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The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants' social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows. [ABSTRACT FROM AUTHOR]

Caring for one's grandchildren has become a more common experience for individuals partly as a result of a longer overlap between the lives of grandparents and their grandchildren. Existing research shows that around 50 per cent of grandparents engage in some grandparental child care in most European countries, however, this proportion is higher among older people with a migrant background, partly due to greater economic necessity among migrant families. Research has also highlighted ethnic differences in parents' child-care selection, even after controlling for their socio-economic status. Building on these strands of work, this paper investigates the differences in the use of (grandparental) child care among parents from different Black and Minority Ethnic (BME) groups in the United Kingdom, using data from Understanding Society. The results show that parents from Other White, Indian, Pakistani, Bangladeshi and African communities are less likely to use child care than White British parents, while the opposite is true for Caribbean parents. However, among parents using child care, individuals from the Other White, Caribbean and African groups are less likely than the White British majority to be using grandparental child care as a supplement to other child-care types, or on its own. Ethnic differentials in the use of child care per se and grandparental child care in particular, have significant policy implications, and may mask other kinds of ethnic differences. [ABSTRACT FROM AUTHOR]

This paper examines the relationships between self-reported loneliness and living arrangements. A structured questionnaire with some open-ended questions was administered face-to-face in English, Hindi or Punjabi to a sample of 161 elderly South Asian immigrants 60 or more years of age living in Edmonton, Alberta, Canada in 2003. The majority of respondents said that they never felt lonely. More than one in three (37.3%) respondents indicated that they felt lonely occasionally, frequently or all of the time. Those living alone were significantly more likely to report feeling lonely at least occasionally than were those living with others, especially those living with their spouse in an extended family. The fact that South Asian immigrant seniors typically lived with others, often in an extended family with or without their spouse, and rarely lived alone protected them to some extent from loneliness. However, our findings showed that among those living with others, it was the amount of waking time spent alone at home and the quality of family relationships rather than living arrangement per se that significantly predicted self-reported loneliness. Nevertheless, living in a larger household was associated with spending less time alone. We discuss plausible influences of culture on expectations regarding family and social relationships and on the meaning of being alone, as well as practical implications for addressing loneliness in a multi-cultural society. [ABSTRACT FROM PUBLISHER]

Using interview data from 30 Tibetan elders living in India and Switzerland, the paper explores the support they received, their perception of intergenerational relationships, and their acceptance of different levels of intergenerational exchange. All of the sample had aged in either India or Switzerland and so provide excellent comparison groups, from respectively a developing and a developed country, by which to study changing filial piety with time, context and socioeconomic conditions. With limited resources in old age, most of the participants in India needed financial support. Among them, parents with many children and children in developed countries received better financial support and collective care than those with one child or all children living in India. In contrast, the participants in Switzerland were entitled to state old-age benefits, and so required mainly affirmation and emotional support. A consequence of living in a developed nation was dissatisfaction when the children adopted western values and the family's cultural continuity was threatened. The findings support two recommendations : in developing countries, the provision of old-age benefits to ensure a minimum level of financial security and independence among older adults ; and in developed countries, the promotion of a mutual understanding of filial piety among different generations of older refugees and immigrants to help ameliorate intergenerational differences. [ABSTRACT FROM AUTHOR]

Currently there is no specific policy on dementia care in India. Rather, the responsibility for care for people with dementia is not clearly articulated and formal care services straddle mental health and aged care. The result is that much care is placed upon individual families. This paper critically reviews Indian legislative and policy documents on this field of care, namely, the Mental Health Act 1987, the National Mental Health Programme, the National Policy on Older Persons and the Senior Citizen's Act 2007. The invisibility of dementia care in public policy translates into the absence of adequate treatment facilities and mental health staff, and leaves informal care-giving unsupported. This gap is replicated in mental health and dementia-care research and literature in India, with little being known about how family carers respond to the experiences of care-giving, manage the stigma, and access support. As India, like other middle-income and low-income countries, is experiencing an increase in its older population, more research is needed to develop the epidemiological, medical and anthropological understanding of ageing, dementia and care. This knowledge is vital to understanding the cultural context of the disease and must also be incorporated into public health policy if there is to be effective management of the rising need for personal care. [ABSTRACT FROM AUTHOR]