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Objective: To explore the range of expectations and plans for retirement of Australian baby boomers in order to inform policy. Methods: A qualitative study of participants recruited to 12 focus groups in NSW in 2004, grouped by socioeconomic status, gender and geographical location. Topics raised included work, retirement and financial and other planning. Transcriptions of the sessions were analysed manually to identify the range of views on each topic and any variation by the selected study variables. Results: Although some baby boomers had planned for their retirement many had not. Socioeconomic status was the most important variable associated with planning. Conclusions: The findings increase our understanding of how baby boomers from different backgrounds are thinking and planning for their retirement. Baby boomers from low socioeconomic backgrounds consider that responsibility for retirement funding should rest either solely, or partially, with the government as they have not had time to accumulate sufficient superannuation.

To determine whether foot and leg problems are independently associated with functional status in a community sample of older people after adjusting for the influence of socio-demographic, physical and medical factors.Data were analysed from the Health Status of Older People project, a population-based study involving a random sample of 1000 community-dwelling people aged 65 - 94 years (533 females, 467 males, mean age 73.4 years +/- 5.87). A structured interview and brief physical examination were used to investigate the associations between self-reported foot and leg problems and functional status. Functional status was assessed using: (i) timed 'UpGo' test, (ii) self-reported difficulty climbing stairs, (iii) self-reported difficulty walking one kilometer, (iv) self-reported difficulty performing instrumental activities of daily living (IADLs), and (v) self-reported history of one or more falls in the previous 12 months. These associations were then explored after adjusting for socio-demographic, physical and medical factors.Thirty-six percent of the sample reported having foot or leg problems. Univariate analyses revealed that people with foot and leg problems were significantly more likely to exhibit poorer functional status in all parameters measured. After adjusting for socio-demographic, physical and medical factors, foot and leg problems remained significantly associated with impaired timed 'UpGo' performance (OR = 2.15, 95%CI 1.55 - 2.97), difficulty climbing stairs (OR = 3.33, 95%CI 1.98 - 5.61), difficulty walking one kilometer (OR = 3.13, 95%CI 2.09 - 4.69), and history of falling (OR = 1.73, 95%CI 1.26 - 2.37).Foot and leg problems are reported by one in three community-dwelling people aged 65 years and older. Independent of the influence of age, gender, common medical conditions and other socio-demographic factors, foot and leg problems have a significant impact on the ability to perform functional tasks integral to independent living.

Aim: This paper presents social science understandings of successful aging for a broad audience in multidisciplinary gerontology in Asia–Oceania. Methods: The international literature on social science aspects of successful aging is reviewed with a focus on Asia and social improvement. Results: New positive approaches to aging research are identifying opportunities for maintaining capacities and well-being over the life course. Successful aging, productive aging, and active aging are key concepts. Increasing life expectancy and fertility control are major social achievements that underpin population aging as the mainstream social transformation facing the world. Asia will be at the forefront of this change and the consequences will vary greatly between cultures, nations, and subgroups within them. Older people generally maintain good quality of life and the capacity to ‘age well’ is influenced by life-long maturation and emotional, social, and economic resources. Good health can be enhanced through positive actions such as physical activity, good nutrition, and not smoking. Mental capacities can also be improved and maintained throughout old age. In advanced old age, the ‘fourth age’, the focus turns to ameliorating the effects of loss and to maintaining dignity. Conclusions: The social sciences contribute knowledge useful for improving life experiences for older people and aging societies. Population aging is central to national economic development. Public policy and individual action concerning aging can benefit all age groups. To better inform these developments it is important to address the serious shortfall of social science research on aging in the Asia–Oceania region.

This article considers developments and directions for environmental gerontology drawing on the three papers in this Forum. The multidisciplinary field came of age during the 1960s with Powell Lawton's powerful environmental press paradigm and its applications to empirical research and building design. Recent theoretical developments in Europe and America have advanced and integrated concepts in psychology, geography, and related disciplines. Time dimensions and active use of space are essential for understanding aging individuals and microenvironments as well as changing populations and macroenvironments. Research on residential environments by health professions is informing community care that is enhancing the independence and well-being of older people. With its proven responsiveness to social and policy priorities, environmental gerontology is now providing strong conceptual and empirical bases for advancing healthy aging and age-friendly societies.

