The relocation stress hypothesis that older people find the move into a nursing home to be stressful was examined using archival time-series data. The prevalence of psychological distress following admission was obtained from nursing notes written on monthly medical charts for 159 residents of four Saskatchewan nursing homes. Excluding those with an organic psychotic disorder (19.5%), the results showed that the majority of new residents (82.7%) were not distressed by the move. However, a large proportion of those who were stressed and, in particular, those who had behavioral problems prior to admission did experience psychological distress on admission, and this proportion dropped slowly over an eight month period. While this evidence does not support a general relocation stress hypothesis, it is consistent with a perceived control interpretation of this hypothesis as well as a number of other interpretations focussing on alternative explanations for the behavioral problems variable.

Leisure represents a positive way to keep relationships satisfactory between caregivers and a person with dementia. Adapted leisure education is a promising approach to assist the family to discover new ways to share good times with their relatives. This study aimed to develop an adapted leisure education program. It included an evaluation of the caregivers’ needs, the program content development, and a pilot study to experiment with the content of the program. Three focus groups of dementia caregivers (n = 19) were conducted to investigate caregivers needs. Based on content analysis of these focus groups and a literature review, the content of the program was developed. The pilot study (n = 4) included a quasi-experimental trial and an implementation evaluation. This study led to the development of an adapted leisure education program that puts caregiver support in a new perspective, focusing on positive aspects rather than the burden of caregiving.

Tools applied at the point of care can provide valuable prognostic information for practitioners. In this one-year, prospective observational study, we examined the association of the short performance physical battery (SPPB) and one-year emergency department (ED) visits and hospitalizations. Overall, 191 new referrals attending an outpatient geriatric clinic in Hamilton, Ontario, were approached, and 120 were enrolled. SPPB and other assessments were completed during the routine clinical visit. ED visits and hospitalizations within one year of the baseline assessment were abstracted from electronic medical records. Logistic regression analyses were used to determine ED visits and hospitalization predictors. The mean SPPB score in the study cohort (mean age 80.6, SD 6.3 years; 53% female) was 6.3 (SD 3.2). SPPB score was associated with a one-year ED visit (OR = 0.90 [0.78–1.03]) and hospitalization (OR = 0.84 [0.72–0.97]) after adjusting for age, sex, and co-morbidities.

Using the 2002 Aging and Social Support Survey (GSS16), multinomial logit regression, and cohort-component projection techniques, this study explored how social support networks, health, and economic characteristics have shaped the residential choices of older Canadians, and predicts how they are likely to do so in the future. It focused on the distribution of 55-to-75-year-olds across three private-dwelling types: general community living, age-restricted housing, and age-restricted housing with nursing care. The analysis shows that social support characteristics are the strongest predictors of dwelling type, meaning that individuals appear to choose their dwellings largely on the basis of their social needs and wants, rather than on their economic or health characteristics. The analysis also indicates an increased age-specific demand for all dwelling types in the future, but with a reduction of over 2 million older Canadians living in dwellings in the general community between 2002 and 2022.

Canada faces a significant challenge in meeting the health care needs of older adults with complex mental and physical health issues. Studies have shown collaborative mental health services to effectively address the diverse health needs of this group. However, an often overlooked yet important aspect of service delivery planning for this population is to ensure that older adults are sufficiently able to access available best-practice services. The article reports on a national consensus-building exercise conducted by the Collaborative Mental Health Initiative—Seniors Working Group to develop a nationally informed framework on the accessibility needs of older adults as they relate to collaborative mental health care. The framework is intended to provide planners, administrators, and providers with an understanding of the unique accessibility needs of older adults across three priority pillars (personal, caregiver, systemic) and to enable them to embed strategies to address these issues within field-based collaborative mental health initiatives.

The aim of this paper was (1) to document the extent to which elderly caregivers of persons with dementia engage in self-help/mutual aid activities such as groups and telephone support and (2) to document the extent to which non-users want to participate in this form of support. Caregivers aged 60 years of age and older were recruited from the Alzheimer's Society of Metropolitan Toronto Wandering Persons Registry. Data from telephone interviews (n = 84) from this multicultural sample showed that 21 per cent of subjects used support groups and 26 per cent of non attenders wanted to be part of a support group. Only 8 per cent of subjects utilized telephone support services yet 57 per cent of non-users wanted to use this service. We also report on other means of support such as use of computer networks and newsletters. The implications of this research for seniors will be discussed in light of these identified needs and barriers to participation.

