Following Canadian estimates of frailty, academic researchers and the Chiefs of Ontario came together to create the first Ontario-wide profile of aging in First Nations people in Ontario. Using self-reported data from First Nations adults who participated in the Ontario First Nations Regional Health Survey Phase 2, we found that First Nations people in Ontario experience higher rates of frailty than the general Canadian population and early onset frailty appears to affect First Nations communities. This is important to consider as communities plan for health care needs of an aging population and is particularly relevant in the face of Covid-19, as we know severity is exacerbated by underlying health conditions.

Literature on food insecurity (FI) and aging is limited and scattered across disciplines, the reasons for which include the nascence of the study of “hunger” more generally, and relatively lower rates of FI among older people. This scoping review synthesized and characterized the current research to prompt a more critical examination of food insecurity and aging. Data extraction included reviewing and characterizing the empirical, methodological and conceptual contributions of each study, accessed from selected health sciences and social sciences databases. Thirty-eight studies were included from 2,041 titles. Different methods and operationalizations of FI and age were found to be used across studies. Thematic analysis revealed, with few exceptions, consistent tendencies towards the biomedicalization of the FI issue alongside aging. These findings reinforce the value of population-level monitoring of FI and uptake of standard measures. Moving forward, the issue of FI and aging is an opportune topic for critical social analysis.

La plupart des recherches sur les grands-parents ont utilisé une perspective micro-sociale, de type interactif et basée sur la notion de rôle. Comme complément à ce corps de recherche, cet article examine les aspects quantitatifs de la transition vers l'état de grand-mère, dans la perspective du cycle de vie. L'analyse est fondée sur des données rassemblées à partir d'un échantillonnage de 666 femmes, choisies au hasard et nées entre 1905 et 1920. L'enquête téléphonique a été réalisée en 1987–88, à Vancouver et à Victoria. Les résultats démontrent que les variables majeures associées à cette transition vers l'état de grand-mère sont le nombre d'enfants et le niveau d'éducation. Les variations concernant l'âge auquel ces femmes sont devenues grands-mères pour la première fois s'expliquent par l'âge au moment de la première naissance et aussi par une variable relative à l'histoire de vie au travail. La temporalité sociale joue un rôle, mais varie selon le statut de « grand-maternité ”. Les variations dans les préférences relatives au meilleur moment pour devenir grand-parent sont associées à l'âge où les femmes ont expérimenté l'état de grand-mère. Les résultats sont discutés à la lumière de ce qui est généralement admis selon la perspective du cycle de vie et des pistes concernant des recherches à venir sont explorées.

To address the issue of falls, which are increasing as the population ages, an intelligent video-monitoring system is being developed. The aim of the study is to explore caregivers’ perceptions of and receptiveness to a prototype of this fall detection system. A cross-sectional mixed-method study was carried out with individual interviews of 18 caregivers. Statistical frequencies and content analysis were conducted (SPSS and N’Vivo). The results show that most participants (n = 15/18) liked the intelligent video-monitoring system and were willing to use it. They would worry less if they could be alerted if a care recipient fell, but they were concerned about privacy and cost. Participants had a positive perception of the system and expressed their wishes regarding the kind of alert and the person to contact in case of a fall.

Applying an employment-income-based procedure for determining retirement, we analysed a large longitudinal data file of Canadian personal income tax returns for individuals to determine who has retired and to assess how successful they are in maintaining their incomes after retirement. The methodological approach may be of interest for possible application in other countries that have suitable data. Our main conclusions are as follows. First, in the two years immediately after retirement, the after-tax income replacement ratios average about two thirds when calculated across all ages of retirement. Second, the ratios tend to increase with the age of retirement. Third, the ratios increase with years in retirement, at least in the first few years. Finally, income replacement ratios are highest in the lowest income quartile and generally decline as income increases; within each quartile, the replacement ratios are higher for those who retired later than for those who retired earlier.

A successful aging (SA) index was captured in a longitudinal population-based cohort study of individuals aged 75 and older and examined longitudinally using growth mixture modelling (GMM) to identify groups with similar trajectories using decedents’ (n = 1,015) last completed interview and up to four previous data collection waves before death. GMM identified a three-class model. Classes were high-functioning, no decline (HN); high-functioning, gradual decline (HG); and low-functioning, steep decline (LS). HN class individuals were significantly younger at death (p < 0.001) and at last interview (p < 0.001), consisted of more men (p < 0.001), and more likely to be married (p < 0.001) compared to HG and LS class individuals. These results demonstrate the different ways in which individuals can experience successful aging at the end of life. This study provides the framework for future research into life-course processes of aging, with important implications for policy and practice.