To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people.One thousand older people (65+) randomly selected from independent residents living in a major city were surveyed about their health status (Health Status of Older People Study). Demographic characteristics, including age, gender, education, income, living alone, widowhood, and childlessness, were analyzed by logistic regression for their association with pain report of differing severity. Path analysis was used to confirm the association with pain severity and further define the role of mood disturbance in mediating this relationship.The prevalence of any pain report for the preceding 12 months was 56.3%. This was reduced when using more restrictive criteria, such that moderate-to-severe pain "at worst" and "at present" was found in 48.7% and 4.1% of the sample, respectively. After adjusting for type 1 error rate, the status of living alone was primarily associated with moderate-to-severe pain at worst, and being a widow(er) was associated with moderate-to-severe pain at present. The latter association had an estimated odds ratio greater than 3 and was characterized by more recent bereavement. Using path analysis, the model that severe pain was secondary to mood disturbance of widowhood, particularly recent bereavement, was tested and confirmed. The model explained 17% of the variance of pain severity in widow(er)s.The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.

Studies of change flowing from important life-course transitions such as retirement are best conducted using panel designs that allow change to be tracked at an individual level. However, for many life-course transitions, sample recruitment is especially difficult because no sampling frames exist for what are relatively rare and nonenumerated populations. This article outlines the difficulties encountered and strategies adopted in obtaining a sample of older Australian workers who were about to retire. It explores the fieldwork problems encountered and the effectiveness of alternative recruitment strategies in meeting core sampling goals. Recruitment strategies are evaluated in terms of their cost, efficiency, impact on data quality, and ability to recruit difficult-to-find subtypes of retirees. The experience of this research team is provided to offer guidance and information for other teams as they seek to recruit samples for retirement studies or for other studies of rare and nonenumerated populations.

Background Multimorbidity has been recognized as a major public health issue, negatively affecting health-related quality of life, including physical, functional, mental, emotional, and social domains, as well as increasing health care utilization. This exploratory study examines selected health outcomes associated with multimorbidity across older age groups/cohorts and gender, comparing Canada and Australia. Methods Data were drawn from the 2008/09 Canadian Community Health Survey and the 2009 Australian HILDA survey. Seven major chronic conditions were identical across the two data sets, and were combined into an additive measure of multimorbidity. OLS and logistic regression models were performed within age group (45-54, 55-64, 65-74, 75+) and gender to estimate associations between multimorbidity and several health-related outcomes, including: loneliness, life satisfaction, perceived health, mobility restriction, and hospital stays, adjusting for marital status, education and foreign born status. Results Overall, country-level differences were identified for perceptions of loneliness, life satisfaction, and perceived health. Australians tended to experience a greater risk of loneliness and lower self-rated health in the face of multimorbidity than Canadians, especially among older men. Canadians tended to experience lower life satisfaction associated with multimorbidity than Australians. No country-level differences were identified for associations between multimorbidity and hospital stays or mobility limitations. Conclusions The associations between multimorbidity and health are similar between the two countries but are variable depending on population, age group/cohort, and gender. The strongest country-level associations are for indicators of health-related quality of life, rather than health care or mobility limitation outcomes.

This paper aims to investigate changing attitudes and policies concerning intergenerational equity in Australia through the aftermath of the Global Credit Crises.

The living arrangements of older adults, which are central to intergenerational support systems in Vietnam, are changing as a result of rapid population ageing and evolving family structure, social norms and values, and socio-economic development. This paper reports on the determinants and consequences of changes in living arrangements of Vietnamese people aged 60 and older using data from the Vietnam National Ageing Survey 2011 and Regional Ageing Surveys 1997 (n= 4,559). The results indicate that a majority are living in multigenerational households but this has declined from 56% to 45% between 1997 and 2011. There have been increases of those living only with a spouse (7.5% to 18%) and living alone (4.3% to 9.4%). Those at more advanced ages were more likely to live alone or in multigenerational households in 1997 but they tended to live with a spouse or adult child in 2011. Having paid work was associated with living alone only in 2011. Additionally, having a son increased the likelihood of living in a multigenerational household, with a spouse, and/or with children in 1997. Other significant influences were health status and urban versus rural residence. The changes indicate overall stability of households but a trend towards Western patterns of modified extended families. This has significant implications on patterns of intergenerational support exchange as well as living standards and subjective well-being. While the family remains crucial for older adults in Vietnam, the evolving responsibilities of social welfare and care for them, especially those living alone, will be increasingly challenging.

