Renewed public awareness of the impact of social isolation on health and wellbeing, particularly among younger and older adults, has prompted greater investment in resources to promote social connection. However, little has been done to address the specific connectedness needs of the 85+ age demographic, one of the fastest growing demographics in the U.S. This exploratory, mixed‐methods study draws on cross‐sectional data collected in 2024 from a longitudinal panel of the over‐85 age demographic to examine how a sample of the 85+ perceive and experience friendship in the latest phase of life. Findings underscore the strong value the oldest‐old placed on their friendships and their longevity, the challenges of making friendships, including diminishing opportunities and openness toward new connections, the shifting composition of the friendship network in later life, and the influence gender can have on these relationships. Results highlight an opportunity for policies across many levels to acknowledge and address friendship as an important social relationship influencing health and wellbeing in later life, including local investment in community‐based social programming and awareness campaigns, state‐wide expansion of mobility solutions for older riders, and a national focus on expanding broadband and device access and coverage for services under Medicare. While this study is not generalizable to all 85+‐year‐olds, it represents a starting point for further research and policy advocacy that includes a consideration of the role of friendship in influencing social health in the latest phase of life.
Social disconnection—isolation and loneliness—is increasingly recognized as a key determinant of older adult health. Cognitive-behavioral interventions can improve social connection for disconnected older adults, yet access can be challenging. Brief interventions that can be integrated into existing infrastructure and programming (e.g., crisis or emotional support phone lines) are urgently needed. One promising approach is Connection Planning, a theory-based and evidence-informed behavioral strategy for promoting feelings of social connection. A pilot program development project was conducted to implement Connection Planning with callers to a statewide Senior Loneliness Line. Partners from the state health authority, social service organization, and an academic research team collaborated to implement and evaluate the program. Factors that facilitated participant engagement with the program included provider characteristics (e.g., empathic) and program characteristics (e.g., scheduling flexibility). Challenges to implementing the program included program promotion and enrollment difficulties and the introduction of new structured elements into calls. Additional needs for training and funding to support program sustainability were identified. Building social infrastructure to promote social connection in older adulthood requires concerted effort from stakeholders across sectors. We discuss the challenges and lessons learned from this cross-sector collaboration to pilot a social connection program for older adults at the state level and suggest opportunities to leverage funding mechanisms and implementation science principles that could support success of future efforts to develop policies and practices that are responsive to older adult social needs.
Global shifts in longevity, fertility, and partnership have disrupted nuclear family relationships, resulting in a growing population who are unpartnered, childless, or who do not include their partners and children in their core discussion networks. Lacking nuclear family ties in a core discussion network could lead to lower satisfaction with one's network which, in turn, is associated with poorer health. Yet, it is unclear if being unpartnered and/or childless (family structure) or being partnered with children but not reporting them as members of your discussion network (network structure) are associated with lower network satisfaction and if these associations are contextualized by gender and global development. We examine the extent to which family structure and core discussion network structure are associated with network satisfaction by analyzing data from the 2015 (57,389 individuals in 18 countries) and 2021/2022 (64,934 individuals in 28 countries) waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Logistic regression results stratified by sex and level of country development indicate that lacking nuclear family ties in a core discussion network is associated with lower network satisfaction, with gendered patterns: men are more dissatisfied without partners, while women are more dissatisfied without children. These associations are consistent across countries but somewhat attenuated in highly developed contexts. As family structures continue to transform, we recommend an increased emphasis on nonnuclear family ties in research and policy to more effectively reduce risks of unmet social and emotional needs in aging populations.
Social sciences research has linked the experiences of caregivers to gendered experiences over the life course; a few studies have crossed these findings with sexual orientation, often introducing stigma and other social impacts. We directly asked caregivers themselves about the perceived influences of gender and sexual orientation on their caregiving experiences. Twenty-three straight women, 15 straight men, 14 lesbian women, and 13 gay men spousal/partner dementia caregivers were interviewed about their caregiving experiences, including the advantages and disadvantages of their gender and sexual orientation in caring for their spouse/partner; these interviews were recorded, transcribed, and content analyzed. Four superordinate themes accounted for advantages, and the same number of comparable themes were found for disadvantages; together, these represent: empathy and emotional expression; bridging household management and relationship tasks; societal factors; and reference to bodies. The synthesis of these findings is illustrative; for example, straight women reported their emotional facility and household management histories as advantages; they also felt burdened and somewhat weighed down by both. Straight men similarly spoke of their emotional reserve as both an advantage and disadvantage—and similarly referencing household management (not trained in the former case, not prepared in the latter). Gay men and lesbians noted the stigma and discrimination that colored their caregiving experiences; they also saw how these struggles became strengths. These data help reinforce and animate existing interpretations of caregiver behaviors, add new nuance and perspective, and offer detail for policy and practice interventions rooted in gender and sexual orientation identities.