Although urinary incontinence (UI) can be managed conservatively, it is a principal reason for the breakdown of in-home family care. This study explored the social interaction processes of knowledge translation (KT) related to how UI management knowledge might be translated within in-home care. In-depth interview data were collected from a theoretical sample of 23 family caregivers, older home care recipients, and home care providers. Constant comparison and Glaser’s analysis criteria were used to create translating knowledge through relating, a substantive theory with 10 subthemes: living with the problem; building experiential knowledge; developing comfort; easing into a working relationship; nurturing mutuality; facilitating knowledge exchange; building confidence; fine-tuning knowledge; putting it all together; and managing in-home care. Findings inform both theory and practice of in-home UI KT, illuminating how intersubjectivity and bi-directional relational interactions are essential to translating in-home chronic care knowledge, which is largely tacit and experiential in nature.

In this study, a number of demographic, health, and personality measures were collected from a sample of institutionalized and non-institutionalized elderly people in Newfoundland. These measures were then regressed on the number of medicines used. The analyses showed that the primary predictor of medicine use in both samples is Disease Severity, a combination of the number of different diseases or disorders and the extent of their severity. This factor accounts for about 28 to 33 per cent of the variance. No other factor predicted medicine use for institutionalized elderly, but for non-institutionalized elderly, Health Rating, how the individual perceives his or her own health, accounts for an additional 5 to 7 per cent of the variance. Disease Severity and Health Rating do not interact, but make independent, additive contributions to predicting medicine use. Disease Severity and Health Rating also predict total drug use and changes in drug use over a period of 12 to 18 months. When variance due to Disease Severity and Health Rating are accounted for, sex and age do not significantly predict medicine use.

In response to the contradictions appearing between, on the one hand, government promotion of family caregiving for elderly parents and, on the other, the rise of autonomist values (as documented in the literature), we surveyed a number of elderly people living with disabilities about the kind of assistance they would like to receive. The present qualitative, thematic analysis is based on the accounts given by 19 elderly people who receive assistance. The findings show that the position of elderly people with respect to their desire to receive (or not receive) substantial assistance from their family rests on a set of values, wishes, and/or fears – including, particularly, adherence to the value of autonomy, the desire to respect freedom (one's own as well as that of others), adherence to norms of familial duty, attachment to one's home, the value placed on solitude and privacy, and the degree of emotional closeness between the elderly and their children. Access to quality formal services also stands out as a factor enabling elderly people to actualize the desire for care which they elicited within the framework of this analysis.

Antidepressant use was examined with samples from long-term care facilities in Toronto (Canada), Sapporo and Naie (Japan), Reykjavik (Iceland) and Prague (Czech Republic). Only in Iceland did the majority of residents with depression receive an antidepressant. Rates of depression and antidepressant use were uniformly low in Japan, and there was a great discrepancy between diagnosed depression and behavioural signs of depression in the Czech Republic. In all countries, about half the recipients of antidepressants have no clear indication of depression present. For some countries, antidepressant use was lower among residents who were female, older and more disabled. Depression is clearly under-diagnosed in the Czech Republic, but low rates of depression in Japan are somewhat more difficult to interpret. Given the widespread consensus that depression is under-detected and under treated, these results suggest that responses to depression could be improved through instruments like the MDS.

This paper presents a selective review of sociological gerontology in Canada, examining where it has been, where it is, and where it could go in the future in four general areas: inequality, population aging and the social construction of crisis; family relations and caregiving; work, retirement and income security; and health, health care systems, and health policy. This review suggests that the sociology of aging has not differentiated itself by the topic studied or by its applied and empirical focus, but rather in its unique perspective that reveals the importance of social structures for the personal and private experience of aging. In doing so, sociological gerontology rejects deterministic assumptions ofinevitability. The importance of relating the personal to the public and of continuing a critical examination of existing trends will continue into the future. An additional challenge will be the generation ofnew knowledge on how to transform institutions so that they better enhance the quality oflife ofseniors, including the identification of support of family structures and community environments, as well as more appropriate health and income security policies. This also includes research on effective and appropriate means of introducing new structures and implementing new policies and programs within the context of current social institutions.

Population aging is an issue of mounting importance throughout the industrialized world. Concerns over labour force shortages have led to policies that prolong working life. Accordingly, present-day workforce participation patterns of older individuals are extensively varied. This study utilized the 2007 General Social Survey to examine factors associated with post-retirement paid work, focusing on the interaction between gender and relationship status, among Canadians aged 50 to 74 who had retired at least once. We find that although being in a relationship is associated with a higher likelihood of post-retirement work for men, the opposite is true for women. Our findings suggest that the gendered association between relationship status and post-retirement work results partly from the gendered associations between relationship status and one’s motivation for learning and community involvement, career orientation, and sense of independence. Gendered meanings of relationship status are thus revealed through analysis of post-retirement work.

