Senior centres have been identified as a “focal point” for delivering services to the rapidly growing older adult populations in Canada and the United States. Despite this important role, academic research studying senior centres has been limited. This scoping review identified English-language empirical research studies focusing on senior centres that were published in an academic journal in 2000 or later. A total of 58 studies were identified (n = 51 American and n = 7 Canadian). The majority of the articles focused on themes related to the participation of individuals at senior centres; a smaller number focused on themes related to the senior centre environment. Based on the findings, it is suggested that future research focus on benefits of senior centre programming, with specific focus on needs of baby boomers; key factors related to funding, space, and staffing; and the characteristics and role of senior centres in the Canadian context.

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne’s interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

Older people are more affected by fear of crime and the possibility of victimization, despite their being at lower risk of harm, than any other population group in Canada. Crime, victimization, and fear are not experienced uniformly among older Canadian citizens and residents, partly because older people do not form a homogeneous group. Being part of an ethnic, religious, or sexual minority, or being mentally frail, can have an impact on an individual’s perceptions and experience of risk. This analysis explores older people’s victimization and fear of crime, while it highlights the lack of consistency in the available data.

This study examines the baseline characteristics and changes in health status and cost of use of health services associated with use of publicly funded home support services. The analysis includes 122 people 75 years of age or more who were eligible for home support services. Over a 6-month period, one third of the sample used home support services for more than 1hr/week; these seniors had higher rates of depression and cognitive impairment, lower levels of physical and emotional functioning, and less effective coping styles than those who used fewer services. Cognitive impairment explained 17 per cent of the variation in use of home support services. At 6 months, use of home support services for more than 1hr/week by seniors with higher levels of need was associated with lower cost of use of health services and lower levels of improvement in health status. These findings suggest the need for further research to identify efficacious ways of providing home support services to this population to enhance their health status using available resources.

Heart failure (HF) is common among long-term care (LTC) residents, and may account for 40 per cent of acute-care transfers. Canadian Cardiovascular Society HF guidelines endorse standard therapies; yet LTC residents are less likely to receive treatment. This qualitative study employed focus groups to explore perceptions, from 18 physicians and nurse practitioners in three Ontario homes, on HF care practices and challenges. For example, participants reported challenges with HF diagnostic skills and procedural knowledge. They also identified the need for interprofessional collaboration and role clarification to improve HF care and outcomes. To address these challenges, multimodal interventions and bedside teaching are required. Leadership was viewed as essential to improve HF care. Several concerns arose regarding knowledge gaps and clinical deficits among primary-care providers who manage heart failure in LTC residents. Multimodal, clinically focused educational and interprofessional solutions are needed to improve HF care in long-term care.

Agitation in older persons is a major problem for the agitated individual and those around him/her. French-language measures of agitation with demonstrated validity and reliability are necessary for research and interventions in the French-speaking community. The goal of this study is to verify the reliability and validity of the “Inventaire d'agitation de Cohen-Mansfield” (IACM), a French version of the Cohen-Mansfield Agitation Inventory. The IACM measures the frequency of 29 agitated behaviours during a two-week period. Ninety-nine residents of a long-term care facility participated in this study. Results demonstrate the inter-rater reliability (r = .72), test-retest reliability (r = .72), internal consistency (Cronbach's alpha from .75 to .77), concurrent validity (r = .74) and construct validity (all r are significant, p < .05) of the IACM.

The aim of the present study was to examine the effect of stressors and other factors on psychotropic drug consumption among the elderly, with an emphasis on individual rather than social factors. Respondents were recipients of a home care program that focusses on personal care rather than health-related care. Data were derived from two in-home interviews (one week apart) of 99 users of psychotropic drugs residing in a socially deprived suburb of a major Canadian city. The initial path-analytic model explained a significant amount (19%) of variance in the amount of drug use. Age, sex, attitudes towards psychotropic drug use, and life events were the predictors which remained in our trimmed model of drug use which explained 17 per cent of the variance. The results suggest that younger individuals reported greater drug use than older respondents. Positive attitudes towards psychotropics and being female were associated with the highest level of drug use. Path analysis did not support our hypothesis of a stress-related mental health model of drug use and, instead, raised important questions regarding social factors. Several explanations for the results are discussed. Suggestions for future study and clinical implications are offered.

