Social Support For Older People Research Articles

Ageism and the digital divide in Switzerland during COVID-19: Lessons for the post-pandemic world

The COVID-19 pandemic erupted in early 2020. The Swiss Federal Council implemented a semi-lockdown in March 2020, asking people, particularly older adults, to stay at home to limit the transmission of the disease and to use digital tools to maintain their social relations and activities. This study inquired how older adults confronting precarity experienced these restrictions, how digital tools functioned in this context, and what learning could therefore be imbibed for the post-pandemic era. We conducted semi-structured telephone interviews with adults aged between 66 and 90 years living in a rural and mountainous Swiss region. The obtained data were subsequently thematically analyzed. The results revealed that the respondents experienced ageism during the semi-lockdown and reported limited or non-existent opportunities to use digital tools to maintain online social contact. This predicament increased their sense of loneliness and amplified their feelings of rejection by the outside world. These observations elucidate the need for the enhancement of non-ageist social support for older people, including individuals with limited social and material resources. We advocate the adoption of innovative initiatives in the post-pandemic era to better include precarious older people in our localities and neighborhoods.

Role of family factors in provision and perception of social support for older people in Iran: a cross-sectional survey

BackgroundIran has experienced a very fast fertility transition. The process of demographic transition, coupled with modernization, has had considerable consequences for the structure and function of families. There is rising concern in Iran about a potential decline in family care and support for older people as a result of these changes. The main aim of this study was to provide a benchmark by examining current associations between family factors and older people’s social support, both perceived and received.MethodsA cross-sectional survey of a random sample of 644 people aged 60 + years resident in Tehran was conducted using stratified cluster random sampling method in 2015. Outcome variables were perceived social support, as measured by Social Provision Scale, and received instrumental social support. Multilevel mixed-effects models were used to examine the hypotheses.ResultsThe analyses showed that most of the family factors measured, including family size (p = 0.01), living arrangements (p = 0.05), and amount of contact with family members (p = 0.001) were associated with older people’s receipt of instrumental social support. Living arrangements and quality of relationships with family members were associated with older people’s perceptions of social support (p < 0.001). Also, a significant gender interaction was found in associations between family size and SPS (p = 0.03). Having a large size family was positively associated with higher SPS for women (Coef. = 3.9, p = 0.009) but not for men (Coef. = -0.4, p = 0.7).Conclusionfindings of this study support the premise that most of family factors play an important role in provision and perception of social support for Iranian older people. Further policies should mostly be selective of those at higher risk of low support such as widowed, childless, those living alone, having poor relationship with their relatives and those with worse health status. The results of this study may be utilized to target older populations who are at higher risk of low support with innovative programs that focus on building social networks and enhancing social support.

Validating the Korean Version of the Duke Social Support Index

Considering the increasing number of older people and one-person households of older people in South Korea as well as the importance of social support among older people, there is a need to develop an instrument that assesses both the structural and functional social support of older people. Accordingly, this is the first study to validate the Korean version of the 10-item Duke Social Support Index (DSSI-10), which is composed of the social interaction and satisfaction with social support subscales. A total of 293 respondents who were over 65 years old and attended welfare centers located in the surrounding area of Seoul participated in this study. We found that the Korean version of the DSSI is a reliable and valid social support instrument that exhibits a two-factor structure like its English version. The DSSI also has the advantage of being able to measure structural and functional social support simultaneously. Developing the Korean version of the DSSI will provide a valuable social support instrument for researchers and practitioners in South Korea, where social support scales measuring both types of social support for older people do not yet exist.

The effects of a mindfulness-based programme on quality of life and social support in older people