To date, sparse literature exists exploring different patterns of social support levels among oldest-old adults, leaving some questions of whether all longevity achievers are those who have high support levels from various sources, or if there is a group of oldest-old adults who are at the highest risk of being exposed to high loneliness levels due to unavailable support from a particular source (e.g., spouse or children). The current study aimed to explore distinct profiles of social support received from four different sources (i.e., spouse, children, friends, and other family members) and how the obtained profiles are associated with loneliness among oldest-old adults. Oldest-old adults who survived to 80 years or older from the Health and Retirement Study and who provided data from 2008 were included in the present study ( N = 1484). Latent profile analyses were first computed to obtain different patterns of support levels perceived from four sources, and mean difference tests were also computed to analyze how each profile was associated with mean loneliness levels. The results indicated that the four-profiles obtained has the best solution. The four profiles model was selected based on the distinct patterns among the classes: Low Spouse Support, Low Children Support (LCS), Low Family Support, and All High Support (AHS) groups were obtained. The AHS group was associated with lower loneliness levels, and the LCS group was likely to have the highest level of loneliness. The findings of the present study can contribute to community-level intervention programs that target older adults or oldest-old adults with high levels of loneliness by taking into consideration their available social support sources and actual support levels perceived from each available source, especially focusing on those who perceive low levels of support from children. Particularly, policymakers should consider prioritizing enhancing intergenerational connections between older parents and adult children, which can enable a regular check-in system for older adults on their available support networks and evaluations of their psychological health, like loneliness and depressive symptoms.
Older custodial grandparents raising adolescent grandchildren are often underprepared to parent adolescent grandchildren with complex biological, psychological, and social needs. Greater understanding of social support networks may contribute to enhancing the well-being and longevity of these caregivers. This study conducted in-depth interviews and applied a social capital framework to explore the structure of and satisfaction with social support networks accessed by nineteen older grandparents raising adolescent grandchildren. Older custodial grandparents raising adolescent grandchildren reported using social support networks from family (89.4%), community groups/organizations (84.2%), friends (73.7%), faith-based communities (68.4%), and neighbors (2.1%). Satisfaction with social support networks varied by the source of social support. The highest satisfaction with social support emerged from family (73.6%), followed by community groups/organizations (52.6%). Older grandparent caregivers expressed some satisfaction with friends (42.1%), faith-based communities (42.1%), and neighbors (36.8%), with lower levels of satisfaction evident in each group. Implications will be discussed for tailoring policy development to the views and unmet needs of older custodial grandparents raising adolescent grandchildren. Collaborative partnerships from a wide array of constituent groups can help to foster policy advocacy and development across all critical domains to enhance social support with and on behalf of older custodial grandparents raising adolescent grandchildren.
Ongoing demographic shifts alongside the normalization of dating technologies as a mode for meeting potential partners makes understanding mid‐ and later‐life adults' perceptions of and experiences with navigating these platforms increasingly important. Drawing on publicly available data from Wave 111 of Pew Research Center's American Trends Panel (2022), we compare perceptions of mid‐ and later‐life adults aged 30 and older as a whole ( n = 4316), as well as experiences of digital dating tech adopters ( n = 1185). We explore perceptions of the overall effectiveness of dating technologies in relationship formation, risk experiences, and attitudes about protective policy measures focusing on intersectional variations by gender, age cohort (30–49, 50–64, and 65+), and dating tech adoption status. Results indicate that both perceptions of effectiveness and experiences with dating technologies are mixed, with adults 65 and older more likely to view online dating as effective in finding a partner. Women across all age groups tend to have more negative experiences. We found age group and gender variations regarding safety concerns including fears around privacy, harassment, and fraud. Overall, harassment and scams are prevalent, with nearly half of online dating users reporting negative experiences and just over half expressing fears of being scammed. In terms of protective measures, most respondents support dating sites/apps requiring background checks. Our findings support the need for utilizing a more intersectional lens when researching mid‐ and later‐life adult's experiences with dating technologies and gathering their perceptions as stakeholders in developing evidence‐informed policies to enhance online dating safety measures.