We explored contextual features shaping end-of-life (EOL) care in residential care facilities by drawing on the perspectives of 11 resident care aides (RCAs) in one Western Canadian urban centre. RCAs characterized EOL care as “providing comfort”, including physical and emotional comfort. Concerns with time and workload challenges dominated accounts and generated guilt, sadness, and frustration. RCAs tried to “find the time” by taking it from themselves or other residents, and by relying on the commitment of co-workers and on families. Findings emphasize the importance of the RCA role (particularly in emotional comfort), yet call for attention to interpretations of what is involved in this work, and to definitions of scopes of practice and training requirements. Findings reiterate the importance, among Canadian RCAs, of appropriate workloads to facilitate quality EOL care, and raise concerns about how time constraints shape EOL care practice and the meanings infusing this practice.

Benzodiazepines are widely prescribed for anxiety, although use of this class of medications has been associated with dependency and cognitive changes. This article describes the study in which we investigated the relationship between the class of benzodiazepine available for use and associated performance on neuropsychological tests in a community sample of 1,754 older Canadians from the Canadian Study of Health and Aging. Benzodiazepines were classified as short-, intermediate-, and long-acting. Associations were calculated between each class of benzodiazepine and eight neuropsychological measures, using multiple regression analysis and controlling for demographic variables. Results showed different effects of the co-variates across the three drug classes, and short half-life benzodiazepines were not associated with any neuropsychological measure. Intermediate half-life and long half-life benzodiazepine use were each associated with two measures. Increased focus on specific domains of cognitive function is needed to improve our understanding of how benzodiazepine use influences cognition.

This article reviews developments in the field of elder abuse and neglect since the publication of Elder Abuse and Neglect in Canada (1991). The arguments made here are twofold: first, we have no idea of the size and nature of the problem of abuse and neglect in the community or in institutions; second, we do not know how to solve these problems or their attendant issues that have been masked by rhetoric and the recycling of information for the past 20 years. It is time to move forward from the “awareness phase”. What we must tackle in the future is as obvious now as 20 years ago. Our knowledge is incomplete (i.e., our glass remains half full) because we lack the type of investigations we most urgently need: prevalence studies in the community and institutions, serious theory development, and random clinical trials to test our interventions both socially and legally.

Data from the Ontario Longitudinal Study of Aging were analyzed to examine the associations of the independent variables income, income change, education, smoking and perceived health with the dependent variable mortality during a ten year follow-up beginning in 1969. The analyses investigate the associations of the independent variables with deaths, with other causes of attrition and with all causes of attrition. The results indicate that smoking is the strongest predictor of mortality, and income is the strongest socioeconomic predictor. The analyses also show that perceived health measured prior to the mortality follow-up masks the association between the independent variables and mortality. Since the exclusion of the perceived health variable did not appreciably reduce the fit of the models, it was omitted from further analyses. The distributions of mortality for the various independent variables differed appreciably between models using deaths and all causes, but the bivariate and multivariate associations between variables were relatively unaffected by the alternative methods of operationalizing the dependent variable.

This paper investigates socio-demographic, family structure and other factors that predict men's filial care involvement. The concepts guiding this investigation are related to family obligations or motivations to provide care — commitment to care, legitimate excuses, and caring by default. Data for this research come the Work and Eldercare Research Group of CARNET: The Canadian Aging Research Network. This work is based on a sample of 772 men who provide assistance to older parents or parents-in-law. Overall, findings demonstrate the value of the conceptual framework for explaining variations in men's care. For example, distance constraints and the commitment of young children, appear to be legitimate reasons for less care involvement. Further, living nearby and being without siblings may “default” men into being more involved in care. This research recognizes men's filial care as a more complex issue than a ‘gender difference’ focus on caregiving has allowed.

The objectives of this three-phased investigation were to (1) characterize existing recreational programming opportunities for tenants residing in assisted living (AL) and (2) gather perceptions on factors influencing activity program planning and delivery. Using an integrated knowledge translation framework during a one-year collaboration, we targeted 51 publicly funded AL sites from two health authorities in British Columbia. We conducted an activity calendar review, staff survey, and interactive symposia to identify factors that enabled or restricted recreational programming. From the information obtained, we determined that all AL sites delivered recreational programming. Although exercise and physical activity opportunities were perceived as having high importance, most activities were social. Staff reported confidence in delivering this type of programming and believed it met the holistic needs of tenants, including their mental well-being, and fostered a sense of community. Future avenues for increasing physical activity of AL tenants should address individual, site, and organizational characteristics.