Abstract The importance of mindfulness in promoting mental health and well-being has been increasingly recognised in recent years. As a result, mindfulness-based interventions have been introduced to improve various aspects of life, including quality of life and social support. The aim of this study was to examine the effectiveness of a seven-week mindfulness-based workshop programme in improving quality of life and social support among participants in the intervention compared to a control group. A total of 257 participants (65+) were recruited and assigned to either the intervention group, which participated in the seven-week mindfulness-based workshop programme, or the control group, which received no intervention. The workshop programme combined two evidence-based programmes: The Chronic Disease Self-Management Programme (CDSMP) and the Mindfulness-based Living Programme. Participants completed two questionnaires (EQ-5D-5L and OSSS-3) to assess quality of life and social support before and after the intervention. Data were analysed using appropriate statistical tests to compare pre- and post-intervention outcomes between groups. The intervention group showed significant improvement in quality of life (p&amp;lt;.001) and social support scores (p = 0.002) after the seven-week mindfulness-based workshop programme. The control group, on the other hand, showed no significant changes in these measures. The significant improvement indicates the effectiveness of the mindfulness-based workshop programme. The results of this study show the positive effects of a seven-week mindfulness-based workshop programme on the quality of life and social support of older people. The results suggest that mindfulness-based interventions can be an effective tool for improving mental health and well-being by promoting quality of life and strengthening social support networks. Key messages • The seven-week mindfulness-based workshop programme improves the quality of life and social support of older people, which can have an impact on overall mental health and well-being in general. • The results of this study can ensure a sustainable impact on achieving better health outcomes and saving resources in the health care system through reduced and more effective use of services.

Factors associated with adaptation level in the older adult residential care facilities: a path analysis.

It has become very common for older adults to relocate to residential care facilities. Yet whether older adults adapt to life in a long-term care residential facility through perception, reflection, and conscious behavioral choices is a challenging social issue. Previous research has shown that adaptation is influenced by physical, mental, psychological, social systems, and other debris factors. However, existing knowledge is often based on unidirectional relationships between these factors and adaptation. Few studies have formally examined bivariate relationships between these factors, and the influence of adaptation between these factors internally remains unclear. Therefore, there is a need to examine the structural causality of adaptation in residential care facilities influenced by a combination of physical, emotional, social and psychological factors, life satisfaction, and social support. The present cross-sectional study recruited older adults from three residential care facilities in Henan province, China, through convenience sampling. The Chinese Nursing Home Adjustment Scale (NHAS), Geriatric Depression Scale-15 (GDS-15) and Social Support Scale (SSRS), Satisfaction with Life Scale (SWLS), and Barthel Index were employed to measure the older adult' adjustment level, depression level, social support, satisfaction with life, and self-care ability of the BMC, respectively. The relationships between depression, social support, self-care, satisfaction with life, and adaptation were analyzed and a structural equation model was developed. A total of 210 participants completed the questionnaire. The model demonstrated an acceptable fit of the data. The results showed that the difference between life satisfaction and depression on the level of adaptation was 60 and 23%, respectively. Social support and life satisfaction had a positive direct effect on the level of adaptation, both showing a positive correlation with the level of adaptation. Depression, on the other hand, have a direct effect on the level of adaptation and showed a negative correlation with the level of adaptation. Self-care ability indirectly influenced adaptation mediated by social support. Social support has a positive impact on both life satisfaction and depression, which in turn promotes adaptation. As a major source of social support, family members and nursing home staff in residential care facilities can enhance social support for older people through improved interaction, which can have a meaningful and positive impact on levels of adjustment. The model demonstrates the strengthening and weakening of social support, self-care, life satisfaction, and depression levels, which can help inform the development of relevant care health strategies for older people to promote levels of adjustment and improve quality of life.

Anxiety, Depression, Loneliness, Spirituality, and Social Support in Older People During the COVID-19 Pandemic

