities in socio-economic status on the health of older people is an important issue for policy makers in the context of population ageing. As older people live in different types of economic circumstances and because, as people age, their desires and needs are different to those of younger generations, measures of living standards need to be appropriate for older people. This paper reports on the validation of a measure of living standards for older people based on Sen's Capability Approach. Using this approach, living standards are conceptualised as varying from constraint to freedom rather than from hardship to comfort. Using the New Zealand Longitudinal Study of Ageing omnibus survey of 3,923 adults aged 50–87 years, the validity of the measure was assessed. The results indicate that this measure assesses what older people are able to achieve. In addition, this measure discriminates better at the higher end of the living standards spectrum than an existing measure that assesses living standards from hardship to comfort in terms of what people possess. From this, a short form of the measure has been developed which offers a conceptually based and valid measure useful for survey research with older people. This measure of living standards provides future avenues for improved understandings of socio-economic position in later life. [ABSTRACT FROM PUBLISHER]

Dementia has been framed and seen as a condition associated with ageing and in particular with advanced age, especially amongst those over 80 years of age. For Maori and Pacific peoples in New Zealand dementia is not necessarily associated with age but is directly related to our respective histories within this country, patterns of migration and the socioeconomic determinants of health for both populations from different tribes and nations. Issues are discussed in relation to Maori and Pacific development and the importance of prevention and early detection of chronic health conditions. Whānau Ora is proposed as a developing indigenous and Pacific model with one of its purposes being is to support individuals and families involved in the management of one or more of the chronic health conditions, that may lead onto dementia as part of the end of life process. This paper proposes that the needs of Māori and Pacific, especially, in the Tamaki Makaurau area (Auckland region) must be included in the planning and decision making of policy and services related to dementia. The health and social inequalities of these populations during life and across generations also need to be considered in planning to prevent dementia from occurring early or in midlife.

Purpose – The purpose of this paper is to describe the development of a centre to promote the spiritual care of older people in New Zealand. Design/methodology/approach – The spiritual scene in New Zealand is described and “spirituality” defined. The history of the Selwyn Centre for Ageing and Spirituality (SCAS) is illustrated by case studies in three areas: research, education and advocacy, noting challenges in providing spiritual care to older people. Findings – The number of New Zealanders claiming a religious affiliation is dropping but spirituality is of interest and relevance to many people. The acknowledgement of Maori spirituality has affected government policy. The SCAS has supported research and provided education throughout the country. Advocacy is difficult where care focuses on the physical and funding for frail older people is limited. Research limitations/implications – While the importance of good spiritual care for older people is clear, this is not easy to achieve. However, an organisation like SCAS has brought the issue to national awareness and made some contribution to increased understanding and improved practice. Practical implications – As the population ages and expressions of spirituality diversify, a deeper understanding of spirituality beyond Christian religion is required. Social implications – While the SCAS focuses on older people, it has formed a nexus of people more widely interested in spirituality at all ages, in different cultures and throughout the country. Originality/value – This is the first description of a New Zealand organisation specifically addressing the spiritual care of older people. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this paper is to explore the immigrant experiences of older Korean people and their intergenerational family relationships in the New Zealand context., Methods: Data were collected from qualitative interviews with older people, community leaders and professionals in Christchurch and Auckland. Data analysis was conducted using concept mapping techniques in the cross-cultural context where two languages were simultaneously used., Results: The findings of the study show that older Korean people in New Zealand were likely to face multiple challenges due to the combined effects of immigration and ageing in a new country. Some older people experienced difficulties in managing their immigrant lives and intergenerational relationships in the transnational family context in which their family members were dispersed across two or more nations., Conclusion: The immigrant experiences of older migrants might be affected by an 'invisible' source of isolation and exclusion at familial, community, societal and transnational levels., (© 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.)