Drawing on the nationally representative CHARLS and HILDA 2013, we examined patterns of caregiving by men and women aged 45 and over in both China and Australia. Caregiving is defined as ongoing care for a household or non-household member with health conditions or frailty in Australia; and care for parents or grandchildren under 16 in China.

A primary societal goal for aging is enabling older people to continue to live well as long as possible. The evidence base around aging well (‘healthy’, ‘active’ and ‘successful’ aging) has been constructed mainly from academic and professional conceptualizations of mortality, morbidity, functioning, and psychological well-being with some attention to lay views. Our study aims to inform action on health promotion to achieve aging well as conceptualized by qualitative research identifying what older Australians themselves value most: continuing to live as long as possible in the community with independence in daily living, and good self-rated health and psychological well-being. Multivariate survival analyses from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) program found that important threats to aging well for the total sample over a 12 year period were chronological age, multi-morbidity, low perceived social support, low nutritional score, and being underweight. For men, threats to aging well were low strain, perceived inadequacy of social activity, and being a current smoker. For women, urinary incontinence, low physical activity and being underweight were threats to aging well. The findings indicate that healthy lifestyles can assist aging well, and suggest the value of taking gender into account in health promotion strategies.

Objective: Ideally, life course data are collected prospectively through an ongoing longitudinal study. We report adaptive multimethod fieldwork procedures that gathered life history data by mail survey and telephone interview, comparable with the face-to-face methods employed in the English Longitudinal Study on Ageing (ELSA). Design: The Australian Life Histories and Health (LHH) Survey was a substudy of the Australian 45 and Up Study, with data collection methods modified from the ELSA Study. A self-complete questionnaire and life history calendar were completed by the participants, followed by a computer-assisted telephone interview recording key life events. Results: The LHH survey developed and tested procedures and instruments that gathered rich life history data within an ongoing Australian longitudinal survey on ageing. Data collection proved to be economical. The use of a self-complete questionnaire in conjunction with a life history calendar and coordinated computer-assisted telephone interview was successful in collecting retrospective life course information, in terms of being thorough, practical and efficient. This study has a diverse collection of data covering the life course, starting with early life experiences and continuing with socioeconomic and health exposures and outcomes during adult life. Conclusions: Mail and telephone methodology can accurately and economically add a life history dimension to an ongoing longitudinal survey. The method is particularly valuable for surveying widely dispersed populations. The results will facilitate understanding of the social determinants of health by gathering data on earlier life exposures as well as comparative data across geographical and societal contexts.

This study compared the friendship interaction of older residents of age-segregated, inner city, high rise public housing to residents of private housing elsewhere in metropolitan Melbourne. All respondents (N = 149) lived alone, had mobility limitations, and had low incomes. Logistic regression analysis, controlling for individual characteristics, showed that the age-segregated sample had relatively more interaction with friends and had less risk of isolation from friends. As predicted by the environmental docility model, age-segregated housing in an inner city location appears to facilitate friendships, particularly for people rendered vulnerable in old age. Housing and planning policies can provide residential environments which facilitate friendship and well-being. Further research is needed to explore the meaning of friend- shipin differentresidential contexts.

This paper examines communication and health issues associated with hearing difficulties reported in a population-based study of older people. One thousand (1000) randomly selected people aged 65 years and over participated in a cross-sectional survey of the health status of older people. Hearing loss was reported by 30% of respondents, a considerably lower percentage than has been reported by other population-based studies. Hearing aid usage, although low, was more typical of expected population rates at 14.8%. Hearing aid use was associated with increasing age and self-reported difficulties communicating one-to-one and in groups. Compared to people reporting good to excellent hearing, people with fair to poor hearing reported poorer general health, suggesting a possible threshold effect between health and hearing impairment. Further research is required to identify the appropriate mix of hearing aids and services required for this population and to examine the thesis of a threshold effect in hearing disability and health status.

Baby Boomers are working and living longer than their pre-war counterparts, and are more likely to live in high density urban housing. This paper examines the relationship between housing type, working status and location of residence on health status in Baby Boomers.We investigated location of residence and housing type in 1009 participants of the Ageing Baby Boomers in Australia (ABBA) Study to identify any predictors of, or correlations between, these variables and health status.Current workers were less likely to report depression than retirees. We found a significantly higher rate of diabetes, obesity and hypertension in retirees than in current workers however rates of obesity, diabetes and hypertension were higher than predicted in current workers.The rates of chronic disease are higher than previous estimates and provide evidence to inform health promotion programs designed to increase physical activity and improve eating habits in baby boomers.