The COVID-19 pandemic has resulted in the threat of death. Some older people feel they are not ready to face the end of their lives, so psychosocial problems arise, such as loneliness, anxiety, and depression. This research study aims to explore some psychosocial aspects, namely spirituality, social support, depression, anxiety, and loneliness in the elderly during the pandemic. The research design was cross-sectional. The total sample was 142 people selected using the purposive sampling method. Data collection used various scales to look at spirituality, depression, anxiety, and loneliness. The results showed that median spirituality and social support scores were high. The median depression and loneliness scores were mild. The average anxiety score for the elderly was normal. Based on the Pearson and Spearman correlation tests, relationships were shown between spirituality and anxiety scores, social support and anxiety scores, anxiety and depression scores, and loneliness and depression scores. The elderly need spirituality and social support when facing the end of life, and during the COVID-19 pandemic, to prevent the emergence of psychosocial problems. Social support and high spirituality must be maintained, even though the pandemic has subsided, in case such a health crisis occurs again. Abstrak Kecemasan, Depresi, Kesepian, Spiritualitas, dan Dukungan Sosial pada Lansia Saat Pandemi COVID-19. Pandemi COVID-19 mengancam banyak jiwa. Sebagian dari lansia merasa belum siap menghadapi akhir kehidupan seperti kematian sehingga muncul masalah psikososial seperti kesepian, cemas, dan depresi. Penelitian ini bertujuan untuk mengetahui aspek psikososial lansia yaitu spiritualitas, dukungan sosial, depresi, kecemasan, dan kesepian selama pandemi COVID-19. Desain penelitian yang digunakan adalah cross-sectional. Jumlah sampel sebanyak 142 orang yang dipilih dengan metode purposive sampling. Pengumpulan data menggunakan berbagai kuisioner untuk melihat spiritualitas, depresi, kecemasan, dan kesepian. Hasil penelitian menunjukkan bahwa median skor spiritualitas dan dukungan sosial termasuk tinggi. Nilai median depresi dan kesepian tergolong ringan. Rata-rata skor kecemasan lansia adalah normal. Berdasarkan uji korelasi Pearson dan Spearman, ditunjukkan hubungan antara skor spiritualitas dan kecemasan, skor dukungan sosial dan kecemasan, skor kecemasan dan depresi, serta skor kesepian dan depresi. Lansia membutuhkan spiritualitas dan dukungan sosial dalam menghadapi akhir kehidupan maupun saat pandemi COVID-19 untuk mencegah munculnya masalah psikososial. Dukungan sosial dan spiritualitas yang tinggi harus tetap dijaga, walaupun pandemi COVID-19 sudah mereda, agar mampu bertahan jika krisis kesehatan muncul kembali. Kata Kunci: depresi, dukungan sosial, kecemasan, kesepian, spiritualitas

Urban-Rural Differences: The Impact of Social Support on the Use of Multiple Healthcare Services for Older People.

BackgroundThere are many kinds of chronic diseases, high incidence and high hospitalization rate in older people caused by population aging. The increasing demand for healthcare services has become an increasingly prominent problem in Chinese society. The purpose of this paper is to explore the influence of social support on multiple healthcare services for older people and the urban-rural differences among them.MethodsThe data are from our field survey in Shaanxi province in 2019. Using the Anderson model as the basic explanatory framework, this paper uses the Tobit-model to analyses the impact of social support for older people on the utilization of therapeutic healthcare services, and the Logit-model to analyze the impact of living arrangements and social support on the utilization of preventive healthcare services for older people.ResultsThis paper examines the impact of formal and informal support on outpatient, inpatient, and preventive healthcare services for older people, provides an in-depth analysis of the differences in the impact of social support on healthcare service utilization between urban and rural older people and analyses the contribution of various factors to the impact. The coefficient effect is divided into two parts: the coefficient “premium” of urban older people relative to urban and rural older people as a whole, which accounts for 10.8% of the total difference; and the “premium” of urban and rural older people as a whole to rural older people, which accounts for 18.9% of the total difference. The coefficient effect accounts for 29.7 per cent of the total difference.ConclusionsRural older people place greater importance on the quantity of formal social support, while urban older people place greater importance on the quality of formal social support. The phenomenon of raising children for old age was evident in the use of healthcare services by rural older people, while the phenomenon of distant relatives being better than close neighbors was evident in the use of healthcare services by urban older people. Free preventive healthcare services in rural China have largely compensated for the lack of health benefits for rural older people.

Nurses’ empowerment and technology use: Literature Review and Research Agenda

Older adults are a very heterogeneous group with different preferences, needs, and lifestyles. Most older people prefer to stay at home in old age. This is also advocated by policymakers and healthcare providers as it results in lower costs to society compared to institutionalization. Digital technologies such as eHealth can cost-effectively contribute to active aging. To use technology in the care of older adults, we need empowered caregivers who can also educate older adults on the proper use of technology as a tool to maintain health. We used the method of scientific literature review. Articles were selected based on the following criteria: Accessibility, scientificity, relevance of content, and timeliness. After selection, the results were analyzed using qualitative content analysis. Content analysis of nine scholarly articles provided insight into how technology is used in caregiving, whether empowered caregivers use technology in caring for older adults, and whether older adults demonstrate some level of autonomy and compliance in their use of technology. We found that technology makes an important contribution to self-management of illness, medication adherence, and contact with older adults with chronic conditions who require constant monitoring. We believe that technology will help improve care and social support for older people and make caregivers' jobs easier. This will be especially evident with the introduction of robotic technology, both in providing social support to older adults and in making it easier for caregivers to lift patients.

