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Objectives This study examines different combinations of informal and formal care use of older adults and investigates whether these combinations differ in terms of need for care (physical and psychological frailty) and enabling factors for informal and formal care use (social and environmental frailty). Methods Using cross-sectional data from the Belgian Ageing Studies (survey, N = 38,066 community-dwelling older adults), Latent Class Analysis (LCA) is used to identify combinations of informal and formal care use. Bivariate analyses are used to explore the relationship between the different combinations of care use and frailty. Results Latent Class Analysis (LCA) identified 8 different types of care use, which vary in combinations of informal and formal caregivers. Older adults who are more likely to combine care from family and care from all types of formal caregivers are more physically, psychologically and environmentally frail than expected. Older adults who are more likely to receive care only from nuclear family, or only from formal caregivers are more socially frail than expected. Conclusions Older adults with a higher need for care are more likely to receive care from different types of informal and formal caregivers. High environmental frailty and low social frailty are related with the use of care from different types of informal and formal caregivers. This study confirms that informal care can act as substitute for formal care. However, this substitute relationship becomes a complementary relationship in frail older adults. Policymakers should take into account that frailty in older adults affects the use of informal and formal care.

Research applying a life course perspective has already shown that inequalities in later life are influenced by conditions earlier in life. Theory and research demonstrate that (dis)advantages are being accumulated throughout the life course and that various disadvantages are combined. In this study we aim to explore how aspects of active ageing occur in the life course and how they protect from or enhance social exclusion. Data were collected through 44 life story interviews with older adults (60 years and over) living in Flanders or Brussels (Belgium). The semi-structured nature of the interviews was based on McAdam’s life story method (2008). Heterogeneity of respondent’s age and gender was guarded. Findings showed that older adults indicated a strong importance of education and labour market participation in their life stories. Not only did these aspects occur in different stories, they were also frequently repeated and strongly emphasized. Education, for instance, was perceived as a key point, leading towork and consequently friendship relationships, which still appeared in their present life. Furthermore, education enhanced self-esteem and belief in own abilities. Also participation in civic activities, such as being a member of a choir or volunteering, were perceived as a positive aspect linked to valuable relationships in later life. This study shows the occurrence of aspects of active ageing through the life and how these influence present active ageing and social inclusion. Furthermore, results demonstrate how work, education, participation, and social exclusion are intertwined both in the current condition and during the life course.

Aim: This contribution seeks to reflect on how older people can be involved in quantitative research. The Belgian Ageing Studies (BAS) - a research project assessing the needs of home-dwelling older adults - will be described. The focus of the project is to provide material for evidence-based local policy development while enabling older adults to participate politically. Methods: The research was developed in co-creation with older people, senior associations, senior advisory boards, local authorities, and other stakeholders. Furthermore, older people are engaged as experts and actors in so-called peer-research. Due to sample representativeness the research provides local governments tools for the development of evidenced-based policy. Findings: The BAS method enhanced building community networks and empowerment of older adults and led to new policy initiatives in municipalities. Conclusions: The BAS method increases older people’s opportunities to participate politically. Suggestions are made to further elaborate this by knowledge exchange among municipalities.

Background: Demographic ageing calls for structural changes of existing and emerging long-term care systems in Europe. Three EU-projects emphasize that it is crucial in these developments to ensure that the ageing population will receive the care and assistance they need to age in dignity and be protected from elder abuse: Eustacea 2008-2010 (European Charter of the rights and responsibilities of older people in need of long-term care and assistance), WeDO 2010-2012 and WeDO2 2013-2015 (for the WEllbeing and Dignity of Older People). Methods: Using a participatory approach these three projects aim to strengthen stakeholders’ (older people, informal carers, volunteers and professionals) ability to participate and cooperate as a partner in the process of long-term care. This contribution will present the development of a methodology to improve quality in care using a bottom-up and inclusive approach. Results: The results discuss the Eustacea-framework, the WeDO-quality framework and the WeDO2 training module, to give insights in how incorporating stakeholders improves the quality of care. A good practice analysis demonstrates success factors and barriers to incorporate the three EU-projects on national and local level. Conclusions: The variety of long-term care systems and the wide number of stakeholders involved across the EU makes it therefore more than ever important to support exchange of experiences and good practices between those at all levels. By exchanging knowledge, learning of each other’s systems and experiences, the use and implementation of innovative solutions for older people in need of care can be greatly facilitated