This qualitative study examines meanings and experiences of ageism for older Australians. While the concept is widely applied in academic social analysis, the term is not understood or used by many of the informants. They talk freely, however, about negative experiences in ‘being seen as old’ and ‘being treated as old’. Active ageing is viewed as a positive way of presenting and interpreting oneself as separate from the ‘old’ group. Informants recognise that older people as a group experience negative treatment in terms of poor access to transport and housing, low incomes, forced retirement and inadequate nursing home care. While few have experienced overt or brutal ageism, interaction in everyday life involves some negative treatment, occasional positive ‘sageism’, and others ‘keeping watch’ for one's vulnerabilities. Health professionals are a major source of ageist treatment. Some older people limit their lives by accommodating ageism, while others actively negotiate new images of ageing for themselves and those who will be old in the future.

It is particularly appropriate in the International Year of Older Persons for researchers and policy makers to reflect on their contributions to improving the lives of elderly citizens. In this essay we draw on our two decades of experience as researchers with a focus on understanding the social dimensions of ageing and an interest in the role of research in informing public policy. One of the most significant changes we see over this period is the shift from an essentially paternalistic view that older people need ‘;experts' to identify their needs and make decisions on their behalf to widespread acceptance of older people's rights to have a say - including a right to be active participants in the policy making process. We look in particular at how the voices of elderly people themselves have come to be heard (or not) in the policy process. We begin by considering the context in which policy-relevant research is generally conducted and note some of the key research directions in this field over the past two decades. Next we examine some of the processes through which elderly people have been engaged as participants in the policy process. These include formal consultation with government and direct political action. We point out the particular value of focused qualitative research in giving a voice to those who are otherwise likely to be excluded from the public domain because of poverty, sickness or disability.

Although most people eventually make a satisfactory adjustment to retirement, some people experience difficulties in managing the transition. While measures of wellbeing are frequently included as outcomes in studies of retirement, few studies have examined the impact of retirement on health behaviours. Further, the contribution of psychological resources such as self-efficacy and sense of coherence in coping with transitions has largely been ignored. Data from the Health Status of Older People project were used to test the hypothesis that psychological resources would moderate the relationship between retirement and changes in health behaviours and wellbeing. People who had retired within the previous 5 years were compared with three other groups: those who were still working, those who were partly retired, and those who had been retired for between 6 and 10 years. Recently retired people were found to be more likely than other groups to have experienced recent reductions in physical and social ...

Objective: To determine to what extent costs of intensive community care can be predicted and by which factors. Method: Costs of community care services were calculated for 497 clients of Linkages (Community Options) projects in Victoria, Australia, in 1992. Results: Costs to government and carers were found to vary by project and were best predicted by client dependency, client incontinence, male carers and non-resident carers. Additional costs related to length of time as a Linkages client. Conclusion: Client and carer characteristics had limited capacity to predict costs (29% of variance explained).

Objective: To determine how well outcomes could be predicted by initial circumstances and subsequent deterioration in clients and carers. Method: Longitudinal data from the Victorian Linkages projects, collected in 1992 and 1994, were examined. Results: Institutionalisation was highly likely in cases where carers experienced reduced motivation to care. Placement in nursing homes rather than in hostels was best predicted by incontinence. Death was associated with changes in health status. Those clients most successful in avoiding long-term institutional care were in stable situations with a spouse carer. Conclusion: The study provides supportive evidence of the capacity of intensive community services to provide alternatives to entry to residential care.

Comparable networks surveys identified the informal relationships which provide social support to older people in urban Japan, provincial Japan, and urban Australia. Spouses, daughters, and sons were major providers of expressive support in all areas. Older Australians had more expressive support from friends while older Japanese had more instrumental support from daughters-in-law. The gender of the older people and their close ties were highly significant in all areas. The many similarities in the social support patterns contrast sharply with East and West differences in cultural prescripts and living arrangements. In these two advanced countries with long life expectancies and high living standards, older people's interpersonal relationships may be converging on the basis of selective affection and choice, rather than obligation, with individuals in and beyond the household and family.