Intergenerational Ambivalence, Loneliness, and Well-Being Among Older Adults in the United States

Intergenerational relationships are important sources of informal social support for older people to maintain their emotional well-being. Previous research has extensively investigated the relationship between intergenerational support and older adult’s psychological well-being. However, the existing research has not adequately examined intergenerational ambivalence – mixed or contradictory feelings toward a family member in another generation or explored the mechanism that links intergenerational ambivalence and psychological well-being. Further, most studies are cross-sectional, which prevents us from establishing causality. This study utilized data from 2006, 2008, 2010, 2012, 2014, and 2016 waves of Health and Retirement Study (HRS), a national representative sample of U.S. adults aged 50 and more (N= 8,017). Structural equation models were used to examine the longitudinal relationship between intergenerational ambivalence, loneliness, depression, and life satisfaction. The final model indicated very good fit (χ2 = 113.31, p < .0001, CFI = 0.97, RMSEA = .05). The results revealed that ambivalence in older parent-adult child relationships predicted higher subsequent loneliness (β = 0.21, p < .0001), which in turn predicted depressive symptoms (β = 0.25, p <.0001) and life satisfaction (β = -0.30, p < .0001). The results demonstrated that loneliness mediated the relationship between intergenerational ambivalence and depression, and life satisfaction. Multiple group analysis was performed to test whether the study relationships varied by gender. Gender differences were found. Findings have implications for prevention and intervention initiatives targeting improving relationships between parents and children, thereby protecting against mental problems.

A Latent Class Analysis of Health-Related Quality of Life in Korean Older Adults

The present study aimed to confirm latent classes in health-related quality of life (HRQOL) in older adults and investigate the characteristics of participants in each class. It aimed to provide basic data to develop interventions for each quality-of-life class by analysing the predictors of each class. Secondary data from a community health survey in G province since 2019 found a total of 41,872 participants. Of them, 9027 were 65 years or older and residing in G Province in 2019, participated in this study. Mplus 8.5 was used to conduct a latent class analysis of five domains of HRQOL. Four latent classes in the HRQOL of older adults, namely, stable type, physical disability type, emotional disability type, and crisis type were found. Certain variables predicted these classes. Based on the findings of the present study, training on functional mobility and balance to prevent falls in older populations and individualised programmes to promote mental health in them should be provided. Moreover, policies should increase medical accessibility and provide social support for older people with low-incomes. Additionally, since physical, psychological, and social health in older adults are inter-connected, a comprehensive care plan is needed to improve their HRQOL.

Alzheimer’s Disease and its Risk Factors: A Case-control Study

Objectives: The etiology of Alzheimer’s disease is supposed to involve environmental exposure and genetic vulnerability. The present study aimed to assess the association between Alzheimer’s disease and its risk factors. Methods: We conducted a case-control study of 95 Alzheimer’s disease patients and 98 matched controls. All participants (case and control groups) were examined by mini-mental state examination. This information was collected by a risk factor questionnaire from January to June 2019. Data were analyzed using logistic regression analysis via SPSS-22 software. Results: The findings revealed the effect of risk factors' odds ratios on the occurrence of Alzheimer’s disease by logistic regression analysis. Sex (female), chronic disease, loneliness or being single, and family history showed positive associations with AD, whereas daily physical exercise, religious beliefs, high level of social communication, and male sex had negative associations with AD development (P &lt; 0.05). Conclusions: The study highlighted the difficulty of etiology and recommended that the effective interventions for social support of older people, psychological condition, chronic disease, and lifestyle may be promising preventive policies.

Factors associated with perceived social support in older people with cancer

OBJECTIVE: To analyze factors associated with perceived social support in older people with cancer. METHODOLOGY: This is a cross-sectional, analytical study conducted with a convenience sample of 134 older people seen at a specialist cancer treatment unit in a hospital located in a municipal district in the South of Minas Gerais state, Brazil. Data collection was conducted by interview and analysis of medical records. Social support was analyzed using the Medical Outcomes Study social support scale. The Mann-Whitney and Kruskal-Wallis tests were used to analyze differences between means. Linear regression was used for analysis of associations. RESULTS: The majority of the sample of older people with cancer analyzed were male, aged from 60 to 74 years, and reported high mean scores for material support; affective support; positive social interaction; and emotional/informational support. Factors with positive associations with social support were: not living alone; income one to three times the minimum wage; having a partner; rating health as good/very good; and presence of comorbidity. Factors with negative associations were: poor/very poor perceived income and polypharmacy use. CONCLUSIONS: This sample of older people reported high mean scores for material support; affective support; positive social interaction; and emotional/informational support. Factors associated with perceived social support were: living arrangements; family income; perceived sufficiency of income; marital status; health self-assessment; comorbidity; and polypharmacy.