This article discusses the First Nations sample of a larger study on dementia care decisions and knowledge sharing. The purpose is to enhance understanding of the process of knowledge sharing among health care practitioners (HCPs), care partners, and persons with dementia (PWDs) within a rural First Nations community. A constructivist grounded theory methodology was used. Nineteen interviews were conducted at three points in time with two dementia care networks that included two PWDs, three care partners, and two HCPs. A sharing dementia care knowledge model was conceived, with the PWDs and their care partners at the centre. Knowledge sharing in the model was represented by three broad themes: (1) developing trusting relationships, (2) accessing and adapting the information, and (3) applying the information. Culturally sensitive approaches were essential to developing trusting relationships. Once developed, knowledge sharing through accessing, adapting, and applying the information was possible.

Competency of witnesses depends upon the accuracy of their memory and their credibility. This paper addresses both of these factors with respect to the elderly. First, a review of the accuracy of the elderly eyewitness in recall and identification of a criminal suspect relative to that of young adults is presented. Secondly, the results of a study testing the perceptions of the legal community and the general public toward the elderly witness are given. And thirdly, the attitudes of the elderly toward police officers, trial judges, crown attorneys, and defense lawyers are discussed. Young adults were found to be seven to 20 per cent more accurate on the average than elderly subjects in recall for crime-related events and in the identification of a suspect. However, results also showed that some elderly subjects are equally as accurate as young adults in the visual identification of a suspect. Police officers, lawyers, probation officers, the general public, and elderly subjects rated the elderly witness relatively high in understandability, activity, potency, and evaluation. These judgements suggest that the credibility of the elderly witness is favorable. Finally, the study showed that elderly subjects perceive trial judges, prosecutors, and defense lawyers positively, and they are particularly supportive of the police.

This article explores how dementia care is provided to First Nations communities in southwestern Ontario. Data were collected through in-depth interviews with health care providers and analysed using a constructivist grounded-theory methodology. Two interrelated frameworks for understanding dementia care were identified: a care delivery framework and a knowledge framework. The care delivery framework identified care goals, care elements being provided, care barriers, and strategies and solutions to deliver care and overcome barriers. The knowledge framework defined four groups of knowledge stakeholders: persons with dementia, informal care providers, formal care providers, and the First Nations community. It identified the knowledge each stakeholder held or needed and processes of sharing – or failing to share – knowledge in dementia care. Several barriers, many created by a lack of knowledge, negatively impacted dementia care. However, health care professionals had effective strategies for providing care, designed to overcome barriers and which encompassed elements of knowledge sharing.

A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000–April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.

This research investigated the prevalence of depression among the elderly Chinese in Canada. The respondents totalled 96 randomly selected elderly Chinese living in Calgary. A 15-item Chinese version of the Geriatric Depression Scale was used as the depression measure. Results show that among the respondents, 9.4 per cent were mildly depressed and 11.5 per cent were moderately to severely depressed. The overall prevalence rate of depression in the elderly Chinese is higher than that of the general elderly population in Canada, but lower than that of the elderly Chinese in the United States. Findings from regression analysis show that having more illnesses, having lived in Canada longer, not knowing English, being younger in age, and having poor physical health are the significant predictors of depression in the elderly Chinese. The results indicate the mental health needs of this group of ethnic elderly. Other research and practice implications of the findings are also discussed in the paper.

The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8 occupational therapists or physiotherapists. Three types of barriers were found: caregiver-related, patient-related and systems-related. Four themes for facilitating pain management were identified: (a) caregivers knowing the patient, (b) family support, (c) caregivers demonstrating understanding and compassion, and (d) teamwork by caregivers. Formal caregivers practising in long-term care institutions encounter a multitude of barriers that hinder the adequate assessment and treatment of pain, such as caregiver beliefs and knowledge and cognitive impairment in patients. Innovative strategies and strong political will are needed to overcome them.

Structured interviews were conducted with forty-eight older clients discharged from a public health nursing service in order to: (1) describe their social support network and (2) identify specific components of social support related to physical, social and emotional health. The sample was comprised primarily of older widows living alone to whom family and relatives contributed the largest amount of support. Correlation analyses revealed that: (1) age, emotional support given by older persons to their supporters and aid given and received by older persons were related to physical functioning; (2) emotional, decisional and aid support given by older persons to their supports (total reciprocity) and femaleness were related to emotional functioning and; (3) emotional and aid support received by older persons and reciprocity were related to social functioning.