This paper presents a typology of older parents caring for adult offspring with lifelong disabilities, as well as barriers to residential planning from the perspectives of older parents caring for adult offspring with lifelong disabilities. Project participants included 54 older parents and one grandparent (all aged 60+). Information was collected via focus groups in six provinces across Canada. Transcripts were analysed using different analytical procedures, including pattern identification, clustering of conceptual groupings, identification of relationships between variables, constant comparisons, and theoretical memos. Older parents' reluctance to engage in the planning of future living options was found to be multi-factorial and linked to the macro- and micro-systems within which these families were embedded.

Drawing on a qualitative study of families' experience with Alzheimer's disease, this paper examines family members' reaction to identity transformation or loss of self in the afflicted loved one, using a symbolic interactionist perspective. The findings show that family members find this aspect of the disease emotionally stressful. Refusing to let go of what remains of the loved one's former self, they employ a number of strategies in an effort to protect her/his social and self-identity. These strategies include concealing information, medicalizing inappropriate behaviour, fostering independence, managing appearance, and perceiving selectively.

This 2014 mapping exercise sought to identify and describe all bereavement support programs and services in the province of Alberta, and compare these to those available four years previously. Bereavement is a common life experience, especially among older persons, with support often needed to assist recovery. We sought program and service information through systematic searches and the snowball technique to identify providers and interview them. Although considerable (330%) growth, and more diversity in providers, programs, and services was evident, bereavement programs were no longer publicly funded. Instead, programs and services were now grassroots in origin, with individuals and community groups largely designing and providing bereavement support services. Bereavement programs are important, particularly for elderly persons who may be the most impacted by the death of a loved one. Whether governments should fund and/or provide these programs is a question that also needs to be addressed.

We used a web-based mixed methods survey (HowsYourHealth – Frail) to explore the health of frail older (78% age 80 or older) adults enrolled in a home-based primary care program in Vancouver, Canada. Sixty per cent of eligible respondents participated, representing over one quarter (92/350, 26.2%) of all individuals receiving the service. Despite high levels of co-morbidity and functional dependence, 50 per cent rated their health as good, very good, or excellent. Adjusted odds ratios for positive self-rated health were 7.50, 95 per cent CI [1.09, 51.81] and 4.85, 95 per cent CI [1.02, 22.95] for absence of bothersome symptoms and being able to talk to family or friends respectively. Narrative responses to questions about end of life and living with illness are also described. Results suggest that greater focus on symptom management, and supporting social contact, may improve frail seniors’ health.

Using post-colonial theory, we sought to determine what current falls prevention recommendations are offered by local falls prevention programmers (LFPPs) to reduce fall rates among Inuvialuit Elders in Inuvik, Northwest Territories, Canada, and to understand how falls prevention programs for Inuvialuit Elders can be co-created with participants to be culturally safe. The findings showed that Inuvialuit Elders and LFPPs in Inuvik recommend adding environment assessments and modifications, physical activity, and education for Elders and caregivers to existing programs. They also felt that for culturally safe falls prevention programs to occur, LFPPs must include the following strategies: establishing trust and rapport within the community, including both Indigenous and non-Indigenous interventions in falls prevention programs, and training others on cultural safety practices.

Supporting sexual rights in residential long-term care is ethically complex. The well-being of care workers and residents is inextricably linked, and increasingly recognized empirically, yet public policy in Canada generally continues to exclusively focus on either the well-being of residents or workers. The consequences of this are particularly evident when we consider how to prevent sexual harassment towards workers without unjustly restricting the freedom of sexual expression for residents living with dementia. Employing Carol Bacchi’s “What’s the Problem Represented to be?” approach, we critically analysed a recent Canadian action plan to prevent sexual violence and harassment. Our analysis suggests that this policy is less than promising and may reproduce the very phenomenon it is intended to redress. The need to refocus prevention efforts on the structural factors implicated in this phenomenon is urgent if we are to support the sexual rights of both care workers and residents.

This article examines how elders who receive social care in the community experience loss of dignity and how they preserve their dignity. Qualitative research revealed that loss of dignity is a major concern for these elders and that they preserve their dignity differently, ranging from actively engaging with life to detaching themselves from life. We conclude that, in later life, preserving dignity while receiving social care differs from preserving dignity in the context of health care, especially health care provided in institutional settings. Furthermore, preserving dignity in later life, while receiving social care, is a complex process, depending not only on performing activities and individual action and responsibility, but also on other actions, some of them involving a certain inactivity/passivity, and interactions with others, especially caregivers. This article offers some insights to developing better policies and care practices for promoting dignity in the context of community-based social care.

Canadians have expressed concern that access to a family physician (FP) has declined precipitously. Yet FP-to-population ratios remained relatively stable over the last decade, and there were perceptions of physician surpluses, at least in urban centres, 10 years ago. We evaluated whether demographic changes among patients and FPs, and in the volume of care received and provided over the period, contribute to this paradox. Given the relationship between age and FP use in fiscal year 1991/1992, an aging population should have been associated with a 2 per cent increase in visits by 2000/2001. Likewise, given the relationship between FP age and workloads in 1991/1992, an aging workforce should have been associated with a 12 per cent increase in service provision a decade later. Yet visit rates and average FP workloads remained unchanged. There was an increase in age-specific rates of FP use among older adults and a decline in rates among the young, and an increase in age-specific workloads such that older FPs provided many more services than their predecessors (30%) and younger FPs provided many fewer (20%). In terms of impact on future requirements for FPs, both changes in age-specific rates of use, and changes in age-specific patterns of FP productivity, trump population aging as key drivers.