Living alone and mortality among older people in V\xe4sterbotten County in Sweden: a survey and register-based longitudinal study

BackgroundLiving alone is increasingly common and has been depicted as an important cause of mortality. We examined the association between living alone and mortality risks among older men and women in northern Sweden, by linking two unique longitudinal datasets.MethodsWe used the Linnaeus database, which links several population registers on socioeconomic and health. This register-based study included 22,226 men and 23,390 women aged 50 and 60 years in Västerbotten County who had participated in the Västerbotten Intervention Program (VIP) during 1990–2006, with a total of 445,823 person-years of observation. We conducted Cox-proportional hazard regression to assess the risk of living alone on the mortality that was observed between 1990 and 2015, controlling for socio-demographic factors, chronic disease risk factors and access to social capital.ResultsOlder men and women who lived alone with no children at home were at a significantly higher risk of death compared to married/cohabiting couples with children at home (with an adjusted hazard ratio of 1.38, 95% CI of 1.26–1.50 in men and 1.27, 95% CI of 1.13–1.42 in women). Living alone was an even stronger factor than the well-established chronic disease risk factors and a lack of access to social capital.ConclusionsA significant association between living alone and mortality among the older adult population in Sweden was observed. Providing good social support for older people is important in preventing the negative health impact of living alone.

Long-term care needs assessments: French and Russian experience

Social support of older people is given a very great attention. In many countries, older people receive long-term care at home. The long-term care (LTC) is actively developed worldwide over the past 20 years. LTC improves the life quality of older people and people with disabilities. Such system includes medical and social services. Currently, in many OECD countries, from a half to three quarters of older people receive long-term care at home. France is one of those countries in which the social support of older people is given a very great attention. In Russia, long-term care is a task of family. Our country is taking first steps in creation of a long-term care system. It is important to take into account the experience of countries that already have specialized social services for older people with loss of autonomy. A new and important element of the LTC system will be a special scale for determining the level of need for long-term care. Such scale helps to differentiate the needs of each elderly person or person with a disability. This paper analyses the methods of determining the level of need for long-term care, used in France and in Russia and describes the advantages and disadvantages of these methods.

COVID-19 in Rural Nigeria: Diminishing Social Support for Older People in Nigeria.

Social support provided by family, friends and neighbors has been essential for the survival and wellbeing of older people in Nigeria. However, the reduced social contact between older people and their social network because of the social distancing recommendations and other non-pharmaceutical approaches to protect them from COVID-19 may threaten their social support. Our study investigated the impact of the COVID-19 pandemic on rural older people in Nigeria using qualitative data collected from 11 older adults residing in rural Nigeria through in-depth interviews. The collected data was translated and transcribed, coded using Nvivo12 and analyzed thematically. Findings show that the COVID-19 pandemic has led to a reduction in both material support in the forms of food and money, and intangible support in the forms of assistance, communication and care, due to limited social contact. Furthermore, the economic consequence of the pandemic may have severe implications for the health and wellbeing of older people. Social workers should therefore advocate the distribution of food and care supplies to rural older people to cushion the economic impact of diminishing social support, and also creatively help them maintain social connectedness.

Exploring the perceptions of people with dementia about the social robot PARO in a hospital setting.

New technology, such as social robots, opens up new opportunities in hospital settings. PARO, a robotic pet seal, was designed to provide emotional and social support for older people with dementia. We applied video-ethnographic methods, including conversational interviews and observations with video recording among 10 patient participants while they were using the robot. We also conducted semi-structured individual interviews and focus groups with nursing staff to gain contextual information. Patient and family partners were actively involved in the study as co-researchers. This study reports our findings on the perceptions of 10 patients with dementia about their experiences with PARO in a hospital setting. Thematic analysis yielded three substantive themes: (a) ‘it’s like a buddy’ – the robot helps people with dementia uphold a sense of self in the world, (b) ‘it’s a conversation piece’ – the baby seal facilitates social connection and (c) ‘it makes me happy’ – PARO transforms and humanizes the clinical setting. Our findings help provide a better understanding of the perspectives of patients with dementia on the use of social robots.