Aims: New Zealand's ageing population threatens the financial sustainability of our current model of health service delivery. The Canterbury Health, Ageing and Life Course (CHALICE) study aims to develop a comprehensive and flexible database of important determinants of health to inform new models. This paper describes the design, methodology, and first 300 participants of CHALICE., Methods: Commencing August 2010, CHALICE is a multidisciplinary prospective random cohort study and biobank of 1,000 Canterbury adults aged 49-51 years at inception, stratified by self-identified Maori (n=200) and non-Maori (n=800) ethnicity. Assessment covers sociodemographic, physical, cognition, mental health, clinical history, family and social, cardiovascular, and lifestyle domains. Detailed follow-up assessment occurs every 5 years, with a brief postal follow-up assessment undertaken annually., Results: For the first 300 participants (44 Maori, 256 non-Maori), the participation rate is 63.7%. Overall, 53.3% of participants are female, 75.3% are living in married or de facto relationships, and 19.0% have university degrees. These sociodemographic profiles are comparable with the 2006 Census, Canterbury region, 50-54 years age group percentages (50.7%, 77.2%, and 14.3%, respectively)., Conclusions: CHALICE has been designed to provide quality data that will inform policy development and programme implementation across a broad spectrum of health indicators.

Objectives: Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ) aims to determine the predictors of successful advanced ageing and understand the trajectories of wellbeing in advanced age. This paper reports recruitment strategies used to enrol 600 Māori aged 80-90 years and 600 non-Māori aged 85 years living within a defined geographic boundary., Methods: Electoral roll and primary health lists of older people were used as a base for identification and recruitment, supplemented by word of mouth, community awareness raising and publicity. A Kaupapa Māori method was used to recruit Māori with: dual Māori and non-Māori research leadership; the formation of a support group; local tribal organisations and health providers recruiting participants; and use of the Māori language in interviews. Non-Māori were recruited through local health and community networks. Six organisations used differing strategies to invite older people to participate in several ways: complete full or partial interviews; complete physical assessments; provide a blood sample and provide access to medical records., Results: During 14 months in 2010-2011, 421 of 766 (56%) eligible Māori and 516 of 870 (59%) eligible non-Māori were enrolled. Participation and contribution of information varied across the recruitment sites., Conclusion: Attention to appropriate recruitment techniques resulted in an acceptable engagement and recruitment for both Māori and non-Māori of advanced age in a longitudinal cohort study., Implications: There is high potential for meaningful results useful for participants, their whānau and families, health agencies, planners and policy., (© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.)

Background: The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand., Methods/design: A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples., Discussion: A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.

Purpose: This study illuminates the concept of "aging in place" in terms of functional, symbolic, and emotional attachments and meanings of homes, neighbourhoods, and communities. It investigates how older people understand the meaning of "aging in place," a term widely used in aging policy and research but underexplored with older people themselves., Design and Methods: Older people (n = 121), ranging in age from 56 to 92 years, participated in focus groups and interviews in 2 case study communities of similar size in Aotearoa New Zealand, both with high ratings on deprivation indices. The question, "What is the ideal place to grow older?" was explored, including reflections on aging in place. Thematic and narrative analyses on the meaning of aging in place are presented in this paper., Results: Older people want choices about where and how they age in place. "Aging in place" was seen as an advantage in terms of a sense of attachment or connection and feelings of security and familiarity in relation to both homes and communities. Aging in place related to a sense of identity both through independence and autonomy and through caring relationships and roles in the places people live., Implications: Aging in place operates in multiple interacting ways, which need to be taken into account in both policy and research. The meanings of aging in place for older people have pragmatic implications beyond internal "feel good" aspects and operate interactively far beyond the "home" or housing.

