This project reviewed prevention, early intervention and treatment approaches to address problem drinking by older people and to assess evidence for effectiveness of interventions (Funded by Joseph Rowntree Foundation).

An evaluation of the Medical Assessment and Treatment Centre at Ashford Hospital, which seeks to establish whether the Centre was able to achieve a more efficient and effective turn round of older patients within the Emergency Department. (Funded by Ashford and St Peter's Hospitals NHS Trust in conjunction with EIHMS).

This study uses two waves of the International Social Survey Programme to examine how the work orientation of midlife men and women changed during the 1990s and how attitudes to paid work change with ageing, comparing across five welfare regime types. (ESRC funded)

Clinical Decisions in Older Patients: A US/UK Comparison

Project team
    Principal Investigator: Sara Arber
    Senior Research Fellow: Ann Adams , Centre for Primary Health Care Studies,
        University of Warwick
    Research Secretary: Sue Venn
Funding
The UK research was part of a larger project led by the New England Research Institutes ( NERI ) in Boston (Principal Investigator: Dr John McKinlay). The project was funded by the US National Institute of Aging, National Institutes of Health, contract number R01 AG16747 for three years, 2000-03.

Aims
The aims of the project were to investigate doctor's decision-making in relation to two common conditions among older people focusing on the influence of:

• UK versus US primary care doctors
•     four patient characteristics - gender, age (55 vs 75), class and race
•     two doctor characteristics - gender and years since completed medical training

Methods
A factorial experimental design was used. A stratified random sample of 128 doctors in the UK and 128 doctors in the US were shown equivalent, culturally appropriate videos of doctor-patient interactions for each condition, following randomisation of combinations of the four patient characteristics and two doctor characteristics. The doctors were interviewed about their diagnosis, test-ordering, treatment, and referral decisions. Half of the interviews were conducted by Ann Adams in the Midlands and half (64) in Surrey and south-east London by the Surrey team.

Evaluation of Medical Assessment and Treatment Centre at Ashford Hospital

Project team
      Principal Investigator: Karen Bryan (EIHMS)
      Senior Research Fellow: Khim Horton (EIHMS),
      Research Investigators: Wendy Knibb (EIHMS) and Tom Daly (CRAG)

Funding
This project was funded by the Ashford and St Peter's Hospitals NHS Trust in conjunction with EIHMS for the period February – August 2004.

Aims
To undertake an evaluation of this new treatment centre at Ashford Hospital to establish whether it was effective in delivering a higher level of patient care to older patients normally assessed by the Emergency Department.

• to establish a baseline of current service delivery so that clinical outcomes relating to the ten conditions identified in the PCT Operational Policy Document, December 2003, could be identified;
  
       to identify the range of services provided by the Ashford Treatment Centrein relation to the ten conditions identified in the Operational Policy Document;
•      to determine user satisfaction of the services offered by the ATC by gathering feedback from patients/GP/emergency services;
  •      to demonstrate the added value of service delivery via the ATC; and
  •      to comment upon the issues for service development for the ATC.
    

Methods
A multi-method qualitative and quantitative approach was used in this study to evaluate the structure, process of the development and outcome of the ATC services, including:

•  visits to the ATC weekly  to create an anonymised database of patient activities

•  comparing this database with information relating to patients in corresponding periods

•  conducting qualitative interviews with patients who had been or were currently being ‘processed' by ATC; and patients at weekends who attended the Emergency Department with conditions that would have been treated by ATC if operational.

•  interviewing by telephone GPs in the localities to determine their views on the impact of ATC on their activities and delivery of treatments to patients.

Evaluation of Residential Care Rebuild and Refurbishment Programme

Project team
    Principal Investigator: Sara Arber
    Research Manager: Cynthia Wyld
    Research Adviser: Kate Davidson
    Research Assistant: Patricia Duff

Funding
This 27-month project (September 2000-December 2002) was funded by Anchor Homes South following their taking over the running of 17 residential homes from Surrey County Council in 1998. The Centre for Research on Ageing and Gender (CRAG) at the University of Surrey undertook the study.

