This article uses findings from qualitative interviews to examine the experiences of members of Saskatoon’s Chinese-Canadian older-adult community in terms of their realities of aging and access to important geriatric resources. Promoting an understanding of both group experience and a broader conceptualization of age-friendly development, we argue that the notion and implications of a spatial ethnic enclave are replaced in the Saskatoon context by a social enclave. This network of social support is evident in Chinese-Canadian older adults’ access to housing, recreation, transportation, and health services. The article concludes with lessons learned that would help enhance culturally pluralistic age-friendly development. This work underlines the significance of social capital development within more marginalized older-adult communities, both as a reaction to outside discrimination, and as a means of ensuring healthy and inclusive community aging.

Increasing expenditures for prescription drugs have placed seniors in the spotlight of health reforms because they are the main users of prescription drugs. Substantial improvements could be made in the utilization of prescription drugs that would enhance the benefits of therapy, and minimize adverse effects, particularly for seniors. A variety of problems have been documented, including the over- and under-use of drug therapy, prescribing errors, treatment compliance, and cost-ineffective prescribing. Health care system policies, selected physician and hospital-based pharmacist interventions, and decision-aids and compliance aids have been shown to be effective for components of the problem. Integration of key policies and interventions into a comprehensive solution for optimal drug use is needed. This will include: (1) revision of policies guiding the relationship between the drug industry and health sector, (2) regulations requiring adequate drug testing in seniors for drug approval, (3) a Consumer Health Institute to provide a central objective resource for patient information and decision support systems, (4) integrated clinical information systems to support prescribing, dispensing and drug and disease management systems for pharmacists and primary care physicians, and (5) reforms in medical training and licensure.

Despite the increasing complexity of nursing home care, the role of physicians caring for residents is largely unexplored. This international, exploratory study sought to learn about physicians’ roles, responsibilities, and tasks as well as investigate the unique qualities of medical practice in nursing homes. We conducted interviews with 18 physicians, who reported making important contributions to the quality of resident care, including clarifying the goals of care, working to reduce unnecessary medication and hospitalization, as well as contributing to staff education. Nursing home practice involved physicians in networks of relations that were instrumental to the quality of medical care and physicians’ job satisfaction. The importance of these relationships disrupts the oft-drawn boundary between the medical and the social, suggesting that good medical practice depends on good social practice. Reflecting the exploratory nature of the study, we recommend research to better understand and support the relational dimensions of nursing home medicine.

The aim of this study was to explore policies and procedures to support employees who retire from the emergency services. Interviews were conducted with participants who were familiar with existing policies and procedures in a large ambulance (n = 8) and fire (n = 6) service in Ireland. Four key themes were identified: (1) “I don’t think it’s a job at 65 to be running out on an emergency ambulance”; (2) “They do genuinely feel a wee bit isolated”; (3) improving the “cultural shock”; and (4) “I just keep going and hope for the best”. Findings point towards retirement as a major life change and highlight a need for more structured, effective pre-retirement preparation. Factors unique to emergency service personnel include the physical and emotional stress involved in emergency service; a strong identification with the service; and a lack of clarity about rules and entitlements, requiring better information and preparation.

The current study investigates the specific role of three executive functions in the explanation of performance variability on laboratory and naturalistic time-based prospective memory tasks in aging. Ninety people aged 18 to 80 years performed three executive tasks assessing inhibition, flexibility and updating, one laboratory time-based task and one naturalistic time-based task. The results indicate that age has a negative impact on the laboratory time-based task and a positive impact on the naturalistic task. The mediation analysis shows that inhibition and flexibility operate as a mediator in the negative relationship between age and the laboratory time-based task. Additionally, the hierarchical regression analyses show that, after controlling for age, none of the executive functions evaluated is predictive of performance of the naturalistic time-based task. Overall, these results seem to suggest that different cognitive processes underlie the performance on naturalistic and on laboratory time-based tasks. Future studies should confirm these results.

To document the reactions and experiences of older persons during the COVID-19 pandemic, we have conducted a qualitative study of 25 older adults (50 years of age and older) throughout the pandemic, using serial interviewing methods. This analysis reports on the data collected from the first two rounds of interviews – one conducted in the summer of 2020 and one conducted in the fall of 2020. Our thematic analysis found eight major themes: thoughts on the dangers of the pandemic, how the virus has changed daily life (including social life), health care during COVID (being a caregiver, losing a loved one, seeking health care), missing spontaneity and dealing with existential dread, the growing frustration, seeking connection through civic participation, adaptation and resilience, and the social ills that the pandemic has revealed. These stories describe both loneliness and connection, hope coupled with disappointment, but overwhelmingly, an insight into what the pandemic has shown us about the social ills that it has revealed.