Background: Older brain age – as estimated from structural MRI data – is known to be associated with detrimental mental and physical health outcomes in older adults. Social isolation, which has similar detrimental effects on health, may be associated with accelerated brain aging though little is known about how different trajectories of social isolation across the life course moderate this association. We examined the associations between social isolation trajectories from age 5 to age 38 and brain age assessed at age 45. Methods: We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and persistent 'child-adult' isolation. A brain age gap estimate (brainAGE) – the difference between predicted age from structural MRI date and chronological age – was derived at age 45. We undertook analyses of brainAGE with trajectory group as the predictor, adjusting for sex, family socio-economic status, and a range of familial and child-behavioral factors. Results: Older brain age in mid-adulthood was associated with trajectories of social isolation after adjustment for family and child confounders, particularly for the 'adult-only' group compared to the 'never-isolated' group. Conclusions: Although our findings are associational, they indicate that preventing social isolation, particularly in mid-adulthood, may help to avert accelerated brain aging associated with negative health outcomes later in life. [ABSTRACT FROM AUTHOR]

ABSTRACT Existing literature suggests that successful ageing is linked to a sense of community (SOC) that is developed through shared daily practices. For migrant groups, SOC can extend across home and receiving countries. In order to understand the issue of successful ageing in place and multiple SOCs among older Chinese migrants, this paper investigated 32 older Chinese migrants' narratives of developing a SOC in their local and home communities. Findings suggest that a SOC can be viewed as constructed through practices such as neighbouring and supportive interactions within local contexts as well as engagement with the home country via new media. The findings provide insights into everyday practices central to the cultivation of a SOC among the participants whose engagements span the cultural spaces of China and New Zealand. For example, the use of media contributes to the participants' SOCs both in China and New Zealand. As a result, they live in a transnational community that can be understood as an 'imagined' community where the participants engage with significant, although absent, Chinese others. Living between China and New Zealand, between homes and between languages, the participants create identity 'inbetweenness' that is constructed at the intersection of interdependent, compatible and mutually reinforcing communities and spaces. The findings therefore extend conventional understandings of ageing migrant experiences that assume successful ageing and community participation occur in one locale to an understanding of multiple SOCs within the context of transnationalism. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of older people living with heart failure and their transitions from independence to dependence and for some death. New Zealand's ageing population is predicted to increase from 12% in 2001 to 25% by the year 2051, similar to the worldwide trend of ageing. A high proportion of these people will have one or more chronic illnesses. Associated with the increase in survival is a growing body of research examining the needs of the older person with heart failure and finding particular problems with end of life care. Older people face many challenges in living with their heart failure, in particular the transition to dependence. To study the transition a longitudinal qualitative study using General Inductive approach was used. Participants were interviewed every 3 months for a 12-month period during 2006-2008. A total of 79 interviews with 25 people were completed. Our findings showed that transition was not a simple linear process with the older person moving from one phase to another; instead their experiences illustrated the complexity of transitions they faced and what helped them to manage these. The older people in this study illustrated the importance of trust in health professionals and believed they would receive good care. Their fears revealed concerns about being a burden as they deteriorate and becoming more dependent. Understanding the complex issues related to transition to dependence can provide health professionals with a framework for assessment and approaches to providing the support required.

Aim: This paper is a report of a study to explore the experiences of 'almost old' women as they grow older while living with a chronic condition., Background: Little is known about the contextual effects of ageing and how it shapes and is shaped by a woman's chronic illness experience. Nurses' understanding of this phenomenon can have positive effects on how their client accesses and responds to healthcare., Method: Seven women aged between 50 and 58 years participated in this interpretive descriptive study that explored the issues of ageing with a chronic condition. Three focus groups were held between March 2003 and March 2004. Transcriptions were analyzed after each focus group. Participants were given the opportunity to respond to the findings as the analysis progressed., Findings: The experience of living with a chronic illness foreshadowed what was to come with ageing and embodied the ageing process: it was just part of their lives. Alongside this, the women now felt less out of place. Their peers were catching up and beginning to experience aspects of participants' everyday reality. The women, however, experienced double jeopardy because ageing amplified the ongoing vulnerabilities of living with a chronic condition., Conclusion: Nurses who recognize the resourcefulness and expertise of women who live with a chronic condition can effectively be co-strategists in their helping them to age well.

