We examined the volunteer service contribution of older adults (N = 100) to volunteer role development and agency attachment. Informed by a developmental regulation framework and socio-emotional selectivity theory, we tested a twofold hypothesis for the premise that greater role development and agency attachment would be experienced by (1) older adults who had multiple goals for volunteering, and (2) older adults who pursued these goals by making greater use of their social resources relative to their physical and cognitive resources. Both hypotheses were supported. Older adults who have numerous motives for volunteering, and who maximize the use of their social skills and prosocial attitudes, are more strongly attached to their host agency and experience higher levels of volunteer role development. Implications for the field of volunteerism are discussed.

This study draws on the life histories of heterosexual childless individuals who have never married, to explore the more subtle ways that age norms affect the subjective experience of singlehood. Specifically, it examines whether or not it is appropriate to speak of transitions in the experience of singlehood. The data clearly reveal the experience of a transition to singlehood. This transition is represented by a change in self-attributed status that occurs over time and is associated with a cultural timetable for marriage. It marks the experience of “becoming single” that occurs when an individual identifies more with singlehood than with marriage. Moreover, I explore the ways in which singlehood is a gendered experience. The results from this study affirm the applicability of life course theory to the lives of single persons and serve to broaden the definition of the concept “transition” to include those not obviously marked by normative events.

A palliative approach to care aims to meet the needs of patients and caregivers throughout a chronic disease trajectory and can be delivered by non-palliative specialists. There is an important gap in understanding the perspectives and experiences of primary care providers on an integrated palliative approach in dementia care and the impact of existing programs and models to this end. To address these, we undertook a scoping review. We searched five databases; and used descriptive numerical summary and narrative synthesizing approaches for data analysis. We found that: (1) difficulty with prognostication and a lack of interdisciplinary and intersectoral collaboration are obstacles to using a palliative approach in primary care; and (2) a palliative approach results in statistically and clinically significant impacts on community-dwelling individuals, specifically those with later stages of dementia. There is a need for high-quality research studies examining the integrated palliative approach models and initiation of these models sooner in the care trajectory for persons living with mild and moderate stages of dementia in the community.

The flow of time can be conceptualized either as a cycle or an arrow. We offer a combined view: a helix. Chronological age (geophysical time reference) is not necessarily identical to biological age (internal time reference), and aging does not necessarily imply senescence. A new scheme of senescence, based on homeodynamics (nonlinear mechanics and nonequilibrium thermodynamics), is introduced as a plausible physical basis for understanding senescence. We propose that energy throughput, initially constructive of forms and functions, becomes destructive once most of the available degrees of freedom have been “frozen out” by the construction. Senescence becomes manifested at that point.

This pilot study examined changes in physical activity and function among older adults moving from community dwellings to retirement living. Twelve community-dwelling older adults, recruited from the wait-lists of two retirement living facilities, were assessed prior to and following the transition to retirement living. Physical activity was assessed using an Actigraph (GT3X+) activity monitor; physical activity by type was reported with the CHAMPS activity questionnaire. Physical function was assessed using the Senior Fitness Test. Objectively monitored total physical activity decreased after the transition to retirement living (p = 0.02). Reports of physical activity by type indicated that only activities of daily living decreased (p < 0.01) although intentional exercise increased (p < 0.03) with the transition. Endurance and strength also improved (p < 0.05 and p < 0.04). Pilot results indicate that possible physical benefits accrue from retirement living, although efforts to reduce sedentary time are needed.

Population aging has become a subject of widespread popular and academic interest. In providing an assessment of the extent of aging that is in prospect, this paper makes available a number of projections of the age-sex distribution of the Canadian population for the 45-year period 1996 to 2041 and comparisons with the previous 45-year period. The projections combine assumptions relating to fertility, mortality, and migration so as to produce future populations characterized as “medium,” “old,” “young,” “high immigration” and “low immigration”. Supplementary calculations include growth rates, for both the total population and selected age groups, and various types of dependency ratios, including ones with a range of age-differentiated weights. It is concluded that substantial aging of the Canadian population appears virtually certain but, based on the demographic evidence, the “dependency burden” is likely to remain below the peak levels attained during the baby boom.

