The goal of the Canadian Longitudinal Study on Aging (CLSA) is to recruit 50,000 participants aged 45 to 85 years of age and follow them for at least 20 years. The sampling and recruitment processes for a study of this scope and magnitude present important challenges. Statistics Canada was approached to collaborate with the CLSA with the goal of determining whether the Canadian Community Health Survey (CCHS) could be used as a recruitment vehicle for the CLSA. In this pilot study conducted in 2004, it was determined that 63.8 per cent and 75.8 per cent of the respondents agreed to share their contact information and their survey responses with the CLSA, respectively. The most commonly reported concerns were confidentiality/privacy issues, lack of interest, and commitment issues. This pilot study identified some challenges to the use of the CCHS as a recruitment vehicle for the CLSA.

The growing population of seniors with disabilities experiences unmet support needs and loneliness. Although support deficiencies can be overcome by peers in support groups, most support groups are inaccessible to older adults with limited physical functioning. Accordingly, this project aimed to develop and test the impact of an accessible telephone support group intervention for seniors with disabilities. Six research questions guided the study. Four telephone support groups with five to six participants (n = 23) were created, each with a professional and a peer (senior) leader. The groups met once a week for 12 weeks. Qualitative analyses of the telephone transcripts and post-intervention interviews of participants and leaders revealed decreased support needs, diminished loneliness, and enhanced coping. Selection, training, and support of peer and professional leaders and member control of discussions were important ingredients of successful support groups.

Canada’s nursing homes have become increasingly dependent on immigrant health care aides. More than any other ethnic group, Filipino women are over-represented among health care aides in the Canadian health care system. This qualitative study explored the employment experiences of Filipino health care aides in nursing homes from their own perspectives as well as those of policy stakeholders. Fourteen in-depth interviews were conducted with Filipino health care aides and long-term-care policy stakeholders in Winnipeg, Manitoba. The results indicated that migrant social networks act as pathways linking immigrant women with employment opportunities in nursing homes. The composition of the labour force is also shaped by management strategies and labour market accommodations that respond to, and reinforce, these social networks. These findings have implications for workforce planning and the quality of care provision in nursing homes.

This study explored whether working within Multispecialty INterprofessional Team (MINT) memory clinics has an impact on health care professionals’ perceptions of the challenges, attitudes, and level of collaboration associated with providing dementia care. Surveys were completed by MINT memory clinic members pre- and 6-months post-clinic launch. A total of 228 pre-and-post-training surveys were matched for analysis. After working in the MINT memory clinics for 6 months, there were significant reductions in mean ratings of the level of challenge associated with various aspects of dementia care, and significant increases in the frequency with which respondents experienced enthusiasm, inspiration, and pride in their work in dementia care and in ratings of the extent of collaboration for dementia care. This study provides some insights into the effect of collaborative, interprofessional approaches on health care professionals’ perceptions of the challenges and attitudes associated with providing dementia care and level of collaboration with other health professionals.

Des problèmes de santé, des attitudes corporelles, le degré d'estime de soi et la satisfaction de vivre ont fait l'objet d'une évaluation portant sur 53 femmes âgées vivant deux situations différentes. Outre le fait que les 25 résidentes d'un foyer de personnes âgées (moyenne d'âge de 79,8 ans) étaient plus âgées, elles ont signalé davantage de problèmes de santé ainsi qu'une perception plus négative de leur corps que les 28 femmes demeurant à domicile (moyenne d'âge de 68,9 ans). Les différences observées, concernant les attitudes vis-à-vis le corps et la satisfaction de vivre, sont à attribuer davantage aux nombreux problèmes de santé signalés par les résidents des foyers de vieillards qu'aux différences d'âges et de conditions de vie. Cependant, et de façon très significative, les résidents des foyers de personnes âgées étaient beaucoup moins satisfaits de leur condition physique (entre autre l'agilité, la force, la coordination) que ceux demeurant chez eux, même si l'on tient compte des correctifs apportés au chapitre de l'âge et des problèmes de santé. Les résultats montrent également que chez les femmes âgées, les attitudes vis-à-vis leur corps sont reliés à l'âge, à la santé et à la satisfaction de vivre. En outre, ces résultats sont analysés sous l'angle de la nécessité d'assurer aux résidents des centres d'accueil l'occasion de pouvoir participer à des activités physiques et à des exercices.

Social Models of aging deal with changes over the life course. Using a loose definition of model, this paper reviews models under the following classification: Allocation models; Construction of the Life Course models; Personality and Socialization models; and Negotiation models. Differences between and within these models are explored, with particular reference to the issue of determinism and the conceptualization of social structure. The life course perspective is recognized as hegemonic in contemporary theorizing about aging, but it is seen as itself embracing diverse models.