The appropriateness of the stress-coping and life transitions models for late life experiences was assessed by examining psychosocial correlates of spouse caregiving in association with widowhood. Data were from the Health Status of Older People (HSOP) survey of 1,000 people aged 65 and over living in the community in Melbourne, Australia. Caregiving was found to be a usual precursor to widowhood and may have prepared older people for widowhood. However, these two life experiences had different consequences. While widowhood appears to be the more severe transition, caring for a spouse often seriously threatens the meaningfulness of life.

This paper draws on primary publications in Austalian gerontology to review knowledge on ageing and support While there is a well-established literature on family care, social networks studies of the 1980s provided more comprehensive views of expressive and instrumental support across a range of relationships. Notwithstanding stereotypes to the contrary, older people contribute as well as receive support. A new generation of qualitive, interpretative shudies are reporting on the meanings and processes of social support as experienced by older people themselves. Policy-related studies examine social support as a cornerstone for community services, and epidemiological investigations examine social influence on health and well-being. The field could be advanced considerably by longiturdinal surveys and qualitative enquiris exploring the diversity of older people in a variety of social settings.

Background: A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care - CLiAC) was developed to improve managers' leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program.Methods: Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be compared by cluster-level analysis. The overall costs and benefits of the program will also be assessed.Discussion: The outcomes of the trial have the potential to inform actions to enhance leadership and management capabilities of the aged care workforce, address pressing issues about workforce shortages, and increase the quality of aged care services. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12611001070921). © 2013 Jeon et al.; licensee BioMed Central Ltd.

This paper examines the impact in Australia of the global financial crisis on the baby boom cohort approaching later life. Data from national focus groups of people aged 50 to 64 years (N = 73), conducted in late 2008, found widespread but variable concern and uncertainty concerning work and retirement plans and experiences. A national survey (N = 1,009) of those aged 50 to 64 years in mid-2009 reported lower levels of financial satisfaction compared with other life domains; many planned to postpone retirement. Findings are interpreted in the context of policies and markets that differed significantly from those in the United States, notwithstanding the global nature of the financial crisis.

This study examines how institutionalisation of older people is influenced by changes in carers' capacities and motivations to care. Longitudinal data were available from Case Manager assessments for 632 highly dependent older clients of intensive community services. The likelihood of entry to an institution over 19 months was found to be significantly and independently associated with ratings of both reduced carer capacity and reduced carer motivation. Important factors in loss of carers' capacity to care were client dementia, poor carer health, and the relationship between client and carer. Important factors in reduction of carers' motivation were client dementia and behaviour problems and the age and initial level of motivation of the carer. While client hospitalisation and inadequate help with client activities of daily living predicted reduction of carers' capacity to care, client use of respite predicted loss of carers' motivation. The findings demonstrate the importance of professional practice which meets specific needs of carers as well as older clients and their families.

The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time.As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity.Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time.Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people.

Research from around the Western World has shown that psychological, socioeconomic and demographic factors can influence levels of financial planning. This study aims to determine how these factors interrelate to predict planning outcomes.Data from the Ageing Baby Boomers in Australia Study were used to examine the effects of multiple factors on financial planning for 709 employed Australians nearing retirement.The results showed that higher income, future time perspective (FTP) and financial knowledge independently predicted levels of retirement planning. The effects of FTP and financial knowledge on financial planning were consistent across levels of socioeconomic status.While similar issues in financial planning appeared across socioeconomic status, a 'one size fits all' approach to retirement policy may not be effective. Instead, policy should be targeted towards the diverse needs of different groups. Raising public awareness of FTP and financial knowledge may provide a useful starting point.

This study attempts to identify any association between length of exposure to urban environmental risk and non-infectious chronic disease in a group of Australian residents who lived in the same location for at least 20 years.Using Australian survey data, we selected 1256 participants who were 45 years and older and had lived in the same location for at least 20 years. We used logistic regression and survival analysis to identify factors associated with the presence of non-infectious chronic disease at baseline and after 7 years.Results show that increasing age, living in an urban area and living in an area with a lower socioeconomic status increase the odds of having a long-term health condition.This study provides empirical evidence that older long-term Australian urban residents are more likely to have a non-infectious chronic disease, which may be associated with environmental exposure, than those living in rural locations.