In 1988 the Alberta government introduced a new resident classification system to measure the nursing care requirements of long-term care facility residents, and to provide case-mix information for a new funding system. This article describes the conceptual and methodological development of the system. Specific steps in the development process were to (1) define key care domains reflecting the major types of assistance required by long-term care residents; (2) identify indicators of care requirements within each care domain; (3) develop criteria for determining which items to include in the final version of the Resident Classification Form; (4) develop decision rules for combining scores on individual items in order to group residents into categories; and (5) test the psychometric properties of the classification system. The classification system has seven categories ordered from low to high in terms of nursing care requirements and a measure of nursing resource use.

To better understand and improve the rehabilitation process of older adults with sensory losses in both hearing and vision or dual sensory impairment (DSI), this study explored the perspectives of health care professionals who work with this population. Thirteen individuals, with varied professional backgrounds, were interviewed about their experiences in working with older adults with DSI. We transcribed and coded the interviews, then conducted content analysis. Regardless of their professional backgrounds, the participants reported additional roles that they perceived they fulfilled: (a) counsellor, (b) navigator, and (c) trainer and re-trainer. These roles involved helping individuals with DSI, and their family, with depression, acceptance, repeat consultations, and way-finding through the health system. From the professionals’ perspective, these additional roles increase workload and place them in situations they were not trained for. They suggest education for all professionals and for family members working with people with DSI; moreover, they suggest a multidisciplinary team rehabilitation approach.

This study investigated the complex mechanisms underlying team-based delivery of person- and family-centred care (PFCC) in geriatric home care. Using a realist synthesis approach, an evaluative framework was developed and populated with 159 references from scoping the literature, consulting Canadian experts in PFCC, purposive searching in PubMed/MEDLINE® and Cumulative Index to Nursing and Allied Health Literature (CINAHL), and reviewing grey literature within Canada. References were selected using a two-person review and/or consensus approach and quality appraisal. Data were extracted and synthesized using context, mechanism, and outcome configurations into a theoretical framework of team-based PFCC in geriatric home care. The framework details the predominant discipline-specific contributions of nurses, occupational therapists, and physiotherapists, their collective contributions through communication in the context of a virtual team, and the system-level support required for comprehensive team-based PFCC delivery. Findings from this study could inform improvements to PFCC education, best practice guidelines, and more integrated delivery of PFCC in geriatric home care and other team-based care environments.

We identified quality indicators (QIs) for care during transitions of older persons (≥ 65 years of age). Through systematic literature review, we catalogued QIs related to older persons’ transitions in care among continuing care settings and between continuing care and acute care settings and back. Through two Delphi survey rounds, experts ranked relevance, feasibility, and scientific soundness of QIs. A steering committee reviewed QIs for their feasible capture in Canadian administrative databases. Our search yielded 326 QIs from 53 sources. A final set of 38 feasible indicators to measure in current practice was included. The highest proportions of indicators were for the emergency department (47%) and the Institute of Medicine (IOM) quality domain of effectiveness (39.5%). Most feasible indicators were outcome indicators. Our work highlights a lack of standardized transition QI development in practice, and the limitations of current free-text documentation systems in capturing relevant and consistent data.

Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: “Culture of Neglect” and “Vigil by the Bedside”. The core category “Normalization of Neglect” was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

Despite Canada’s increasing population of seniors and the varying long-term care (LTC) strategies that provinces have implemented, little research has focused on understanding the extent to which publicly funded residential LTC bed supply varies across provinces, or the factors influencing this variation. Our study involved an analysis in which we examined the association of three select jurisdictional characteristics with LTC bed supply: population age demographics, provincial wealth, and provincial investments in home care. No significant cross-jurisdictional “ecology” or inter-relatedness was found between the variation in LTC bed supply and any of the examined variables. Interprovincial variation in bed supply also did not statistically influence alternate level of care days specific to LTC waits, suggesting that these days were not influenced simply by differences in LTC bed supply and that other provincial-level factors were in play.

The aim of this study was to develop a case-finding tool enabling the identification of residential care facilities that provide inadequate care to impaired older persons and assess its validity. This was done using data from a recent study that involved 88 homes for the aged located in the Eastern Townships of Quebec. For that study, facility managers were interviewed for information about themselves and their residence, while quality of care was assessed with the QUALCAEE Scale for each of 301 residents of the selected homes. Multivariate regression analyses helped develop a short questionnaire that can be completed during a telephone interview with the facility manager. With 85 per cent sensitivity and 65 per cent specificity in identifying homes delivering inadequate care, this case-finding questionnaire is simple, inexpensive and shows good evidence of validity.