New approaches to residential continuing care for frail seniors include a shift toward more social care models that involve hiring multiskilled workers and expectations of family involvement as partners in care. Recall and stylized time-use methods were used to assess the types of tasks and amounts of service provided by family and staff caregivers in three models of care. Findings are that family members provide about 30 per cent of on-site services to residents. Family members spend most time in enhancing well-being, while staff spend most time in housework. Patterns of care differ across Adult Family Living, Assisted Living and Dementia Care settings. Sustainability of these patterns of care depends upon adequacy of staffing and reasonable expectations about family resources.

In the absence of a universally agreed-upon definition of successful aging, researchers increasingly look to older adults for layperson views of aging and definitions of successful aging. To use lay definitions in studies of aging, however, researchers must address the definitions’ consistency. In 2004, surviving members of the Manitoba Follow-up Study male cohort (mean age: 83 years) were asked twice for their definition of successful aging. A consistency category was assigned based on the similarity of themes in each of 654 pairs of definitions. At least half of the main themes were similar in 70 per cent of the definition pairs; 80 per cent of respondents repeated at least one theme. Positive or negative health events in the four-week interval between definitions and specific respondents’ characteristics did not vary across consistency categories. This evidence for consistency supports our continued reliance on lay definitions of successful aging.

This study sought to ascertain whether occupational noise-induced hearing loss (NIHL) increased the risk of falls requiring hospitalization among retired workers. The study population consisted of males (age ≥ 65) with an average occupational noise exposure of 30.6 years and whose mean bilateral hearing loss was 42.2 dB HL at 3, 4, and 6 kHz. Seventy-two retired workers admitted to hospitals after a fall were matched with 216 controls from the same industrial sectors. Conditional logistic regression models were used to estimate the risk (odds ratio; [OR]) of falls leading to hospitalization by NIHL categories. Results showed a relationship between severe NIHL (≥ 52.5 dB HL) and the occurrence of a fall (OR: 1.97, CI95%: 1.001–3.876). Reducing falls among seniors fosters the maintenance of their autonomy. There is a definite need to acquire knowledge about harmful effects of occupational noise to support the prevention of NIHL and ensure healthier workplaces.

The need for assistive technologies in Canada is increasing, but access is inconsistent and fragmented which can result in unmet needs. We aimed to identify citizens’ values and preferences for how to enhance equitable access to assistive technologies and to engage policymakers, stakeholders, and researchers in deliberations to spark action. In spring 2017, we convened three citizen panels and a stakeholder dialogue. Key panel findings were included in an evidence brief that informed dialogue participants. Thirty-seven citizens participated in panels and emphasized the need for access to reliable information, equitable access to assistive technologies regardless of ability to pay, and the need for collaboration. Twenty-two dialogue participants focused on the need for a guiding framework that supports fundamental change across the country. The proposed policy framework can enhance access to assistive technologies through enabling simplified policies and programs, along with fostering robust data collection and evaluation to support countrywide innovation and accountability.

This paper reports on a project aimed at creating support groups for caregivers of the frail elderly and assessing their impact on participants. The effect evaluation was based on a quasi-experimental design with repeated measures (n = 120). The results show that participation in support groups did not lower the caregivers' subjective burden, and indeed contributed to its increase. Conversely, such participation appears to have had a stabilizing effect on their level of depressive symptoms. Both these effects, reported at the end of the support group experience, persisted three months later. Various possible explanations of these contradictory results are discussed.

The physical and social environments are recognized as important therapeutic tools in the care of nursing home residents with dementia, yet little is known about the environments of rural nursing homes. This study was conducted in one rural health authority (16,000 km 2) in the province of Saskatchewan. Long-term institutional care was provided in seven small (15 to 35 beds), publicly funded nursing homes, none of which had separate dementia special care units (SCUs). The Physical Environmental Assessment Protocol (PEAP) was used to evaluate the facilities on nine key dimensions of dementia care environments. Facilities were most supportive in provision of privacy and least supportive on maximizing awareness and orientation. Focus groups were conducted with registered nurses, nursing aides, and activity workers. Staff caregivers identified six special needs of residents with dementia that were difficult to meet in the nursing homes, two of which were related to the physical environment (safety and a calm, quiet environment) and four of which were related to the social environment (meaningful activity and one-to-one contact, opportunity to use remaining abilities, flexible policy, and knowledgeable caregivers who enjoy working with persons with dementia). Staff suggested separate dementia SCUs as one approach to managing dementia care but also identified challenges in creating dementia units in small rural facilities. Results provide support for conceptual models of dementia care settings that emphasize the interaction of organizational, social, and physical factors.

The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be described; consequently, gaining insight from various stakeholders about safety issues relevant to the home care sector is necessary in order to inform strategic directions for future research. To begin to map a research agenda, a three-part environmental scan was conducted: (a) a pilot study with home care recipients and providers; (b) key informant interviews with researchers, health care providers, policy makers, and decision makers; and (c) a review of literature in three topic areas. Only the results of the key informant interviews are reported here.

