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Purpose Spouses of persons with dementia often take on caring responsibilities that can be overwhelming and negatively affect their well-being. To support the development of effective services and promote carer well-being, we aim to describe carer experiences and needs in everyday life.

Methods Semi-structured phone interviews were conducted with a convenience sample of 24 spouses caring for a partner with dementia in Sweden. The interviews explored experiences of caring for a partner with dementia. Interviews were analyzed with thematic analysis.

Results The analysis generated two themes: “Being consumed by caring” and “Longing to be seen and feel supported”. The first theme showed that spouse carers experience a transition from spouse to carer and feel confined in their new situation. The second showed that to be supported, spouse carers need to feel acknowledged in their situation, and formal care must meet their partner's needs, as carers' needs are enmeshed with those of their partners.

Conclusion Spouse carers of persons with dementia often feel trapped by caring responsibilities. To feel supported, they need to be acknowledged both as individuals and as part of a couple. Health and social care professionals should focus on maintaining spouses' sense of self and adopt a couple-centred approach.

OBJECTIVES: Social relationships are fundamental to well-being in later life, yet few studies differentiate between relationship types and the mechanisms through which they operate. This study models how different types of social relationships are associated with life satisfaction in very old age, considering the psychosocial pathways of perceived emotional and practical support, and loneliness.

METHOD: Direct and indirect associations between relationships and life satisfaction were tested using structural equation modelling on 1,213 community-dwelling older adults (77+) participating in the Swedish Panel Study of Living Conditions of the Oldest Old. .

RESULTS: Close family relationships emerged as the most important, and while children were inherently positive for life satisfaction (standardised coefficient 0.23, p < 0.01), partners had a positive association only through indirect pathways (0.14, p < 0.01) and a negative direct association (-0.19, p < 0.01). Friends were associated with life satisfaction through emotional functions while other relatives and weak ties showed no significant associations.

CONCLUSION: In very late life, life satisfaction appears to depend on the emotional quality and perceived support within close relationships. As demographic shifts continue, future cohorts may have fewer children and more diverse social networks. These changes may increase the importance of non-kin relationships and more distant relatives for maintaining well-being in old age.

Despite the universal social policies of Sweden's welfare state, recent decades have seen decreasing public benefits and increasing socio-economic disparities, affecting the financial wellbeing of older adults and their younger family members. This repeated cross-sectional study explores the development of intergenerational financial transfers in Sweden over the past two decades, examining transfers involving older parents and their children and grandchildren, and patterns related to gender and social class. It utilises data from the Swedish Panel Study of Living Conditions of the Oldest Old, from 2002 to 2021, along with descriptive statistics and logistic regression models, to study shifts in donor-receiver proportions and gender/social-class disparities. The findings revealed that approximately one in four parents provided financial support to younger generations, while very few received such support. Downward financial transfers increased over time, with growing focus on grandchildren. No significant gender differences in providing were identified; however, women's contributions increased in frequency and amount, compared to previous cohorts of women. Men's contributions remained relatively stable over time. Parents in higher social classes were more inclined to provide financial support than parents in lower classes; this difference grew over time. Additionally, parents in higher social classes more frequently provided higher amounts than their counterparts. In conclusion, this study underscores changing gender and social-class patterns in financial contributions made by parents to their children and grandchildren in contemporary Sweden. Understanding these levels and subgroup differences is crucial for shaping policies and mitigating the potential growth of socio-economic inequality in future generations. © The Author(s), 2025.

OBJECTIVES: Loneliness arises from a discrepancy between the relationships one desires and those one experiences. This study examines the relative importance of relationship quantity and quality for loneliness in older adults.

METHOD: The study was a cross-sectional, representative survey of 474 adults aged 77 and above living in Dalarna, Sweden. Loneliness was measured using the three-item UCLA Loneliness Scale. Four ordinal logistic regression models of loneliness were developed: one for quantity of relationships and three for quality of relationships (closeness; conflict; closeness and conflict combined). Perceived social support was included in the quality models.

RESULTS: The quality models explained the most variance in loneliness and had better model fit. Having a partner was associated with less loneliness, even when there was conflict. Having a close relationship with children was associated with less loneliness, but a lack of closeness or the presence of conflict was associated with more loneliness. Perceived social support was associated with less loneliness.

CONCLUSION: Quantity and quality of relationships are both associated with loneliness in older adults, but relationship quality appears to have greater importance. Specific types of relationships are also relevant, highlighting the need to consider relationship dynamics when designing interventions to reduce loneliness.

