This study is a comprehensive portrayal of childlessness in later life, describing childless older adults’ specific characteristics related to childlessness, their personal and social characteristics, and well-being in comparison with older adults with children. A cross-sectional survey was conducted among 543 adults (60+), 47.0% (255) of whom were childless. Reasons for childlessness include personal choice (35.3%), life events (24.3%), health problems (23.1%), and partner-related factors (21.2%). A total of 14.9% of childless older adults had received professional medical help in attempts to become pregnant; 5.5% of childless older adults had undergone abortions; 37.3% indicated that their childlessness was undesired; and for 32.2%, it was desired. In comparison to older adults with children, childless older adults reported significantly lower life satisfaction ( p < .05), were not more socially, emotionally, or existentially lonely, and did not experience lower levels of meaning in life ( p > .05).

Objectives The guiding principle of current aging policies has been to promote older adults to live in their private homes, but little attention has been paid to social exclusion of older adults receiving home-based care. The aim of this study is to increase understanding on different patterns of multidimensional social exclusion among older adults receiving formal home care services, and through this to shed light on the possible challenges of current aging-in-place policies.Methods The survey data were collected in 2022 among older adults aged 65 to 102 years receiving home care services in Finland and merged with administrative data (n = 733). A latent class analysis was used to identify different types of social exclusion. Multinomial logistic regression modeling examined factors associated with different social exclusion types.Results Four social exclusion types were identified: (1) not excluded (16.9%), (2) homebound economically excluded (40.1%), (3) excluded from social relations (28.6%), and (4) multidimensionally excluded (14.3%). Poor self-rated health and poor functional ability significantly increase the risk of being multidimensionally excluded or homebound economically excluded. The group using home care and medical services the most are the most multidimensionally excluded. The group living in urban areas are more likely to be excluded from social relations.Discussion Different types of social exclusion should be acknowledged when addressing social exclusion among home care clients. Enhanced measures should be developed to support older adults using home and healthcare services the most, as they are at high risk of severe exclusion.

Civic engagement is increasingly relevant for healthy and active ageing and addressing social exclusion among older people. Current research focuses primarily on formal volunteering, overlooking other ways older people contribute to their families and communities. This study addresses these gaps by recognising civic engagement as multi-dimensional - including associational engagement, informal care-giving, formal volunteering, digital engagement and formal/informal political engagement - and exploring activity combinations among older individuals. Using data from the 2016 European Quality of Life Survey (33 European countries), it examines the civic engagement of 9,031 individuals aged 65+. Descriptive analysis maps their multi-dimensional civic engagement, while latent class analysis identifies distinct engagement profiles and explores which activities are combined. It also investigates the socio-structural and social capital resources associated with each profile. Findings reveal that 32 per cent of older individuals are not engaged in civic activities. Among the civically engaged, five profiles emerge, illustrating varied engagement across multiple activities. Many older people (35.8 per cent) combine several civic activities, albeit in different combinations. Informal care-giving can be found in all profiles; and for a large part of the population, it is their only civic activity, while another profile displays older Europeans engaged in several activities simultaneously. Higher levels of socio-structural resources are associated with greater diversity in civic engagement in later life. Interventions and policies therefore must consider the diverse circumstances and preferences of older people and valorise and include all forms of multi-dimensional civic engagement, including informal care-giving, in policy making.

To gain insights into vulnerable lifecourses and give a voice to those often underrepresented in quantitative research, this study examines the life stories (past, present and future) of 19 financially excluded older adults using an adapted version of McAdams' life-story interview scheme. Although these life stories demonstrate an accumulation of many disadvantages and an uncertain future because of current financial situations, the stories also reflect the generativity, resilience, coping strategies and agency of financially excluded older adults. We demonstrate how the experienced lifecourse is built around both negative and positive turning points and transitions which go beyond the classical education-work-retirement triumvirate, and how socio-cultural life scripts are used as a framework to build one's own life story in order to achieve continuity. The discussion highlights the potential for deploying the life-story method as a qualitative resource for providing individualised care.