Discourse on male sexuality in mid-to-later life has exploded in recent years (Gullette 1998). Attention to this topic has been spurred by the advent of (highly profitable) sexuopharmaceutical 'solutions' to erectile changes affecting older men. 'Success' stories abound in the media and in medical literature related to the restoration of faulty erections and ailing sex lives through drugs such as Viagra (sildenafil citrate), Uprima (apomorphine) and Cialis (tadalafil). In this paper we explore some of the ways in which notions about ageing and male sexuality are changing in popular cultural and medical texts in response to the advent of Viagra and the increasing authority of biomedicine in this area. We also demonstrate how the recent biomedical endorsement of 'sex for life' (the imperative to maintain an active youthful masculine [hetero]sexuality - defined in terms of male orgasm through penetrative sex) may be challenged by the very accounts of older men who are, or have been, affected by erectile difficulties and have used drugs like Viagra themselves. We present the perspectives of mid-to-late life heterosexual men in New Zealand whose stories question the contemporary biomedical privileging of erections and intercourse 'at any cost and at any age'. We argue that the current push to identify and treat so-called erectile dysfunction (and restore erections and penetrative sex to relationships) neglects some men's own experiences of alternative modes of relating sexually that they identify as 'normal', 'healthy', 'enjoyable' and 'satisfying' for them and their partners; and undermines their understanding of such changes as positive outcomes of ageing, experience and maturity.

This paper draws on a study of social aging among women in urban New Zealand for a comparative analysis of grandmother as a marker of being socially old. The paper features the views and perspectives of the women themselves and examines ethnic group identification as a source of variation. Data collected in a series of indepth interviews with women representing four ethnic groups indicate similar patterns regarding prevalence of transition to the role and recognition of grandmother as one of the roles treated by others as primary in definition of old, but differences regarding how the role is treated in self definitions. In the women's own definitions, being a grandmother is treated as one among a configuration of markers of old age and its significance rests on how the role connects with the other markers. Six other markers were implicated: a shorter future, social generativity, social status, seniority, social renewal, and social integration. Ethnic variation in how the grandmother role connects is evident in respect to all six and relatively strong in the case of social status, seniority, social renewal, and social integration. Indicated for further study is the influence of ethnic culture and also the interaction of ethnicity with other sources of variation such as age in years and marital status.

roy d.e. & giddings l.s. (2012) The experiences of women (65-74 years) living with a long-term condition in the shadow of ageing. Journal of Advanced Nursing 68(1), 181-190. Abstract Aims. This paper reports on a study that explored experiences of women (65-74 years) as they grow older while living with a long-term condition. The phenomenon of focus was 'ageing with a long-term condition', rather than the experience of developing a long-term condition after reaching older adulthood. Background. People with long-term conditions are living into older age. There is limited literature on the nexus of ageing with a long-term condition. It is known that ageing shapes and is shaped by women's experiences of living with a long-term condition. Methods. In this interpretive descriptive study, nine women participated in a series of three focus groups held in 2007 and 2008. Transcripts were analysed thematically and participants given the opportunity to respond to the analysis. Findings. 'In the shadow of ageing' was the overarching theme. The women reported that although their long-term condition remained the referent point in their daily lives, for others including health professionals, the focus was on their appearance and the effects of older age. To overcome the back-grounding of their long-term condition, the women used 'strategies already-in-place'; it became 'just another thing to deal with'. Ageing, however, remained 'a privilege'. Conclusion. If health professionals focus on age and its concomitant effects, rather than a woman's long-term condition, they are at risk of delivering inappropriate care. They need to be prepared to advocate for the special needs of older women who live with a long-term condition and remain cognizant of the women's resourcefulness and expertise developed over time. [ABSTRACT FROM AUTHOR]

Background: The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous MĀ, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for MĀori and non-MĀori in New Zealand. Methods/design: A total population cohort study of those of advanced age. Two cohorts of equal size, MĀori aged 80-90 and non-MĀori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (MĀ tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for MĀori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples. Discussion: A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined. [ABSTRACT FROM AUTHOR]