In 2011, in the Interlake region of Manitoba, a human-made flood displaced 17 First Nation communities whose peoples have deep ancestral ties to their land. The human-made flood and forced displacement created devastating effects such as premature death, worsening chronic illnesses, depression, and loneliness. In 2015, a First Nations Elders gathering was held in Winnipeg to discuss ways to heal from the human-made flood with more than 200 attendees. A qualitative approach within a participatory framework was used to document Elders’ perspectives. Twenty-three Elders participated in video-recorded, semi-structured interviews in Ojibway and English. Small group discussions were documented and transcripts were transcribed verbatim. Elders’ recommendations towards reconciliation with minoayawin (well-being) were shared via a healing booklet and website. Elders shared their insights about their peoples’ and communities’ need to heal and offered these strategies to move forward: forgive, stand united, promote self-determination, reclaim cultural identity, and connect with the land.

Frailty puts individuals at increased risk for poor health outcomes. Elderly individuals use a disproportionate amount of emergency department (ED) resources. To investigate the relationship between frailty markers and the effect on ED use by community-dwelling seniors, we conducted a secondary analysis of a 22-month prospective randomized control trial in Montreal, Canada, using the Service Intégrés pour les Personnes Âgées en Perte d’Autonomie (SIPA) database. We assessed a sample of 565 individuals using five frailty markers: physical activity, strength, cognition, energy, and mobility. Univariate and multivariable logistic regression was performed to assess for potential relationship between frailty markers and ED visits. The findings revealed that 70 per cent of the participants had at least three frailty markers. No relationship was found between frailty markers and ED visits. These results suggest that in severely functionally disabled, community-dwelling elderly, the presence of frailty markers does not appear to predict ED visits.

In the field of social gerontology, some evidence exists to support Cowgill's theory that modernization leads to a decline in the status of the old. However, all of the evidence to date consists of objective indices of status such as education or income. The study reported here uses the factorial survey approach to directly measure the perceived status of various ages, and of both males and females. The results indicate that there is in fact an inverted U-curve of status across the life span, and that the perceived status of females is lower than that of males in the midlife period.

There were a few minor variations in the status ratings due to sex, age, and the type of question asked. Females rated middle aged males slightly higher in status that did males, and older respondents rated the very young and the very old higher than did younger respondents. The most significant factor affecting the status ratings was age, but since the oldest respondent was only 35, this study must be replicated with older samples.

We hypothesized that changes over time in cognitive performance are associated with changes in driver perceptions, attitudes, and self-regulatory behaviors among older adults. Healthy older adults (n = 928) underwent cognitive assessments at baseline with two subsequent annual follow-ups, and completed scales regarding their perceptions, attitudes, and driving behaviours. Multivariate analysis showed small but statistically significant relationships between the cognitive tests and self-report measures, with the largest magnitudes between scores on the Trails B cognitive task (seconds), perceptions of driving abilities (β = –0.32), and situational driving avoidance (β = 0.55) (p < 0.05). Cognitive slowing and executive dysfunction appear to be associated with modestly lower perceived driving abilities and more avoidance of driving situations over time in this exploratory analysis.

Self-care disability is difficulty with or dependence on others to perform activities of daily living, such as eating and dressing. Disablement is worsening self-care disability measured over time. The disablement process model (DPM) is often used to conceptualize gerontology research on self-care disability and disablement; however, no summary of variables that align with person-level DPM constructs exists. This review summarizes the results of 88 studies to identify the nature and role of variables associated with disability and disablement in older adults according to the person-level constructs (e.g., demographic characteristics, chronic pathologies) in the DPM. It also examines the evidence for cross-sectional applications of the DPM and identifies common limitations in extant literature to address in future research. Researchers can apply these results to guide theory-driven disability and disablement research using routinely collected health data from older adults.

To date, associations between psychosocial driving variables and behaviour have been examined only cross-sectionally. Using three waves of data collected annually from 928 older drivers (mean age = 76.21 years; 62% male) enrolled in the Candrive II cohort, we examined in this study whether changes in attitudes and perceptions towards driving (decisional balance and day and night driving comfort) were associated with changes in older adults’ reported restrictions in driving practices and perceived driving abilities. Multi-level models revealed that older adults who showed an increase in negative attitudes towards driving over time were more likely to report more-restricted practices (greater avoidance of challenging driving situations) and perceived declines in driving abilities compared to individuals whose attitudes towards driving remained stable across two years. This work supports previous findings and offers a new understanding of how attitudes relate to driving perceptions (e.g., comfort) and self-regulation in older adults over time.

Long-term care is a growing component of health care spending but how much is spent or who bears the cost is uncertain, and the measures vary depending on the source used. We drew on regularly published series and ad hoc publications to compile preferred estimates of the share of long-term care spending in total health care spending, the private share of long-term care spending, and the share of residential care within long-term care. For each series, we compared estimates obtainable from published sources (CIHI [Canadian Institute for Health Information] and OECD [Organization for Economic Cooperation and Development]) with our preferred estimates. We conclude that using published series without adjustment would lead to spurious conclusions on the level and evolution of spending on long-term care in Canada as well as on the distribution of costs between private and public funders and between residential and home care.