Studying the life courses of older people: The McAdams life-story interview Research among older people often focuses on the present. Nevertheless, life course research can help to understand how certain behavior and feelings take shape and evolve throughout the course of life, and how life events at a younger age can influence conditions, behaviors and feelings in later life. In this article, we focus on the McAdams life story interview method, which we applied in three different studies. We describe the different steps, reflect on the main pitfalls in the implementation of this approach and explain how we attempted to avoid them. The experiences and reflections of both the participants and the researchers are discussed.

AbstractThis chapter introduces the topic of social exclusion in later life and presents a rationale for this edited volume. It will provide an overview of existing knowledge, focusing specifically on research deficits and the implications of these deficits for scientific study in the area, and for effective and implemental policy development. This chapter will outline the aim and objectives of the book in response to these deficits and will outline the book’s structure and the critical approach that is adopted for the volume, and that is rooted in state-of-the-art conceptual knowledge.

AbstractThis concluding chapter outlines key contributions of the book, indicating how the individual chapters have pushed beyond the current state-of-the-art scientific knowledge on social exclusion of older people. Drawing together some of the major cross-cutting themes emerging from the different parts of the book, the chapter highlights interconnections between the contributing chapters and deepens our understanding of the conceptual framing of social exclusion of older people. We use this frame as a basis for developing a new research agenda that relates not only to future empirical and conceptual research, but also to policy development in the field of social exclusion in later life.

AbstractThis chapter reports on a cross-national exploration on manifestations and drivers of exclusion from social relations, in rural Britain and Belgium. Each study was composed of a quantitative and qualitative phase. The quantitative phases operationalised exclusion from social relations using existing datasets within each country while both qualitative phases comprised life history interviews with older people. The results demonstrate that although social relations are vital for several reasons (e.g. health and care, practical support in times of poverty, safety), older participants in both countries regularly face exclusion from social relations (e.g. feelings of loneliness, isolation, “bad” social relations). The results show a strong interrelationship between exclusion from social relations and other domains of exclusion (e.g. economic and material exclusion). In terms of drivers of exclusion from social relations, the life stories revealed micro risk factors (e.g. marital status and gender), exo (e.g. being remote and rural living) and macro drivers of exclusion from social relations (e.g. inadequate social security and population change). The conclusion discusses the main limitations of this cross-national exploration and offers some tangible policy and further research recommendations.

Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.

Utilizing a mixed-methods research design consisting of two consecutive phases, this study investigates older adults’ perceptions and understanding of social connectedness factors influencing late-life volunteering. In the first phase, quantitative data from the Belgian Ageing Studies project ( N = 24,508, from 89 municipalities) was analyzed through regression modeling. In the second, qualitative phase, focus groups with older people were conducted in each of the six research locations, to elucidate and build on the quantitative results. The research findings indicate that formal connectedness is highly influential for both the potential to volunteer and actually doing so. Membership of an association and being a new resident are key determinants for volunteering in later life. Moreover, local policy also functions as an important bridge between long-term residents and new residents in terms of the social structure of the society and the extent to which people are integrated into the community.

Cet article examine le parcours de vie des personnes âgées à faibles revenus en Suède et en Belgique, selon une approche comparative des politiques sociales de ces deux pays. L’étude porte sur les conditions de vie actuelles de ces personnes âgées, ainsi que sur les événements et parcours à l’origine de leur faible niveau de ressources. Une analyse secondaire qualitative de 49 récits de vie a permis d’identifier cinq parcours menant à un faible niveau de revenus, signe de la relation complexe entre parcours de vie et précarité économique. Les divers événements de la vie interagissent fortement entre eux, soulignant la nécessité de développer les interventions sociales afin d’apporter un soutien coordonné aux personnes confrontées à de multiples difficultés tout au long de leur vie et dans différents contextes sociaux. Les conclusions de l’étude soulignent également la nécessité de pousser plus avant les recherches sur les processus sociaux responsables des situations de faibles revenus chez les personnes âgées dans différents types d’État-providence.