Guided by a theorisation of voluntarism as a critical process shaping local outcomes of changes underway in health care systems and in rural communities, this paper re-analyses qualitative results from previous case studies of rural ageing to deconstruct the multifaceted role of the voluntary sector in facilitating the emergence of homes and communities as 'new' spaces of care. The specific focus is on the lived experience of voluntary sector care providers from the perspectives of non-profit organisations, community groups and families as well as elderly residents of rural communities in Canada and New Zealand. The findings confirm the local dynamics of voluntarism as a crucial yet neglected component of sustainable rural services and communities. More importantly, they reveal the voluntary sector as a major source of resistance to both the short-term changes mandated by restructuring and longer-term changes associated with rural ageing and service decline. It is through resistance that voluntary organisations and volunteers are seen to be engaging most intensely with the challenge of ageing in place within evolving spaces of care. A more nuanced understanding of their complex role is a prerequisite for developing informed policy on rural ageing and care provisioning. [ABSTRACT FROM AUTHOR]

In imagining how their lives might turn out, 100 young New Zealanders aged between 16 and 18 years wrote descriptions of their future lifecourse. Their descriptions of themselves at the nominal age of 80 years form the basis of the research reported in this paper. For these young people, ageing and old age are understood as accomplishments in the context of an imagined lifecourse. They see personal ageing as shaped by a common temporal ordering of life events that ensures material security, financial success, and an enduring intimate relationship. In imagining themselves aged 80 years, three key themes that constitute a discourse of 'accomplished ageing' were identified: the experience of old age would be contingent on achievements throughout the lifecourse; old age would be a time for harvest; and while people may look old they can continue to 'be' young. Although their images of bodily appearance included some negative stereotypes of old age, appearance and bodily function were understood as amenable to life-long self-management. The young people imagined themselves as life-long active agents, and framed a positive image and homogeneous social identity for older people. The 'accomplished ageing' discourse has implications for how ageing is understood by young people. In particular, the social identity that accomplished ageing implies may shape how they relate to those who do not accomplish ageing in the imagined optimistic and homogeneous way. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) triples a person's risk of active tuberculosis (TB) and is associated with increased mortality. It is unclear whether diabetes status and/or the associated renal dysfunction is associated with poor TB outcomes in New Zealand, which has high diabetes screening. Aim: To characterise the population of TB‐DM and TB‐alone to assess the effect of diabetes status and renal function on hospitalisation and mortality. Methods: Clinical records from all adult patients diagnosed with TB in Auckland over a 6‐year period (2010–2015) were reviewed. Baseline demographics, clinical presentation and microbiological data were assessed to compare the rates of hospitalisation and mortality between those with TB‐DM and TB‐alone. Statistical significance was defined as P < 0.05. Results: A total of 701 patients was identified with TB; 120 (17%) had an unknown diabetes status and were excluded, and 135 had co‐existing diabetes. The TB‐DM and TB‐alone groups had similar distribution of TB site and proportions of Mycobacterium tuberculosis culture positivity. Univariate analysis showed TB‐DM patients had statistically significantly higher proportions of acute hospitalisation and mortality. Multivariate logistic regression showed only a reduced estimated glomerular filtration rate (eGFR) accounted for the higher rates of hospitalisation, with the odds of hospitalisation increasing by 2% for every unit decrease in eGFR. The odds of mortality increased by 6% for every year increase in age, and the odds of mortality increased by 3% for every unit reduction in eGFR. Conclusions: Diabetes is associated with higher TB hospitalisation and mortality; however, this is likely mediated by increased age and chronic kidney disease. [ABSTRACT FROM AUTHOR]