To document the use of health services for psychological distress symptoms, we collected data from a cross-section of adults aged 65 years and over. Nearly 13 per cent met DSM-IV criteria for mood or anxiety disorders. In addition, 42.4 per cent of those having at least one DSM-IV diagnosis reported having used health services. Results show a direct association between the presence of a probable DSM-IV diagnosis and health service use. However, our results show no significant association between gender and health service use, and do not support the hypothesis that minimal social support increases the probability of older adults using health services for psychological distress. The analysis suggests unmarried elders are more likely than married elders to use health services. Furthermore, this study shows that older adults having a high level of daily hassles reported using health services for psychological distress than those reporting a low stress level. We conclude that a large proportion of elderly mental health needs in Quebec are potentially not being met.

The current study examines constructs that contribute to the well-being of an international sample of older married adults. A convenience sample of 208 participants was recruited through an Internet site as well as more traditional means such as newspaper advertisements and contact with community groups. The resulting structural equation model provides further support for the revised theory of cognitive adaptation. Within this model, the direct and indirect contributions of personality, marital satisfaction, and cognitive adaptation are examined in relation to well-being. Contrary to previous findings, personality appears to have an indirect effect upon both marital satisfaction and well-being. Cognitive adaptation, in contrast, has both a direct and indirect effect upon the well-being of older adults. Limitations of use of the Internet as a vehicle for data collection are considered as well as directions for future study.

Des approches humanistes sont essentielles pour explorer les principales politiques touchant la gérontologie et la gériatrie. Cet article décrit comment l'approche de « l'éthique publique, » c'est-à-dire l'examen des principales valeurs sous-tendant et orientant le procédé d'élaboration des politiques publiques, peut nous faire davantage comprendre les politiques ayant trait au vieillissement. Pour illustrer cette analyse, des exemples tirés d'une étude comparative entre le Canada et les États-Unis sont fournis. Parmi les éléments analysés, on trouve d'abord les principales valeurs sociales formant la toile de fond de cette étude, particulièrement l'opposition entre l'individualisme et le collectivisme. Ensuite, la définition et la résolution des problèmes reposent à la fois sur les faits et les valeurs. Elles impliquent une discussion sur les facteurs sociaux intervenant dans la « crise » du vieillissement, notamment la polarisation des gens en groupes d'âge et la rationalisation des ressources destinées aux soins de la santé. Finalement, la nature du débat public et du discours moral, en qualité de procédé guidant l'élaboration de politiques publiques, est étudiée, et les répercussions quant à l'importance des valeurs dans l'élaboration de nouvelles politiques à venir sont également considérées. Le procédé d'élaboration des politiques publiques, notamment la manière dont il relève les défis associés à une population vieillissante, en dit long sur la cohésion et l'intégrité sous-jacentes de notre société et sur le degré d'humanisme que l'on trouve au sein des principales politiques et institutions sociales.

This study examined the cost-effectiveness of a multifactorial falls prevention program and estimated the trade-off between the extra costs of such a program and the additional reduction of unintentional falls. Cost-effectiveness was evaluated using the traditional incremental cost-effectiveness ratio (ICER) and the net benefit regression framework (NBRF). Using the NBRF, decision making was formalized by incorporating values of willingness to pay (WTP) a priori. The results failed to provide evidence that a multifactorial falls prevention program was cost-effective. Participant adherence to recommendations ranged from low (41.3%), to moderate (21.1%), to high (37.6%). A future challenge is to understand more clearly the relationship between the community-dwelling older adult, potentially modifiable risks for falls, adherence to multifactorial risk factor recommendations, costs, and resulting effects of falls prevention practices. Future economic evaluations of falls prevention interventions remain necessary and should consider the NBRF so that regression tools can facilitate cost-effectiveness analysis.

New Brunswick is one of the provinces most affected by the aging of the population. Moreover, aging at home in Francophone minority communities is a major challenge in rural areas. The goal of this paper is to identify the main advantages and disadvantages of aging at home and to expose organizational strategies deployed by seniors and their families in order to promote aging in place. The case study is the method of analysis that we have recommended. Our methodology is based on content analysis of 13 semi-structured interviews with seniors and their children. The results show that family and community support, resourcefulness and resiliency, the practice of leisure activities as well as the living environment are among the principal means used by older adults to promote aging at home.

Because medication prescribing and use have become a normative aspect of health care for older adults, we seek to understand how individuals navigate prescribed-medication use within the context of aging. We reasoned that, for those who are ambulatory, medication use is likely influenced by ethnocultural meanings of health and experiences with alternative approaches to health care. Accordingly, we conducted a qualitative study, with in-depth interviews, on a diverse sample of older adults in order to identify elderly persons’ perceptions and uses of medicines. Our findings depict older adults as active agents – who draw on a lifetime of experience and knowledge – who take responsibility for adherence (or non-adherence) to medicines and their associated effects on their own bodies. We represent the older person as a “pharmaceutical person” whose experiences of aging are inextricably tied up with the negotiation of medicine-reliant health care.