Aims

•  to evaluate the effects of rebuilding and refurbishment on residents, relatives and staff in five homes taken over by Anchor Homes South .

Methods
Three phases of semi-structured interviews with residents, relatives and staff.

• Phase 1 - prior to moving to a temporary establishment
• Phase 2 - during the time spent at the temporary home
• Phase 3 - after returning to the newly built/refurbished home.

Website: http://www.foodinlaterlife.org

Project Team
    Award Holder : Sara Arber
    Research Fellow: Kate Davidson
    Research Fellow: Helen Marshall

Funding
This project has been funded by the European Union, (Contract No: QLK1-CT-2002-02447, 36 months January 2002 - December 2005). CRAG is responsible for the data collection of two work packages (WP5 and WP6) in this project, leading on the design of WP6.

Aims
The aims of work packages 5 and 6 are:

•     To determine the role of formal (eg food related, social or health) services in food procurement and consumption
•     To determine the role of informal (eg family, friends, neighbours) services in food procurement and consumption
•     To investigate the nature of older people's meal consumption including: time of day, composition of meal, and types of foods consumed
•     Investigate the social aspects relating to older people's meals including the importance of other people and the roles they play
•     To compare the above aims across cultures, age groups, living circumstances and gender

Methods
Work packages 5 and 6 comprise a multi-method approach, including qualitative interviews with 80 older people analysed with the assistance of the CAQDAS package MAXqda; and food consumption and food shopping diaries analysed using SPSS. The sample includes 40 men and 40 women, equal numbers aged 65-74 and 75+ and equal numbers living alone and with partners. Data collection is carried out in 8 European countries (n=640).

Publications
Data collection has recently been completed, publications will follow shortly.

Further information: Kate Davidson

Gender, Employment and Pension Acquisition: Trends and International Comparisons

Project Director
Jay Ginn

Funding
This ESRC project (Award No. R000271002) was funded for 30 months, from October 1999-March 2002 (extended to September 2002).

Aims
    To consolidate and extend sociological understanding of the gendered nature of ageing, focusing on the way women's employment interacts with pension systems and how this relationship is changing. Specifically:

•     To improve understanding of the differing and changing implications of ageing, family roles and generation, according to gender and class
•     To contribute to influencing pensions policy
•     To raise awareness of gender issues in pension reforms among pensioners, trade unionists and other user groups

Main objectives

•     To consolidate and extend previous research on the effects of the changing mix of public and private pensions using secondary analysis of national datasets (GHS and BHPS). In particular to examine how women's paid and unpaid work influence their acquisition of pensions, in order to understand how marital and parental status, educational level, occupational class and ethnicity affect employment, earnings and pension scheme membership. The research will examine the emerging polarisation in the 1990s of women's employment and earnings patterns across the working life and the consequences for women's pensions in the future.
•     To assess the gender impact of recent and planned pension reforms in a range of liberal democracies, through an international conference and edited book, Women, Work and Pensions: International issues and prospects . These would promote awareness of the gender issues to be considered in planning pension reform.
•     To organise a new Research Network on Ageing in Europe, with a stream at the European Sociological Association 2001 conferences.
•     To write a sole-authored book, Gender, Pensions and the Life Course (Policy Press, 2003) , focusing on UK data and the effects of recent pension changes. This would contribute to understanding of social policy in this area and would provide an accessible and comprehensive source of information on gender and pensions for user groups, policy makers and the academic community.