Given the urgency of finding cost-effective and innovative solutions to providing community services for aging in place, novel solutions that take advantage of existing infrastructure are clearly needed. In this sequential mixed-method study, we chose to explore the role that nursing homes could play in offering services to a non-traditional target population, namely seniors with loss of independence living in the community. Forty-two (n = 42) nursing homes in the province of New Brunswick completed an online survey, and 10 agreed to participate in face-to-face interviews. Results show that 100 per cent of participants agreed that nursing homes could offer services to seniors in their communities for aging in place. Results suggest that nursing homes are cost-effective, innovative solutions for aging in place.

Quality of life and well-being of older patients in chronic care facilities is often determined by their relationships with nurses. The authors developed and tested a scale to assess patients’ views of what matters most when relating to nurses. Based on the humanistic nursing theory by Paterson and Zderad (1988), 69 items were created and tested with a sample of 40 patients, resulting in refinement of a scale with 24 items. This scale was factor analysed on responses from 249 patients residing in five facilities in Ontario, Canada. The Humanistic Relationship Importance Scale demonstrated strong internal consistency, stability, and reliability with a five-factor solution (α = .87). Construct validity was supported through factual identification. This scale is a valid measure of patients’ perspectives of a nurse-patient relationship in chronic care and can be used to measure health professionals’ relationships with their older patients and evaluate interventions to enhance relational care.

Drawing from life course theory, this article examines gender differences in formal assistance among functionally dependent Dutch older persons within five distinct marital history groups – first-married, never-married, divorced (not remarried), widowed (not remarried) and the remarried. Hierarchical logistic regression analyses are performed for each of the marital history groups to test hypotheses regarding the interrelationships among gender and three sets of variables: 1) measures of age and functional health; 2) measures of socio-economic status; and 3) measures of the social network. The results indicate gendered patterns of formal help use among the first-married, never-married and widowed. Consistent with other studies, older first-married women are approximately three times more likely to receive formal help than are men, a difference that remains robust after statistically controlling for other factors, including frailty of spouse. However, we also find that never-married women are about one-third as likely to use formal help than are never-married men, which may be reflective of different preferences regarding formal service use. Among the widowed, we find that men with poorer functional health are more likely to receive formal help than are their female counterparts, suggesting contrasting patterns of help-seeking behaviour and social vulnerability. Additional differences are observed among the marital history groups in terms of the other independent variables, which are also interpreted from a life course perspective.

Computer-based, cognitive training procedures aim to increase safety by improving skills related to driving, such as speed-of-processing and the Useful Field of View. The current study assessed the effectiveness of DriveSharp in training older drivers in a naturalistic class setting. Participants (n = 24) attended 10 hours of DriveSharp classes over 5 weeks. Pre- and post-testing sessions assessed improvements on a dynamic hazard perception test, Trails A and Trails B. A control group (n = 18) completed only pre- and post-testing sessions. In-class training times were lower than expected. Participants’ improvement in the games leveled off after the first assessment and the DriveSharp group did not demonstrate a significant improvement in performance compared to the control group. Among several usability issues, the most problematic were misunderstanding task goals and the difference between training and evaluation. There are several implications for those using DriveSharp to enhance older drivers’ safety.

Contractile, histochemical and biochemical properties of the triceps surae were compared in 13 aerobically trained male subjects aged 63 to 76 years. Electrical stimulation of the triceps surae was used to determine muscle twitch, tetanic, and fatigue parameters. From these tests, twitch tension (Pt), time to peak tension (TPT), half relaxation time (RT), tetanic tensions at 10(Po10), 20(Po20), and 50(Po50) Hz and a fatigue index (FI) were calculated. Muscle samples from the belly of the lateral head of the gastrocnemius were obtained using the needle biopsy technique. A portion of each sample was tested histochemically for myosin ATPase (pH 4.30, 4.58 and 10.00) and NADH-tetrazolium reductase in order to classify fibre types (ST, FTa, FTb) and to determine fibre areas. The remainder of each sample was analysed for succinic dehydrogenase (SDH) and phosphofructokinase (PFK) enzyme activities. Significant correlations were found between fibre areas (both ST and FT) and Po10/Po50 and FI. No significant relationships were noted between Pt, 1/2RT and MVC and any histochemical parameter. SDH and PFK activities did not correlate significantly with any histochemical or physiological parameter. Regular endurance exercise apparently does not retard the decline in contractile properties seen with the aging process. Substrate related regulatory enzyme activities (PFK) and marker enzyme activities (SDH) from skeletal muscle of the elderly are much lower than activities found in younger subjects, despite regular aerobic exercise.