This article explores the complexities of responding to elder abuse cases when victims oppose the prosecution of their abusers. What little published guidance there is for prosecutors and others involved in responding to elder abuse through the criminal justice system tends to focus on how to prove a case without victim testimony rather than addressing the questions of should prosecution move forward against the victim's wishes and, if so, how. Drawing on empirical research and legal scholarship from both the elder abuse and intimate partner violence fields, this article explores three core controversies: whether victims can meaningfully exercise autonomy, whether prosecution enhances or undermines victim safety, and whether prosecutorial decisions should be guided by utilitarian or retributive theories of justice. The article draws lessons from these controversies to propose a victim-centered approach that seeks to balance the victim's autonomy and well-being with the criminal justice imperative to hold wrongdoers accountable. It delineates elder abuse-specific factors to consider when assessing the state's interest in prosecution and describes strategies designed to reduce the risk of abuse and other harms, empower victims, and promote justice.
Caring for aging parents has largely become a normative societal expectation. However, approximately 25% of children experience neglect or abuse in their lifetime with reports suggesting that 89% of survivors are maltreated by one or both parents. Despite some available literature, little attention has been given to how daughters who have experienced childhood maltreatment at the hands of their mother go on to provide them dementia care. As the incidence of dementia continues to rise, a growing number of individuals with dementia will be cared for by those they once maltreated. Accordingly, it is imperative to understand the nuances of how this population navigates dementia care. Data for this analysis were drawn from the Aging at Home Alone study, a National Institutes of Health (NIH) funded protocol that focused on the experiences of community‐dwelling live‐alone persons with dementia and their collaterals ( N = 96). Analyses were conducted on the subsample of adult daughters who were maltreated by their mothers during childhood and subsequently provided them dementia care ( n = 7). Using content analysis, 251 pages of narrative data were analyzed to examine the intricacies of how this distinct population provided dementia care to their mothers. Despite exposure to maltreatment during childhood, each daughter provided their mother stable and non‐volatile dementia care. Analyses indicated daughters provided care to their perpetrating mothers by (a) setting boundaries, (b) utilizing peripheral resources, (c) acknowledging the childhood trauma, and (d) participating in self‐care activities. Often overlooked in the literature is acknowledgment that not all familial relationships are positive as many caregiver‐care recipient relationships are characterized by past trauma. This study is one of the first to address the nuances of caring for a mother with dementia who mistreated them during their childhood. Findings demonstrate difficulties providing support but show that stable dementia care is possible. Understanding unique caregiving relationships can inform policies that promote trauma‐informed care practices, ensuring that both caregivers and care‐recipients receive compassionate, effective support.
As interventionists and policymakers aim to strengthen marriages and families, research on the nuances of romantic relationships, particularly among historically disadvantaged populations, grows more important. In its simplest form, the dynamics of a marriage consist of a combination of emotional highs and lows. Spousal support is generally a relational boon, capable of contributing to stability and happiness. On the other hand, negative interactions (e.g., criticism, unmet demands) can damage relationships and lead to instability or divorce. Although research has studied various correlates of spousal support and negative interactions, relatively little knowledge exists on these constructs among African Americans in long‐term marriages. To understand the correlates of spousal support and negative interactions among African Americans in long‐term (≥20 years) marriages, this study used data ( n = 200) from The National Survey of American Life Adult Reinterview (NSAL‐RIW). Our emphasis on long‐term marriages contributed to a sample that consists largely of older adults. Data analyses revealed that African Americans in long‐term marriages report high levels of emotional and instrumental spousal support and relatively low levels of negative interactions with their spouses. Gender, education, family income, and length of marriage were significantly associated with emotional and instrumental spousal support. Spousal negative interactions were associated with gender, family income, and marriage duration. Grounding policies and interventions in research that considers what strong couples have done well is an important first step toward building more strong, healthy relationships in underserved communities.
The increasing frequency and severity of hurricanes induced by climate change, heighten the importance of understanding the emergency preparedness and needs of older adults with disabilities. This segment of the population faces an elevated risk of injury or death in hurricanes and other weather-related emergencies, but little is known about their preparation for and evacuation intentions regarding such emergencies. Even less is known about communities' readiness to address older adults with disabilities' needs during emergencies. We examine hurricane readiness at the individual level using data from an online survey of Floridians aged 50 and older ( n = 3918) and at the county level using administrative data from 65 of Florida's 67 counties. Results of individual-level analyses revealed that older adults with self-reported mobility or vision impairments had lower odds of being hurricane prepared, suggesting they may have unmet needs in such emergencies. Results of county-level analyses yielded mixed results. Although counties with higher proportions of their residents having limited abilities tended to have more special needs emergency shelters, counties with higher proportions of their residents using special equipment tended to have fewer—rather than more—such shelters. Our study provides insight that can inform policies aimed at safeguarding older adults with disabilities from the risks posed by the warming planet's intensifying storms.