Background: This contribution seeks to reflect on the challenges and opportunities of involving older people in aspects of research, policy and social change at a local level. The focus is the ‘Belgian Ageing Studies’, a research program which monitors the needs, as well as issues of quality of life, among home-dwelling older people in order to provide tools for evidenced-based ‘age-friendly’ policies at a local level. In particular, we aim to identify how the physical, social, psychological and political environment of urban neighbourhoods can support frail older people to age in place. Methods: This contribution uses a mixed method approach, combining quantitative data from the Belgian Ageing Studies in Flanders and Brussels (N=73632) with qualitative data (17 focus groups) from the “Active Caring Community” project in 3 urban neighbourhoods. Results: Data-analyses reveal that although frail older people living in urban environments experience neighbourhood exclusion on several domains, several opportunities exist which can balance these deficits. The results point towards the importance of environmental factors in relation to issues of autonomy, control and power, even when people are in need of long-term care and assistance. Conclusions: Through discussion, a number of policy recommendations and strategies to support active ageing and ageing in place for frail older people living in urban environments will be discussed

Background: In research insufficient attention is given to developing an old age social exclusion scale. This contribution therefore focuses both on identifying dimensions relating to social exclusion in later life and the construction of an old age specific social exclusion measure. Methods: A systematic review was performed by identifying relevant studies through searches of databases (e.g. Web of Science & Sociological Abstracts). Only studies addressing social exclusion or inclusion among home dwelling older adults were incorporated. Because of the heterogeneity of the studies’ methods a narrative synthesis was conducted to review the findings. Based on this review we constructed a social exclusion measure using data from the Belgian Ageing Studies, a survey among home dwelling older adults in Flanders. In order to develop this scale, an exploratory factor analysis was conducted followed by a confirmatory factor analysis using the Lavaan package in R. Results: The review revealed that different dimensionsare used to measure social exclusion in later life. Participation, social relations and exclusion from services are the most occurring dimensions followed by financial resources, material resources, neighbourhood exclusion and housing. The global model, including items for ageism, participation, financial exclusion, neighbourhood exclusion, access to services, housing and social relations, provided a good fit (CFI=.955, TLI=.948, RMSEA=.028, N=34.658) Conclusions: Future research could investigate the measurement equivalence of the proposed scale. This instrument could also be applied to identify geographical differences in later life social exclusion and to examine individual and environmental determinants.

Introduction: Prisons from all over the world are faced with an increasing population of older people. Although the proportion of older prisoners is increasing, their needs are seldom taken into account in designing correctional programs (e.g. sport activities, (vocational) education, socio-cultural training courses, mental health care). However, research has shown the importance of participation in these programs. The purpose of this study is to get insight into participation of older prisoners. Methodology: Based on a quantitative survey this study investigates the relationship between prisoners’ age and participation. Data from 486 prisoners from one prison in the Northern part of Flanders (Belgium) are analyzed. In order to answer the research questions bivariate and regression analyses are performed. Results: The regression analysis shows that the older prisoners were, the less likely to participate. The bivariate findings indicate that older prisoners (50+) participated more in none or only one correctional program compared to younger (18-25 years) and middle-aged prisoners (26-50 years). Older prisoners appealed more to mental health care services compared to younger prisoners. Sport activities and vocational training reached mainly younger prisoners. Considering educational courses, older prisoners participated less than the middle-aged prisoners, but more than the youngest. Finally, there was no significant relationship between attending a socio-cultural training course and a prisoner’s age. Conclusion: Age is an overall determining factor for participation, but this relation depends on the kind of program. The article concludes by discussing some practical and policy recommendations to increase the access of older prisoners to these programs.

In Europe there is a considerable rise of the proportion people aged 65 and older. Within the EU-27 their proportion increased from 13.7% in 1990 to 17.4% in 2010. In spite of this, little research addresses social exclusion in later life. Theoretical development of social exclusion has mainly focused on (migrant) adolescents, middle-aged adults and more recently also on people with mental health problems. The few studies focussing on older people conclude that social exclusion increases with ageing, pointing to the need for later life perspectives in social exclusion research. Age-related changes such as retirement, greater risks of reduced mental health, physical limitations, loss of autonomy, loss of partner, family and friends, age-related discrimination and ageism make older people more vulnerable to social exclusion. Besides these individual changes, globalisation, social developments, digitalization and changed marital and family patterns can also affect the likelihood of older people's social exclusion. The article at hand will theoretically explore this under-researched intersection of social exclusion and later life. More precisely, this article examines, based on existing literature, different dimensions of social exclusion and what these dimensions mean in older people's life. Analysis on the data of the Belgian Ageing Studies, a large-scaled survey among approximately 73.000 older people, will illustrate this. The discussion highlights the main research gaps in social exclusion among older adults and formulates recommendations for future research.