Self-rated health is commonly employed in research studies that seek to assess the health status of older individuals. Perceptions of health are, however, influenced by individual and societal level factors that may differ within and between countries. This study investigates levels of self-rated health (SRH) and correlates of SRH among older adults in Australia, United States of America (USA), Japan and South Korea. We conclude that when examining correlates of SRH, the similarities are greater than the differences between countries. There are however differences in levels of SRH which are not fully accounted for by the health correlates. Broad generalizations about styles of responding are not helpful for understanding these differences, which appear to be country- and possibly cohort-specific. When using SRH to characterize the health status of older people, it is important to consider earlier life experiences of cohorts as well as national and individual factors in later life. Further research is required to understand the complex societal influences on perceptions of health., The Australian data on which this research is based were drawn from several Australian longitudinal studies including: the Australian Longitudinal Study of Ageing (ALSA), the Australian Longitudinal Study of Women’s Health (ALSWH) and the Personality And Total Health Through Life Study (PATH). These studies were pooled and harmonized for the Dynamic Analyses to Optimize Ageing (DYNOPTA) project. DYNOPTA was funded by a National Health and Medical Research Council (NHMRC) grant (# 410215).

This article aims to provide an overview of issues and developments in ageing and housing in Western societies – particularly North America, Europe, and Australia. We aim to demonstrate the centrality of population ageing and cohort succession for understanding the operation and long-term change of housing markets as well as the consequences of housing for ageing individuals’ wealth and social inequalities. We also present new understandings on the meaning and use of home and neighbourhoods for older individuals. Interrelationships between ageing, health, and housing are shown to have significant implications for the independence, safety, and participation of older people, while housing costs and wealth have a significant bearing on financial well-being. ‘Ageing in place’ including home modification and moves to more or less appropriate housing are major processes of adaptation to age-related changes. Providing supportive environments can enable vulnerable older people to maintain their independence and well-being with less of the expense or demoralising dependency involved in receiving services.

This paper draws on primary publications in Australian gerontology to review Australian knowledge on ageinig and families. Government funding has played a large part in increasing psychological research on caregiver stress and applied studies of the needs and supports of older clients of community services. Priorities for further research are: better appreciating diversity among different social groups, revealing older people's own experiences of families, and developing better theoretical frameworks of how individuals fit within broader social structures. Research can play a major part in confronting public misperceptions of ageing and suggest how practitioners can work most effectively with frail older people according to their particular family situations.

To investigate the travel habits and preferences of city-dwelling older Australians with a falls risk, and factors influencing outings. A retrospective cross-sectional survey was conducted with 96 community-dwelling adults with a falls risk. The mean age of participants was 78.2 years (SD 5.33). The majority were women (77%). Most (75%) went on five or more outings per week (mean 6.9 outings). Men drove more than women (41% vs 31%). Shopping was the most common reason for outings. Walking was the most frequent mode of travel, and buses were both the easiest and most difficult. Factors that enabled bus travel included bus stop location, good services and cheap fares. Primary reasons for restricting outings were poor health, transport barriers, neighbourhood safety and personal motivation. These older adults went out nearly every day. Findings can be used to improve transport services for older people.

The planning and delivery of care systems require knowledge on the ways in which individuals access available services that are funded by a range of health and community services. The aims of this study were to identify distinct groups of Home and Community Care (HACC) clients in New South Wales, Australia, based on patterns of actual service use, and to understand the health and social needs and resources of client groups that access different mixes of services. Multiple data sets linked at the individual level - including the 45 and Up Study community survey, the HACC Minimum Data Set and the Admitted Patient Data Collection for hospitals - provide an innovative basis to investigate the complexity of access to service use. Data were collected between 2006 and 2008. A cluster analysis based on clients' type and volume of community service use was conducted on the 4890 HACC clients in the linked dataset and nine distinct clusters of clients were identified. Three of these clusters were considered 'complex', in terms of the range of community and hospital assistance received, while the others comprised mainly of one or two dominant service types. The analytical approach and findings developed here provide a client-centred approach to monitor and evaluate access to local service systems that are being reformed to better integrate the delivery of health and community services currently funded and managed separately by national and state governments.

With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly ( n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0–3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4–8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills.