Loneliness is unequally experienced among older populations, reflecting structural inequalities across multiple life domains. However, research on loneliness in later life has disproportionately focused on individual characteristics (e.g., physical health, mental health, personality traits), often overlooking structural inequalities in access to opportunities and resources—inequalities that are frequently linked to discrimination and social exclusion. This chapter aims to enhance understanding of the interrelation between loneliness and social exclusion by applying a multidimensional framework that connects exclusion in various life domains to loneliness in later life. Specifically, we examine five key dimensions of old-age social exclusion: economic, social, service-related, community/spatial, and civic exclusion. We analyse empirical evidence demonstrating how exclusionary processes at the individual, community, and societal levels contribute to loneliness, highlighting that loneliness is not merely a personal experience, but a broader issue shaped by multidimensional and societal mechanisms. By framing social exclusion as both a theoretical lens and a practical tool, this chapter contributes to the growing field of integrated loneliness research. Our discussion underscores the need for multilevel interventions that address not only personal risk factors but also the structural determinants of loneliness in later life. © The Author(s) 2025.

BACKGROUND: Informal caregiving is a crucial-albeit often invisible-part of the support system that enables older people with chronic diseases, disability, or age-related conditions to live in the community. However, providing informal care can affect caregivers' lives.

AIMS: To explore 1) the level of care intensity among older caregivers, 2) the relationship between the intensity of caregiving and the negative experiences reported by caregivers, and 3) the variations in unmet support needs depending on the intensity of caregiving.

METHODS: Between May and September 2023, we conducted a national representative survey to map informal caregivers in Sweden. A total of 25,776 older adults aged ⩾65 years were sampled. Marginal probabilities were calculated to obtain results adjusted for age, sex, and level of education.

RESULTS: A total of 15,129 people aged ⩾65 years responded to the survey (58.7%), of which 2157 were informal caregivers (14.3%). During a typical week, 68.6% of caregivers provided 1-10 h of informal care, 14.6% provided 11-29 h, and 16.8% provided at least 30 h of care. Women (63.1%) and caregivers aged ⩾75 years (64.1%) were overrepresented in the group providing high-intensity informal care. A higher intensity of care was related to reporting more negative experiences and worse health, as well as to experiencing more unmet support needs.

CONCLUSIONS: While most older informal caregivers reported low-intensity engagement and overall good satisfaction with their situation, a non-negligible fraction provides high-intensity help and has unmet needs that should be addressed by targeted interventions rather than one-size-fits-all policies.

Purpose

The aim of this study was to investigate the effect of time-assistive products in supporting persons with mild to moderate dementia to achieve their time-related activity goals given their time processing ability.

Materials and methods

A multicentre single-blinded randomised controlled intervention study. A total of 73 persons with mild to moderate dementia aged ≥60 years were recruited through memory clinics across Sweden, of which 57 completed the three-month follow-up (intervention group n = 26, waiting list control group n = 31). The intervention group received individually prescribed time-assistive products. The primary outcome measure was the Canadian Occupational Performance Measure (COPM). Comparative analyses were done of the differences in COPM ratings at baseline and after three months within and between groups. KaTid-Senior was used to measure time processing ability.

Results

After three months, COPM ratings, adjusted for time processing ability, had significantly improved in the intervention group regarding satisfaction with performance (p = .028, 𝜂2p = 0.09) but not for performance (p = .053, 𝜂2p = 0.07). The change from the ratings at baseline to the ratings at 3 months was clinically significant in the intervention group as their improvement exceeded 2 points on a 10-point scale both for performance (mean 2.8, CI 1.8–3.7) and satisfaction with performance (mean 3.4, CI 2.3–4.6).

Conclusion

Prescription of time-assistive products can support persons with mild to moderate dementia in their daily time management in relation to individual time-related goals. However, given the weak evidence base, further research is needed on the effectiveness of time-based assistive products for persons with dementia.

Implications for rehabilitation 

• Knowledge of how to remediate problems with daily time management in dementia is limited and there is a lack of randomised controlled trials on this subject.
• This study found that time-assistive products can support time-related activities for older adults with mild to moderate dementia.
• While time processing ability decreased over the study period, satisfaction with the performance of time-related activities increased in persons who received a time-assistive product compared to the control group.
• This study contributes to the knowledge on evidence-based time-related interventions for persons with dementia.

Loneliness refers to the negatively perceived mismatch between one’s desired and actual engagement in social relations. Besides the individual suffering it implies, epidemiological evidence has suggested that loneliness is a critical determinant of mental health in late life. In this chapter, we provide definitions, operationalisations, prevalence estimates, and risk factors of loneliness in older people. Further, we summarise epidemiological evidence on the association between loneliness and depression, anxiety, suicide, and cognitive disorders and cover their potential underlying mechanisms. Despite an existing link between loneliness and mental health disorders, more evidence is needed to disentangle causality, bidirectionality and underlying mechanisms. Last, we discuss intervention strategies to reduce loneliness in older adults, focusing on their individual goals, challenges, and potential future development, as well as on the importance of inclusive communities and neighbourhoods. Interventions to facilitate social interactions and improve one’s social cognition seem promising yet challenging to implement and assess. Addressing loneliness remains a critical task to promote health in an ageing society.