Increased longevity is occurring worldwide with the greatest increase in the numbers of the very old. Many gerontological scholars have noted that these changes pose a risk of exclusion of the very old whose ability to participate in society may be compromised by bodily challenges. While the growing number of people aged 80 years and over raises many issues concerning health and social care needs, demands for a skilled workforce, and scope for technical innovations designed to compensate for the infirmities of advanced old age, these topics tend to exclude consideration of the everyday experiences, interests and wishes of those in deep old age. The qualitative research reported here focuses on people in advanced old age and the associated corporeal challenges they may face, set in the context of living on the San Juan islands off the coast of Washington in the Pacific Northwest of the United States. The participants of this study were islanders ranging in age from 80 to 102 years with a median age of 83 ( M = 85.9, SD = 5.95). A mixture of semistructured interview and a photo elicitation methodology was employed. The results of the study demonstrated that, while integral to daily life in deep old age, corporeal challenges per se did not necessarily lead to a sense of exclusion, at least in the context of island life. Thematic analysis of the findings suggested the importance of context in framing corporeality, and the need to look beyond objective indicators of disability and function to acknowledge the role of social belonging in ensuring the continuing citizenship and social engagement of people in their ninth decade and beyond.
Social participation is likely to decrease among older adults as disability levels increase. However, it is a modifiable determinant of health that can impact older adults' well-being and quality of life. Thus, this secondary data analysis aimed to understand what challenges older adults aging with a mobility or vision disability face with social participation, as well as their solutions for addressing those challenges. Interview data were obtained from the Aging, Challenges, Concerns, and Everyday Solution Strategies study. Six activities were chosen based on a taxonomy of social activities and a conceptual model of participation. Frequency counts were gathered through a thematic analysis to understand the number of challenges and response strategies. Over half of the older adults who had a mobility disability shared that visiting family and friends (57%) was their most challenging social activity. The identified challenges hindering them from completing the social activity were primarily personal, followed by accessibility and environmental. Older adults with a vision disability shared that going to entertainment events or activities (26%) was their most challenging social activity. Resources, such as community interventions, can support older adults with mobility or vision disabilities in participating in social activities. As such, future research, policy, and interventions should consider external support components to assist older adults with a mobility or vision disability with social participation.
Men's Sheds are grassroots organizations that began in Australia and have expanded to other parts of the world. They provide spaces for men to make new friends, participate in projects together or learn new skills. Men, as compared to women tend to have smaller social networks and less support in older adulthood, therefore navigating retirement and other age-related adjustments may be more challenging without support resources. The purpose of this paper was to explore how Irish Men's Sheds helped men with the transition to retirement. Interviews with Men's Sheds members aged 65+ ( N = 37) were completed in County Limerick, Ireland. Transcripts were analyzed thematically, and two themes were identified: (1) Filling the Void and a subtheme on Continuous Achievement, and (2) Intentional Preparation. Many of the men who were interviewed were unsure how to spend their time before joining the Men's Shed. After participating, they reported enjoying the connections with other men and having something useful to do. Some men specifically sought out a Men's Shed as they approached retirement after seeing their peers struggle with the adjustment. The men perceived Men's Sheds to be beneficial and saw them as a purposeful and productive outlet to engage in. Men without access to community organizations such as Men's Sheds may be at greater risk for loneliness and social isolation in older adulthood. Policies are needed to help prepare men for the psychological transition to retirement and to help organizations such as Men's Sheds remain financially viable.
This study examines the integration of older African immigrants in the United States through work, which provides them autonomy in later life. The study utilizes qualitative data from 27 older African immigrants from Sub‐Saharan Africa living in Georgia. The older adults are 55 or older and immigrated to the United States after 1990. The participants are from five countries (Cameroon, Nigeria, the Democratic Republic of Congo, Togo, and Zambia). Their ages range from 55 to 85 years old. There are 18 men and nine women. Six participants had doctoral degrees, nine had master's degrees, six had associate or college degrees, six had vocational training, and some had college, secondary, or primary education or no formal education. Eighteen participants were employed full‐time. I apply thematic analysis to highlight emerging themes. The findings demonstrate the importance of the push and pull factors in determining immigrants' decisions to migrate in later life. Other findings highlight the challenges older adults, especially African immigrants, encounter to remain active and gainfully employed. The challenges include problems of language and accent and the classification of foreign credentials in the job market. The participants expressed the necessity to work because of family and societal obligations or perceived obligations back in their countries of origin, most notably the desire to achieve autonomy in later life. This paper contributes to the literature on the diverse aging population by expounding on the contributions made by older immigrants in the workforce, their families, and society. With the information acquired from older African immigrants, we can continue advancing policies that address the concerns of our diverse aging population. Policies should aim at training that targets older adults from diverse linguistic, educational, and cultural backgrounds. Policies should also lay out clearer pathways to financial independence, including education on the role of social security and other safety net programs for older Americans. Policies must reflect the importance of healthcare in later life, so healthcare policies should address issues on cultural competencies in training healthcare providers and educating older adult immigrants on navigating the healthcare system.