To measure the prevalence of urinary incontinence (UI) in a community-dwelling sample and the impact of self-reported UI on well-being and activity in older men and women.Participants were older adults aged ≥65 years. Measures included the frequency of urgency incontinence, depression, positive and negative affect and social activity, independence in activities of daily living (IADL) and self-rated health. The data were collected by face to face interview (1994) and computer assisted telephone interviews (1996).Of the 796 participants, 28% experienced urgency incontinence and 21% reported stress incontinence occasionally or often, with higher rates among women. The threshold for the impact on depression, negative affect and IADL was with occasional occurrence of urinary urgency incontinence. For positive affect and self-rated health, the threshold was experiencing urinary urgency incontinence often. The presence of urinary stress incontinence was associated with depression, IADL dependence, self-rated health and positive affect. Overall, women with incontinence had higher negative affect scores, but men with stress incontinence had higher scores than those without.The impact of incontinence highlights the need for more effective management of the condition. The threshold for the effects of urinary urgency incontinence on mental health and functionality is lower than for the effects on general health. There is a need to consider how older people judge the impact of UI in the design of targeted health promotion programmes.

The purpose of this study was to develop a Community Care Research Agenda to give direction to research across community-based services for older people, for the next 3-5 years.This study used a four-round Delphi method to verify, rate and rank research questions and issues identified by sector stakeholders. Thirty panellists were selected to represent all key stakeholder groups within community care.The research agenda comprises the 30 questions/topics, in ranked order, considered by the panellists to be of the highest priority. The largest subgroups of issues pertain to approaches to care (30%), program outcomes and effectiveness (13%), funding (10%), and workforce (10%).Having a National Community Care Research Agenda will provide focus and direction for researchers, service providers and funders in developing and conducting high priority, high value research that can inform improvements in policy and practice in community care for older people.

The aim of this qualitative study was to explore baby boomers' views and plans in the early days of the global financial crisis (GFC) in 2008.Informants from National Seniors Australia were interviewed in 15 focus groups conducted nationally. Transcripts were analysed by themes from semi-structured questions.The GFC was found to shake the confidence and plans of boomers. Many workers decided to delay retirement and save longer following losses in superannuation. Those retired on market-linked superannuation felt forced to reduce expenses and restrain lifestyles. Those on full pensions were relatively unaffected.The GFC called into question boomers' expectations for retirement. While financial markets are showing signs of recovery, the GFC had precipitated a decision to work longer and to draw conservatively on retirement savings that may take many years to recover. The volatility of financial and employment markets underscores the value of the Age pension.

This paper examines the impact of the global financial crisis (GFC) on employed Australian baby boomers.A nationally representative sample of 1009 boomers aged 50-64 years completed a survey by telephone interview mid 2009.Compared with 1 year ago, 38.9% of working boomers reported being financially worse off and this was more so for women (42.4%) than men (35.6%). Following the GFC, 41.4% of women and 31.9% of men had decided to postpone their retirement plans.The GFC is affecting the retirement preparations and plans of Australia's baby boomers. Policy implications include reduced resources for retirement needs, and uneven and differential impacts for those with interrupted employment histories, notably women.

Background Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community. Methods The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk. Results Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors. Conclusion Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.

Background In Australia, the Home and Community Care (HACC) program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8%) participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis. Conclusions HACC clients have high rates of modifiable lifestyle risk factors and health conditions that are amenable to primary and secondary prevention, presenting the potential for implementing preventive health care programs in the HACC service setting.

The large baby boomer cohort is beginning to reach retirement age. This paper reviews recent Australian literature on baby boomers' health and health behaviours. Databases were searched for peer-reviewed literature and the Internet for online studies and reports. The boomers can expect an increased life span compared to those in later life now. Boomers' health behavioural risks include physical inactivity, low vegetable consumption, obesity and rising medical risk due to increasing prevalence of diabetes. Their health will impact on workforce participation and retirement timing. There is substantial scope for health improvement and consequent quality of life as boomers age. However, little is known about health decision-making, inequalities between social groups and health information sources. Future research can yield a better understanding of the health trajectories of baby boomers in order to plan for health and service needs for an ageing Australia.

The capacity to measure change is essential in examining successful adaptation to ageing. Few studies measuring change have compared findings using pre—post approaches (employing difference scores) with those from retrospective approaches (employing self-ratings). Where this has occurred, differences have been attributed either to ceiling and floor effects or to the operation of social comparison (Choi, 2002, 2003). Our study compared pre—post and retrospective measures of change in health, health behaviors, and wellbeing over periods of 1 and 3 years among retirees. Retrospective measures were found to be more positive than pre—post measures. This discrepancy was associated with floor and ceiling effects and with a robust self-image, but not with recency, social comparison, or social desirability response sets. Pre—post difference scores have limitations as indicators of change, particularly where ceiling effects operate. A retrospective perception of improvement, combined with deterioration in scores, may result from successful psychological adaptation as people grow older.