As an initial step in the improvement of interventions for the depressed elderly, the present study attempts to identify the strategies they spontaneously use to cope with depressive feelings. Fifty two older persons answered two questionnaires, one measuring the intensity of depressive symptomatology, the other dealing with coping strategies and their usefulness. Results suggest that, as a whole, coping strategies used by the elderly do not fundamentally differ from the ones advocated by younger individuals, in that they favor strategies involving goal-oriented action. The subjects who reported the most depressive feelings differed from the others on two points: they less frequently relied on the strategy of problem solving and they considered general activity as less useful in their struggle against depressive feelings. Implications for the development of services for the elderly, in particular the secondary prevention of depression, are drawn.

This study examines the decision of institutionalizing an elderly parent suffering from cognitive impairments and the various people involved in this process: the elderly person, the informal caregiver, certain family members and health and social service professionals. Based on a qualitative analysis of interviews conducted with 16 elderly people and their family networks, this study reveals the importance of considering the point of view of everyone involved. The results show that one of the main reasons behind the decision to institutionalize an elderly person is the appearance of disturbing behaviours related to his or her cognitive impairments. Diverse strategies used by family members and health and social service professionals in order to bring about the institutionalization of an elderly person when he or she is opposed to it are presented as well as the ethical dilemmas this raises. We conclude with a presentation of research and intervention recommendations.

We establish the potential for outcomes evaluation of a long-term care population-based dataset. Data come from the Health Care Financing Administration's case-mix and quality demonstration project including all Medicare/ Medicaid certified homes of five U.S. states during 1992–1994. Using the Minimum Data Set, we identified nearly 70,000 residents over 65 years of age with congestive heart failure. We provide a preliminary analysis of pharmacotherapy of congestive heart failure and its effects on decline in physical functioning. Functional outcome, expressed as the rate of ADL decline, was improved for patients on combination therapy relative to those on digoxin or ACE-inhibitors alone. The availability of a population-based data set provides a means of evaluating current policies and practices.

This study explored middle-aged, university educated women's views of their own future aging, using a combination of qualitative and quantitative techniques. Seventy-four university graduates, aged 45 to 65, were interviewed about their views of aging and their employment histories. They also completed questionnaires measuring personality, self-efficacy, well-being, depression and social support. Content analysis of interview responses revealed that most women were optimistic about their own old age and expected overall stability in themselves, their financial situation and their relationships, with an improvement in the area of leisure. Positive expectations of stability were associated with satisfaction with oneself and past accomplishments. A typology of accommodation to future aging, derived from the data on women's expectations and preparations, captured four patterns of cognitive, affective and behavioural dynamics. Women with different accommodation types differed primarily on well-being, neuroticism and employment histories.

Sixteen healthy community residing elderly adults and 16 university students completed the Locomotor Maze test of extrapersonal orientation. They were given maps with nine location dots in a 3 × 3 matrix that corresponded to nine red discs on the floor of the experimental room. Participants were asked to walk the path outlined on each map without turning the map. Six maps were presented with paths increasing one segment in length with each subsequent map. The older adults committed more errors on the longer maps and took more time to make direction choices than young people. Because participants were free to consult the map throughout each trial, reliance on memory for landmaks and routes that characterizes earlier research was eliminated. It is suggested that the decreased performance shown by elderly adults on this task may be due to difficulty with working memory and mental rotation or increased field dependence.

This study examines the influence of chronic health conditions and socio-economic status on overnight admission and length of stay among Canadian seniors. Incremental multivariate logistic and zero-inflated negative binomial regression models assessed the relationship between selected predictors, overnight admission, and duration of stay. The findings show that all chronic health conditions and socio-economic factors examined were significantly associated with overnight hospital admission. However, seniors with cardiovascular health conditions, the very old, and seniors living in lower-income households had a greater risk of longer stays. Canadian seniors diagnosed with hypertension, cancer, diabetes, and stroke had greater risk of longer overnight hospital stays. Seniors aged 75 to 79 years, 80 years or older, and those living in lower-income households (≤ $39,999) were more likely to have a longer overnight hospital stay. Findings suggest that improving seniors’ health and socio-economic status may reduce the risk of overnight admission and longer stays of hospitalisation.