Later life disability poses a significant public health challenge, and while research often concentrates on physical limitations, understanding the full spectrum of disability requires a comprehensive approach. This study employs latent profile analysis (LPA), a statistical technique that identifies underlying subgroups or profiles within a larger population based on patterns of responses to multiple indicators, to classify disability. We examined one wave of existing panel data from 414 participants aged 72–106 living in retirement communities. We focus on the following disability indicators: basic and instrumental activities of daily living; physical, cognitive, and sensory impairments; and participation restrictions. Three distinct profiles emerged. The largest group (58%), “Low Disability,” exhibited minimal disability across all domains and superior psychological well-being. The second group (38%) experienced “High Physical and Functional Disability,” with a higher prevalence among older, unmarried women. The smallest group (4%) displayed “High Cognitive-Sensory-Functional Disability,” marked by extensive cognitive impairment and the highest functional and sensory limitations, prevalent in advanced age with poorer psychological outcomes of all profiles. Notably, participation restrictions showed minimal variation across disability profiles. The findings emphasize the need for a data-driven policy framework addressing disability profiles. Efficient resource allocation and targeted support are crucial, and prevention strategies should proactively address individuals at risk of transitioning into higher-multidomain disability profile membership. Given the connection between disability and mental health, addressing these concerns can enhance overall health and well-being. Future research should explore changes in disability group membership over time in diversified samples.
Mobility devices are crucial in enhancing activities and participation for individuals with mobility disability, particularly among the rapidly expanding population of older adults worldwide. This paper explores patterns of mobility device use among a nationally representative cohort of community-dwelling older adults in the United States, using data from the National Health and Aging Trends Study (NHATS) waves 1-9 (2011-2019). Our descriptive analysis focuses on the characteristics of incident mobility device use, its influencing factors, and related user experiences, aligning with the NHATS late-life disability framework. Mobility devices were categorized into walking aids (WAs), wheeled and seated mobility devices (WSMDs), and mixed use of both. We identified 2,943 incidents of mobility device use among 2,591 participants, spanning 47,722 person-years in community settings, yielding an incidence rate of 61.7 per 1,000 person-years. Over half (51.3%) of mobility device use ended in 1 year, with WAs being the predominantly used (63.8%). About one-third (30.5%) of these incidents involved a change in device combinations, with a notable shift towards WSMDs and mixed use over time. We found that older adults using WSMDs or changing their device combinations were in a more vulnerable state, while those using mixed devices or changing their device combinations experienced poorer user experiences. This study advocates for the implementation of rental and recycling programs, the involvement of NGOs and professional associations, and the adoption of flexible policies responding to the dynamic patterns of mobility device use among community-dwelling older adults. It also recommends expanding services to better serve vulnerable subgroups.
The articles included in this issue address older patients’ experiences in navigating the complicated health care system. They recognize that older patients are confronting a bureaucratic system that varies greatly from their earlier life experiences and
By 2030, an estimated 21.6% of the U.S. population will exceed 65 years old. Within this demographic, ongoing broad efforts are needed to address modifiable factors related to common chronic conditions of aging. Digital, or “serious,” health games offer one innovative approach to reach and engage older adults, with documented positive impacts on physical, mental/cognitive, and social health. Informed by healthy aging theory and community-engaged, user-centered design methods, our multidisciplinary team has developed a prototype multicomponent educational exergame designed to educate about and promote healthy lifestyle behaviors (i.e., healthy eating, physical activity), stimulate cognitive functioning, engage movement, and promote social connection. Additionally, we included functional near infrared spectroscopy (fNIRS) in our pilot work to measure real time brain activation during gameplay. Our objectives are to: 1) describe the formative development and testing process of an example multi-component educational exergame, including multidisciplinary team science collaboration, application of aging theory, and use of community-engaged and user-centered approaches; and 2) present a pilot study examining implementation and multiple aspects of an innovative educational exergame, including usability, acceptability, preliminary impact, and cognitive function measurement using brain imaging technology (fNIRS) to measure changes in cognitive load during gameplay. The results provide initial support for acceptability, usability, and positive perceived impact, as well as the preliminary encouraging pre to post improvements in behavioral intention, content knowledge, and relative neural efficiency. This paper also explores the potential of implementing serious health games in senior centers as part of their regular programming.