Objectives: Individuals with schizophrenia develop dementia in late life at higher rates than the general population. This is arguably explained by high rates of chronic medical conditions and exposure to antipsychotic medications. This risk has implications for public health. We aimed to test this in a large New Zealand database. Methods: Participants in this study were New Zealanders aged 65 years or older who had an interRAI assessment completed during the study period (July 2013–June 2020). This cohort study analysed data from 168,780 individuals. The majority were European (87%), and mostly assessment was for home care (86%). Results: There were 2103 individuals with schizophrenia, 1.25% of the total sample, mean age of 75 years (±1.9) and 61% female. A minority of individuals with schizophrenia, 23%, also had a dementia diagnosis. At 82 years of age (±1.7) and 60% female, 25% of individuals without schizophrenia had a dementia diagnosis; the difference from rate of dementia in individuals with schizophrenia was not statistically significant. Conclusions: These findings suggest that further study is needed about the processes that lead to dementia diagnoses in older individuals with schizophrenia. [ABSTRACT FROM AUTHOR]

Objectives. To project the prevalence of people receiving dialysis in Australia for 2021–30 to inform service planning and health policy. Methods. Estimates were based on data from 2011 to 2020 from the Australia & New Zealand Dialysis & Transplant (ANZDATA) Registry and the Australian Bureau of Statistics. We projected dialysis and functioning kidney transplant recipient populations for the years 2021–30. Discrete-time, non-homogenous Markov models were built on probabilities for transition between three mutually exclusive states (Dialysis, Functioning Transplant, Death), for five age groups. Two scenarios were employed – stable transplant rate vs a continued increase – to assess the impact of these scenarios on the projected prevalences. Results. Models projected a 22.5–30.4% growth in the dialysis population from 14 554 in 2020 to 17 829 (‘transplant growth’) – 18 973 (‘transplant stable’) by 2030. An additional 4983–6484 kidney transplant recipients were also projected by 2030. Dialysis incidence per population increased and dialysis prevalence growth exceeded population ageing in 40–59 and 60–69 year age groups. The greatest dialysis prevalence growth was seen among those aged ≥70 years. Conclusion. Modelling of the future prevalence of dialysis use highlights the increasing demand on services expected overall and especially by people aged ≥70 years. Appropriate funding and healthcare planning must meet this demand. [ABSTRACT FROM AUTHOR]

Objectives: Dietary intake information is key to understanding nutrition-related outcomes. Intake changes with age and some older people are at increased risk of malnutrition. Application, difficulties, and advantages of the 24-hour multiple pass recall (24hr-MPR) dietary assessment method in three cohorts of advanced age in the United Kingdom (UK) and New Zealand (NZ) is described. Participants: The Newcastle 85+ study (UK) recruited a single year birth cohort of people aged 85 years during 2006–7. LiLACS NZ recruited a 10-year birth cohort of Māori (indigenous New Zealanders) aged 80–90 years and a single year birth cohort of non-Māori aged 85 years in 2010. Measurements: Two 24hr-MPR were conducted on non-consecutive days by trained assessors. Pictorial resources and language were adapted for the New Zealand and Māori contexts. Detailed methods are described. Results: In the Newcastle 85+ study, 805 (93%) participants consented to the 24-MPR, 95% of whom completed two 24hr-MPR; in LiLACS NZ, 218 (82%) consented and 203 (76%) Māori and 353 (90%) non-Māori completed two 24hr-MPR. Mean time to complete each 24hr-MPR was 22 minutes in the Newcastle 85+ study, and 45 minutes for Māori and 39 minutes for non-Māori in LiLACS NZ. Dietary assessment of participants residing in residential care and those requiring proxy respondents were successfully included in both studies. Most participants (83–94%) felt that data captured by the 24hr-MPR reflected their usual dietary intake. Conclusions: Dietary assessment using 24hr-MPR was successful in capturing detailed dietary data including information on portion size and time of eating for over 1300 octogenarians in the UK and New Zealand (Māori and non- Māori). The 24hr-MPR is an acceptable method of dietary assessment in this age group. [ABSTRACT FROM AUTHOR]

This paper examines how bluespaces inform experiences of place, being aged, and wellbeing among seniors on Waiheke, an island within the greater Auckland area in northern New Zealand. We draw on photo-elicitation interviews with seniors aged 65-94 to argue that bluespaces shape metaphors of 'islandness' that, in turn, help maintain wellbeing. We conclude that, although island settings pose unique challenges for seniors, (e.g. potential isolation, and a lack of advanced care), drawing on the qualities of bluespaces helps maintain a secure sense of self anchored in strong affective ties to place. [ABSTRACT FROM AUTHOR]