AIM:This paper aims to identify barriers that frail community-dwelling older adults experience regarding access to formal care and support services. BACKGROUND:Universal access to healthcare has been set by the World Health Organisation (WHO) as a main goal for the post-2015 development agenda. Nevertheless, regarding access to care, particular attention has to be paid to the so-called vulnerable groups, such as (frail) older adults. METHODS:Both inductive and deductive content analyses were performed on 22 individual interviews with frail, community-dwelling older adults who indicated they lacked care and support. The coding scheme was generated from the conceptual framework '6A's of access to care and support' (referring to work of Penchansky and Thomas, 1981; Wyszewianski, 2002; Saurman, 2016) and applied on the transcripts. FINDINGS:Results indicate that (despite all policy measures) access to a broad spectrum of care and support services remains a challenge for older people in Belgium. The respondents' barriers concern: 'affordability' referring to a lot of Belgian older adults having limited pensions, 'accessibility' going beyond geographical accessibility but also concerning waiting lists, 'availability' referring to the lack of having someone around, 'adequacy' addressing the insufficiency of motivated staff, the absence of trust in care providers influencing 'acceptability', and 'awareness' referring to limited health literacy. The discussion develops the argument that in order to make care and support more accessible for people in order to be able to age in place, governments should take measures to overcome these access limitations (eg, by automatic entitlements) and should take into account a broad description of access. Also, a seventh barrier (a seventh A) within the results, namely 'ageism', was discovered.

This paper focuses on the prevalence and measurement of old-age social exclusion. Currently there is limited knowledge of the prevalence of old-age social exclusion in Belgium. Although studies have already shown that older adults can experience exclusion in more than one dimension, the multidimensional nature of social exclusion is often lost when constructing a scale. Consequently, this paper’s aim is twofold. First, it examines the prevalence of different dimensions of old-age social exclusion in Flanders and Brussels and seeks to demonstrate the influence of applying different measurement thresholds. Second, this study develops an old-age social exclusion measure that preserves its multidimensionality. Descriptive and Latent Class Analysis were performed on the Belgian Ageing Studies data (2008–2014), a survey among home-dwelling older adults (60 + years) (N = 20,275; 80 municipalities). Findings revealed that older adults are mainly digitally excluded and excluded from the neighbourhood, civic participation, and social relations. More than 60% older adults experience exclusion in two or more dimensions. The use of different thresholds, however, leads to different interpretations concerning the prevalence of social exclusion. Results of the Latent Class Analysis revealed four categories of old-age exclusion: those at “low risk”, “the non-participating financially excluded”, “the environmentally excluded” and the “severely excluded”. The discussion emphasizes the importance of preserving a multidimensional perspective when studying social exclusion. When addressing old-age exclusion, policy should be sensitive to the diverse categories and realize that one-size-fits-all policies and interventions are no solution.

Prevalence data of elder abuse from social and health services only present a tip of the iceberg. A large amount of situations of abuse is left undetected. Professionals often lack knowledge and skills on the topic of abuse. Consequently, this paper focuses on supporting professionals to prevent and assess elder abuse by developing and testing the Risk on Elder Abuse and Mistreatment Instrument (REAMI), using a mixed method design. Quantitative data from a widespread screening among 1920 older clients of home care are analysed with exploratory and confirmatory analysis. In addition, 24 professionals who have used the REAMI have been qualitatively interviewed about their practical experience and critical reflection on the instrument and its use. These interviews were transcribed and content analysed. Findings provide evidence of good internal reliability and internal validity of the REAMI and its three dimensions: 1) risk factors of the older person, 2) risk factors of the environment, 3) signals of abuse and mistreatment. Users report an increase of knowledge and awareness among staff, satisfaction with the possibilities for prevention and the user-friendliness and brevity of the REAMI. However, some users are missing a follow-up protocol: what to do when risks are assessed? In the discussion, the argument is developed that the REAMI can be used to examine risk at elder abuse, although an overarching protocol to support prevention and intervention which embeds the detection instrument is needed.

While there is a substantial body of work that describes how exclusion from social relations can lead to loneliness, it has not been rigorously tested in relation to other outcomes such as life satisfaction. In addition, it is hypothesized that psychosocial resources can modulate the experience of exclusion from social relations. Therefore, the current paper studies whether resilience, coping styles and mastery moderate the impact of both objective and subjective experiences of exclusion from social relations (i.e. social isolation and loneliness) on life satisfaction. Longitudinal data on a sample of 872 community-dwelling older people (>60 years) were collected. Participants filled out a questionnaire (T0, T1 after six months) including measures of social relations, psychosocial resources and life satisfaction. To examine the moderating effects of the selected resources, their interaction effects with levels of exclusion on life satisfaction were studied by means of multiple linear regression models (using Hayes).

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.