Western societies are experiencing a dramatic growth in the population aged 75 and older. Changes in family composition raise questions about who will care for those who need assistance. We compared population projections to the year 2030 of those families aged 75 and older in Canada and France. Over the next 25 years, the pool of potential family carers, (i.e., spouses and children), will broaden from the effect of the baby boom and increased proportion of women with spouses. The populations most dependent on formal care, with no potential support from a child or a spouse, will increase more sharply in Canada (123%) than in France (34%) but at a slower rate than the total population. Policy and programs in both countries will need to prepare for a greater number of elderly spouses providing care and in Canada, at least, a significant increase in the number that will need to rely on formal services.

This article discusses a longitudinal study of caregivers (n = 195) from a representative sample of caregivers pf Spanish, ADL-disabled persons, aged 65 and over carried out to assess the role of social support and religiosity in the development of depression. Depressive symptomatology was assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. One year later, 119 of the caregivers were contacted again. Stability of depression over 1 year was observed in most participants. Poor physical health and low self-esteem, as well as incontinence in the care recipients, were significant predictors of the development of depressive symptoms. Social support had a differential effect on the development of depression, depending on how much assistance with activities of daily living the caregivers had to provide. Religiosity seemed to have no effect. Depression in caregivers is related more to their health and psychosocial resources than to the amount of care they provide. Poor health status, low self-esteem, and lack of emotional support may be useful indicators in identifying caregivers at high risk for depression.

Currently, 564,000 Canadians are living with dementia. This number will continue to rise as the population ages. Family physicians play an integral role in the diagnosis and management of dementia patients. Although studies have looked at family physician perspectives on dementia care in the urban setting, much less is known about challenges in rural areas. This study aimed to explore rural family physicians’ experiences in caring for patients with dementia in rural Alberta, Canada. We conducted three semi-structured focus groups with 16 family physicians to evaluate barriers and facilitators to providing care to persons with dementia in three rural communities. We developed focus group questions based on the theoretical domains framework (TDF) and analysed them using a framework approach. Physician capabilities, opportunities, and motivations appear to play important roles in caring for these patients. These research findings can be used to advance quality of care for rural dementia patients.

This study documented the provision of services and issues experienced by community organizations supporting older adults and caregivers in the province of Quebec during the coronavirus disease (COVID-19) pandemic, as well as promising strategies to adapt the provision of services in this context. A cross-sectional electronic survey using open- and closed-ended questions was conducted in July 2020. Almost three-quarters of the 307 respondents (71.4%) reported having maintained services at least partially throughout the lockdown, and the majority (85.3%) adapted their services. Among key challenges, participants reported difficulties identifying and supporting older adults at greater risk of vulnerability (54.8%), managing health risks for service users (60.2%), and recruiting volunteers (59.5%). Promising strategies included strategies to reach out to older adults and understand their needs (e.g., systematic phone calls) in addition to direct interventions supporting them (e.g., activities promoting social ties); implementing prevention and protection measures; accessing and using technologies; human resources management (e.g., recruiting new volunteers); finding financial support for their organization; developing intersectoral partnerships (e.g., multisectoral crisis cell); and promoting a positive view of older adults. The integration of multiple perspectives from different stakeholders may help identify strategies potentially transferable to other crises in order to meet older adults’ needs.

As part of its recruitment process, the Canadian Longitudinal Study on Aging (CLSA) will face the challenge of screening out individuals who are sufficiently impaired in their ability to provide informed consent. In the process of developing the design of the CLSA, a review of the literature was performed with the goal of identifying currently existing telephone cognitive screening tools that can be used to identify eligible study participants for population-based research on aging. We identified 12 telephone screening tools, four of which were based on the Mini-Mental State Exam (MMSE) and eight that were based on other face-to-face screening tools. Characteristics – including the constructs measured, the length of time for administration, the scoring/classification scheme, and any information regarding the validation of each tool – were extracted and summarized.