Low vision assistive devices are often positioned as enabling continued social participation and engagement by older adults in everyday activities; however, previous research suggests that the use of such technologies is restricted by various environmental factors. With little attention previously paid to the discursive environment, this critical discourse analysis critically examined how aging persons with vision loss and assistive technology (AT) were constructed and the occupational possibilities promoted and marginalized through technology use in six Canadian newspapers. In total, 7,289 articles were screened, 1,867 articles underwent a full-text review, and 51 articles were selected for data analysis. Results highlight four key discursive threads related to the framing of disability and AT, positioning of seniors with vision loss, and the ideals and occupations to be attained through AT, and point to the importance of re-configuring discourses addressing AT for seniors with vision loss to expand occupational possibilities and embrace collaborative design approaches.

In its first national strategy on dementia, the Government of Canada has highlighted the need to improve quality of care for individuals living with dementia, with emphasis on following best practices and evidence in care delivery and providing care staff access to education and training. It is also known that the design of the physical environment of care homes is integral to the care experience of individuals living with dementia. Therefore, this study aims to identify the best national and international practices implemented in care homes for people living with dementia in: (1) education, training, staffing, and care practices; and (2) environmental design and physical infrastructure, through the review of relevant grey literature. This article highlights key recommendations for improving the quality of care for residents living with dementia in care homes, such as: (1) facilitating translation of training into practice, (2) maintaining consistent staffing levels, and (3) designing care homes to facilitate wayfinding, accessibility, safety, comfort, appropriate sensory stimulation, familiarity, and homelikeness. The findings from this review are expected to inform the development of guidelines for a provincial dementia-friendly care home designation program and various advocacy efforts to help achieve the objectives of the national strategy on dementia.

A partial evaluation of the comprehensive home care and home aid policy of the Ministry of Social Affairs (MAS) of Quebec was undertaken. Three different home care and/or home aid programs serving three urban catchment areas were compared for this purpose. Two of these programs offer comprehensive home care and home aid programs, while the third one offers nursing services at home only. One hundred clients from each program were interviewed at their admission and six months later. Three random samples of elderly from each of the catchment areas were also drawn to take into account local characteristics in the comparison of the clienteles. The study has shown that 1) the three clienteles do not differ except on a few variables. These differences are not systematically related to the type of program (comprehensive/nursing only). 2) That the clients who, on admission, have the profile closest to the client profile established by MAS, were among those that the interviewers could not find for the second interview. And, 3) a comparison of the clients of three programs (on living arrangements, functional impairments and chronic illness), with that of a random subsample of the elderly population, have shown that the former have a higher probability than the latter to wish to leave home. Thus the two comprehensive home care programs seem to experience difficulties in reaching the goals that the ministerial policy has set forth for them.

A review of the literature shows that only a weak connection exists between objective memory tests and self-evaluation memory questionnaires. The object of the present study was to explore which of the mnemonic, affective or psychosocial factors influence subjective evaluation of the memory function. This study is composed of a self-evaluation memory questionnaire, an ecologic-type objective memory evaluation, two affective state measures, anxiety and depression, and an inventory of life events. Sixty elderly persons took part in the study. They were divided into two groups, with attribution to a group depending on whether or not they considered themselves to have problems with memory Results supported the hypothesis that subjective and objective evaluations of memory comprise different components. Contrary to an objective test, self-evaluation of memory is strongly related to affect rather than being a perfect representation of actual mnemonic ability and this in spite of the ecological character of the memory test.

Cet article discute des limites auxquelles il faut faire face quand la notion de risque devient le facteur-clé dans une évaluation clinique. Ainsi, on présente la capacité de se choisir une place en centre d'accueil, pour illustrer la façon dont le problème est défini. En l'absence de composante évaluative, il est démontré que l'information habituellement recueillie ne peut être utilisée pour évaluer les risques sans y inclure un élément normatif. Une discussion concernant la nature du risque montre que les orientations normatives sont inhérentes à la perception du risque. Les principaux inconvénients, de permettre que les résultats soient étroitement rattachés à la notion de risque, sont de deux ordres: (1) les probabilités des risques ne sont pas connues et (2) les enjeux, chargés de valeurs, demeurent inconnus.

This study examines a comparative sample of native and non-native Canadian elderly. Findings indicate that the native population is seriously disadvantaged in terms of housing and health care services. In terms of informal networks and assistance to the elderly, native Canadians rely almost exclusively on informal networks while others receive some assistance from formal agencies as well. These and other issues are discussed relative to future research and the development of theory.