EXPLORING THE PERCEPTION OF PATIENTS WITH DEMENTIA ABOUT A SOCIAL ROBOT PARO IN A HOSPITAL SETTING

PARO, a robotic pet, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perception of persons with dementia about the role of PARO in a hospital setting. Video-ethnographic methods were applied. Patient and family partners were involved in the fieldwork of data collection and analysis. We conducted conversational interviews with ten patients with dementia staying in a geriatric unit and video observations. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”, the robot helps persons with dementia to uphold a sense of self in the world, (b) “it’s a conversation piece”, the baby seal facilitates social connection, and (c) “it’s all about love”, PARO transforms and humanizes the clinical setting. Our findings contribute to providing a better understanding of the direct perspectives of patients with dementia on the use of the social robot.

IT’S MY BUDDY: EXPLORING THE PERCEPTIONS OF PEOPLE WITH DEMENTIA ABOUT THE SOCIAL ROBOT PARO IN A HOSPITAL SETTING

New technology such as social robots opens up new opportunities in hospital settings. PARO, a robotic pet seal, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perceptions of persons with dementia about PARO’s role in a hospital setting. Video-ethnographic methods were applied. We had conversational interviews with and video observations of 10 older people with dementia in the geriatric unit of a large Canadian hospital. Also, semi-structured interviews and two focus groups were conducted with 10 staff members in the local unit to gain contextual information. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”—the robot helps people with dementia uphold a sense of self in the world; (b) “it’s a conversation piece”—the baby seal facilitates social connection; and (c) “it’s all about love”—PARO transforms and humanizes the clinical setting. Our findings help provide a better understanding of the direct perspectives of patients with dementia on the use of social robots. Instead of substituting human contact, the social robot complements emotional care and supports our fundamental human need for love.

Adaptation and validation of the Instrumental Expressive Social Support Scale in Portuguese older individuals.

Objective to adapt and validate the Instrumental Expressive Social Support Scale (IESS) in a sample of older people.Method methodological study. The sample of 964 community-dwelling older people was randomly divided into two groups. The first group was used as a calibration sample to study the number of factors underlying social support through Principal Axis Factoring, and the second group as a validation sample to test the “best fit” model through Confirmatory Factor Analysis.Results exploratory Factor Analysis suggested a three-factor solution, which was confirmed by Confirmatory Factor Analysis. The factors were similar to those in the pre-existing dimensions of the original instrument and were named as Sense of control (α = 0.900), Financial support (α = 0.802), Familiar and socio-affective support (α = 0.778). Confirmatory Factor Analysis showed acceptable fit. The model’s goodness-of-fit indexes were satisfactory (χ2/df = 5.418; CFI = 0.903; NFI = 0.884; RMSEA = 0.098). The convergent validity was supported by associations between social support and medication adherence and positive affect. The discriminant validity was evidenced by association with negative affect. The reliability analysis showed high values of internal consistency.Conclusion the instrument proved to be a valid measure for the assessment of social support in older people.

‘The own’ and ‘the wise’ as social support for older people living with HIV in the United Kingdom

AbstractAs the HIV population ages, how the ageing and HIV experiences intersect to shape the lives of older people living with HIV (PLWH) becomes an increasingly pressing question. This multi-method study investigated social support, mental health and quality of life among 100 older PLWH in the United Kingdom. Drawing on data from three focus groups and 74 life-history interviews with older (aged 50+) White men who have sex with men (MSM), and Black African and White heterosexual men and women, living with HIV, we explore participants’ distinctions between, evaluations of and access to sources of social support. Participants distinguished between support from the HIV-negative (Goffman's ‘the own’) and experientially based support from other PLWH (Goffman's ‘the wise’), and viewed the former, while valuable, as needing to be supplemented by the latter. Furthermore, access to experientially based support varied across participant groups, whose communities had different histories with HIV/AIDS and thus different degrees of knowledge about HIV and avenues for connecting to other PLWH. Thus, social support among older PLWH cannot be neatly divided into ‘formal’ and ‘informal’ domains, or fully appreciated by applying traditional social support measures, including, in the context of health conditions, ‘peer support’ created through formal service organisations. Rather, older PLWH's own distinctions and evaluations better illuminate the complexities of social support in the context of ageing with HIV.