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Background: Information communication technology (ICT) such as the Internet, mobile phones, computers and tablets, has become a central part of daily life. However a large number of older people do not use ICT, putting them at risk of exclusion from the digital society. Aims: To investigate level to which older people or are “e-included” (or engage with ICT) across various contexts, the factors which influence their e-inclusion and their access to ICT-based care, and the effects of ICT-use on their quality of life. Methods: Using a mixed method approach, I collected both secondary and primary data from numerous different sources including national datasets, the MonAMI project, the relevant literature, and interviews with older adults and technical experts. Analysis: Quantitative and qualitative analyses were performed according to the dimensions of the 6C framework for e-inclusion. The effects of ICT use was assessed against the domains of the ASCOT and WHOQOL models of quality of life. Results: Older people’s e-inclusion and access to ICT-based care were affected by a number of person-centred and environmental factors. There were marked variances in level of e-inclusion with the older population, which was partly attributed to a cohort effect. The evidence showed that access to ICT-based care was affected by local eligibility policies and care practitioner endorsement. Analyses revealed that ICT use positively affected older people’s quality of life in terms of maintaining independence and social networks, and improving psychological wellbeing. However, ICT-use had negative effects on older people’s sense of privacy. Moreover, ICT-based care services proved to be obtrusive and stigmatising for many older people. Conclusion: The findings highlighted a paucity in targeted policies which consider older people’s specific digital interests. There is also a need for a better understanding of the effects of ICT-based care on older people’s quality of life.

This study is concerned with the issue of substitution between formal and informal care in Britain between 1985 and 2000. This period provides the conditions for a ‘natural experiment’ in social policy. During the late 1980s/early 1990s, there was a rapid increase in long-stay residential care for older people, which came to an end around the mid-1990s. The key issues examined here are whether this increase in formal services led to a decline in provision of informal care, and whether this was subsequently reversed. For reasons identified in the literature review, the focus is on provision of intense informal care by adult children to their older parents, trends in which are identified using General Household Survey data. The study shows that there was a significant decline in provision of intense and very intense co-resident care for older parents between 1985 and 1995, which came to an end in the mid-1990s. A number of potential explanations for these trends are explored, including supply-side explanations in terms of changes in socio-demographic factors and employment rates, and an alternative demand-side explanation in terms of changes in ‘spouse care’. The study finds that, under certain circumstances, key trends in intergenerational care were negatively related to changes in long-stay residential care. In particular, the study finds evidence of substitution effects between nursing home/hospital care and very intense co-resident care for older parents provided by adult children for 50 hours a week or more. A key policy implication is that an expansion of very intense formal services for older people could bring about a decline in some of the most intense forms of intergenerational care for older people. The study relates these conclusions to options around reform of the long-term care system currently under consultation in England following the recent Green Paper on social care.