Midlife Attitudes to Retirement. International Comparison of Changes 

Project team
Principal Investigator: Sara Arber
Senior Research Fellow: Jay Ginn

Funding
This project was funded by the ESRC (Grant no. 108404) from August 1 2004 November 30 2004

Aims

• To examine changes in the attitudes of midlife men and women to employment and retirement, comparing cohorts aged 50-69 in 1989 and 1997
• To compare these changes across five distinct types of welfare regime in Europe
• To analyse how attitudes of midlife men and women to retirement change with advancing age
• To compare these changes across the five welfare regimes

Methods
Data from two waves of the International Social Survey Programme(ISSP) 1989 and 1997, was used to examine the work orientation of men and women aged 50-69. In these years, the ISSP provides information on attitudes to work and alternative uses of time, as well as sociodemographic information. Individuals were interviewed and asked to complete a self-completion questionnaire on how they would prefer to rebalance their time use between paid work, housework, family, friends and leisure. Those employed more than 10 hours per week were asked about the quality of their job, in terms of rewards and adverse conditions. First, analyses were used to estimate changes across the eight year gap in the two waves of ISSP, comparing five countries from different welfare regime types – Norway (social-democratic), Britain (liberal), West Germany (conservative-corporatist), Hungary (transitional) and Italy ( Mediterranean ). Second, quasi-cohorts were constructed to simulate ageing across eight years, and attitude changes with ageing were analysed, comparing the five countries

Website: Sociology of Sleep

Project Team
    Principal Investigator: Sara Arber
    Project Manager: Jenny Hislop
    Research Fellow: Robert Meadows
    Research Administrator: Sue Venn

Funding
This project was funded by the ESRC (Award No. RES-000-23-0268) for 30 months from October 2003-April 2006.

Aims
To investigate the inter-relationship between the sleep patterns of partners: (a) To identify any differences between partners' sleep behaviour, (b) To see how each partner's sleep affects the other, (c) To ascertain any differences in perceptions of 'sleep needs' and 'sleep rights', both their own and their partner's. (d) To identify how each partner justifies (or not) their sleep reality.

•  To examine how findings under the above aim are associated with changes across the life course according to chronological age and to 'life events' such as marriage, the ages of children and changing work demands.

•  To understand and explain any gender differences, in terms of modes of embodiment and the nature of roles of each partner in the public and private spheres.

•  To integrate physiological knowledge about sleep (i.e. actigraphy measurement) with sociological understanding and to examine the physiological impact each partner is having on the other during sleep.

Methods
A multi-method cross-disciplinary approach, including qualitative interviews with 40 couples, one week audio sleep diaries, one week actigraphy, a follow-up qualitative interview with each partner in the couple, and buccal swabs for PER3 analysis.

Further Information: Robert Meadows

Older People and their Families: Autonomy and Decision-Making in Later Life

Project team
Principal Investigator: Sarah Hampson (Psychology Department)
    Co-Investigators: Sara Arber (CRAG) and Hilary Thomas (Royal Surrey County Hospital )
    Research Fellow: Tushna Vandrevala (Psychology)
    Research Assistant: Tom Daly (CRAG)

Funding
This project has been funded by the Nuffield Foundation (grant number AGE/00061/G) for 33 months from September 2002 to May 2005.

Aims

•  To understand the views of older people about the use of life prolonging medical technologies used to increase life span at the final stages of life, focusing on the use of CPR (Cardiopulmonary resuscitation), ventilation, artificial (tube) feeding and Do-not-attempt to resuscitate (DNAR) orders.

•  To understand the attitudes of the confidants of older people about use of life prolonging medical technologies for their older relative and for themselves.

•  To examine what facilitates communication between an older person and their significant family member (confidant) about whether they would wish to have life prolonging medical technologies during the final stages of life, and decisions about drawing up a Living Will or Advance Directive.

•  To design and evaluate a leaflet for older people to provide advice on communicating their wishes about whether to have life prolonging medical technologies.

Methods

•  10 focus groups with older people from different types of organisational settings to discuss their views of medical care during the final stages of life

•  Semi-structured (tape-recorded) Interview in the home with 69 people aged 65+, selected from the age-sex registers of 4 General Practitioners in 3 economically diverse areas in SE England . Letters sent to prospective participants (age 65-69, 70-74, 75-79 and 80+, and equal numbers of men and women).

•  Separate interview with 53 confidants. Confidants were nominated by the older person as the person that they were closest to.

•  Design of leaflet for older people about Care and Decision Making at the End of Life. Leaflet evaluated by brief interviews with older people and health care practitioners.

Further information: Tom Daly