Background: Priority setting in a climate of diverse needs and limited resources is one of the most significant challenges faced by health care policymakers. This paper develops and applies a comprehensive multi-criteria algorithm to help determine the relative importance of health conditions that affect a defined population. Methods: Our algorithm is implemented in the context of the Waikato District Health Board (WDHB) in New Zealand, which serves approximately 10% of the New Zealand population. Strategic priorities of the WDHB are operationalized into five criteria along which the algorithm is structured—scale of disease, household financial impact of disease, health equity, cost-effectiveness, and multimorbidity burden. Using national-level data and published literature from New Zealand, the World Health Organization, and other high-income Commonwealth countries, 25 health conditions in Waikato are identified and mapped to these five criteria. These disease-criteria mappings are weighted with data from an ordered choice survey administered to the general public of the Waikato region. The resulting output of health conditions ranked in order of relative importance is validated against an explicit list of health concerns, provided by the survey respondents. Results: Heart disease and cancerous disorders are assigned highest priority rankings according to both the algorithm and the survey data, suggesting that our model is aligned with the primary health concerns of the general public. All five criteria are weighted near-equal across survey respondents, though the average health equity preference score is 9.2% higher for Māori compared to non-Māori respondents. Older respondents (50 years and above) ranked issues of multimorbidity 4.2% higher than younger respondents. Conclusions: Health preferences of the general population can be elicited using ordered-choice surveys and can be used to weight data for health conditions across multiple criteria, providing policymakers with a practical tool to inform which health conditions deserve the most attention. Our model connects public health strategic priorities, the health impacts and financial costs of particular health conditions, and the underlying preferences of the general public. We illustrate a practical approach to quantifying the foundational criteria that drive public preferences, for the purpose of relevant, legitimate, and evidence-based priority setting in health. [ABSTRACT FROM AUTHOR]

In older people with diabetes, multimorbidity is highly prevalent and it can lead to poor quality of life. The overall purpose of this study was to examine the association between the social environment, psychosocial support and constraints, and overall quality of life among older people with and without with diabetes and multiple chronic illnesses. Self-reported data from participants in a cohort study of older New Zealanders was analysed. Responses from 380 older people diagnosed with diabetes and multiple chronic illnesses were compared with 527 older people with no health issues on indicators related to the associations of neighbourhood, health and ageing, using structural equation modelling. The final model suggests that social provision, purpose in life and capabilities mediated between the social environment and quality of life, indicate that older people with positive social environment (i.e., neighbourhood advantage, residential stability) are much less likely to experience depression due to having good social support, meaningful life purpose and opportunities to engage. Perceived neighbourhood advantages, such as positive neighbourhood qualities, social cohesion and housing satisfaction, along with the focus on increasing social support, enhancing purpose in life and supporting one's capability to achieve, may serve as protective factors against depression. Environmental and personal circumstances can contribute to quality of life among older people with diabetes and multimorbidity. By providing older people with diabetes and multiple chronic illnesses a socially just environment that challenges ageism and other forms of oppression, this could reduce social disparities in health, improve inclusion and access to resources. Social and healthcare professionals are encouraged to design clinical care guidelines and rehabilitation goals from a wholistic and person/client centred approach to support older people with diabetes and multiple chronic illnesses. [ABSTRACT FROM AUTHOR]

This paper focuses on contemporary public perceptions of the challenges of combining paid work and raising a family, set against the backdrop of concerns about low fertility, structural population ageing and the composition of the future labour force. Australasian policy makers have responded to these issues with various initiatives aimed at assisting people who are raising families and engaging in paid work. The New Zealand Working for Families package, the Australian Family Tax Benefit package, and the two countries' parental leave and women-focused policies are compared, with a focus on cross-national similarities and differences. The most significant difference between the two nations is the lack of a paid parental leave scheme in Australia, but the family-friendly policies are similar in perpetuating tensions between ensuring both present and future labour supply. The policies are aimed at providing incentives to be in paid work when parents have children, but tend to reinforce the notion of work and family as separate spheres, and potentially contribute to social divisions between parents and non-parents by providing cash benefits to families with children. This analysis suggests that Australasian societies may be on the cusp of a more collective articulation of people's obligations to one another and the nation, including the collective consequences of personal lifestyle decisions such as choosing not to have children. [ABSTRACT FROM AUTHOR]

Workforce ageing is likely to lead to labour and skills shortages. Many governments are seeking to increase workforce participation by older workers and to discourage early retirement. Thus factors that influence retirement decisions are important in both personal and policy terms. Information on a range of factors, including health and financial circumstances, is reviewed in this paper, with particular reference to New Zealand sources, especially the Health, Work and Retirement Study. The findings of the qualitative interviews that were part of this study illustrate how the influences interact, and highlight the importance of life-course factors, both personal and contextual, which underlie decisions about workforce participation in mid- and later life. [ABSTRACT FROM AUTHOR]

Abstract: To date, women''s accounts of sexuality and sexual changes in mid-later life have been neglected by both feminists and gerontologists. In addition, women''s responses to male partners'' use of sexuopharmaceuticals such as Viagra (as a “solution" for erectile changes affecting older men) have received little attention. This paper reports on a New Zealand-based research which involved in-depth interview with 27 women, in mid-later life, who were partners of men that used Viagra. We analyse the accounts of 15 women who discussed changes/‘improvements'' in their sexuality over the life course and with their partners'' use of Viagra. Central to the accounts we present is an articulation of an active and desirous female sexuality in mid-later life. These narratives, we suggest, not only challenge the culture stereotype of mid-later life sexual decline for women, but also open up new spaces for feminist theorizing of heterosexuality and changing experiences of heterosexuality across the course. [Copyright &y& Elsevier]

INTRODUCTION: Pacific populations in New Zealand are aging, but little is known in the health-care environment about their experiences with cognitive impairment. AIM: The aim was to explore the needs of Pacific peoples affected by age-related cognitive decline from the perspectives of health-care providers. METHODS: Six health-care service providers from organisations focused on Pacific patients were interviewed to determine services available to aged Pacific peoples, access, and whether they met Pacific people's needs. RESULTS: Three areas of concern were identified by all participants: access to services; getting a diagnosis; and communication and language. Many experienced a lack of information and poor access to services. Diagnosis of cognitive impairment was frequently made difficult by inconsistent access to general practitioners in lower socio-economic areas. Communication was hindered by poor access to information in Pacific languages. DISCUSSION: Common themes noted by all participating health-care providers indicated the needs of aged Pacific people experiencing cognitive decline were often not being met. [ABSTRACT FROM AUTHOR]

Animal therapy has been shown to have both physiological and psychological benefits for older people, including improvements in outlook and social interaction. Volunteer-led animal visitation programmes are common within residential aged care facilities in New Zealand. Visits by animals and handlers are intended to improve the quality of life of people in residential care. Very little research has been conducted on the informal animal visitation programmes typical in care facilities in New Zealand. This project examined the experience of animal therapy in two residential aged care homes that receive animal visits from an animal welfare organisation. In-depth interviews were conducted with seven older people about their experiences of the programme and analysed using narrative analysis. Three overarching narratives were identified: animal therapy as a fleeting pleasure, residential care as a sad environment, and identity outside residential care as highly valued. Older people in residential care do value animal therapy, but it is narrated as a fleeting pleasure, rather than having a long-lasting or far-reaching impact on the daily experience of residential care. In some ways, the structure of the animal therapy programme may underscore the challenges to everyday autonomy and identity experienced in residential aged care. These findings can be used to develop animal visiting programmes which recognise the importance of a valued social identity in later life. [ABSTRACT FROM AUTHOR]