Showing papers in "Canadian Journal on Aging-revue Canadienne Du Vieillissement in 2011"

Conceptualizing age-friendly communities.

Abstract: On the political and policy front, interest has increased in making communities more "age-friendly", an ongoing trend since the World Health Organization launched its global Age-Friendly Cities project. We conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective. We thereby aim to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area. Ecological premises (e.g., there must be a fit between the older adult and environmental conditions) suggest the need for a holistic and interdisciplinary research approach. Such an approach is needed because age-friendly domains (the physical environment, housing, the social environment, opportunities for participation, informal and formal community supports and health services, transportation, communication, and information) cannot be treated in isolation from intrapersonal factors, such as age, gender, income, and functional status, and other levels of influence, including the policy environment.

Epidemiology of Falls in Older Age

Abstract: Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and fall-related injuries and the impact of population aging. The magnitude of the problem is described in terms of the classification of falls and measurement of outcomes, including fall incidence rates across settings, sociodemographic determinants, international trends, and costs of falls and fall-related injuries. Finally, public health approaches to minimize falls risk and consequent demand on health care resources are suggested.

Beyond the 'iron lungs of gerontology': using evidence to shape the future of nursing homes in Canada.

Abstract: Institutionalization of the Elderly in Canada suggested that efforts to address the underlying causes of age-related declines in health might negate the need for nursing homes. However, the prevalence of chronic disease has increased, and conditions like dementia mean that nursing homes are likely to remain important features of the Canadian health care system. A fundamental problem limiting the ability to understand how nursing homes may change to better meet the needs of an aging population was the lack of person-level clinical information. The introduction of interRAI assessment instruments to most Canadian provinces/territories and the establishment of the national Continuing Care Reporting System represent important steps in our capacity to understand nursing home care in Canada. Evidence from eight provinces and territories shows that the needs of persons in long-term care are highly complex, resource allocations do not always correspond to needs, and quality varies substantially between and within provinces.

Aging and the Body: A Review.

Abstract: In this article, we examine the existing sociocultural research and theory concerned with the aging body. In particular, we review the body image and embodiment literatures and discuss what is known about how older adults perceive and experience their aging bodies. We analyse how body image is shaped by age, culture, ethnicity, gender, health status, sexual preference, and social class. Additionally, we critically elucidate the embodiment literature as it pertains to illness experiences, sexuality, the everyday management of the aging body, appearance work, and embodied identity. By outlining the key findings, theoretical debates, and substantive discrepancies within the body image and embodiment research and theory, we identify gaps in the literature and forecast future, much-needed avenues of investigation.

Internet Use and Psychological Wellness During Late Adulthood

Abstract: An aging population is best served by social, personal, and health support focused on maintaining and maximizing personal independence The Internet affords numerous opportunities for individuals of all ages to communicate, access information, and engage in recreational activities A community-based sample of 122 adults over 60 years of age completed a questionnaire which assessed three clusters of characteristics: (a) frequency and patterns of Internet use, (b) well-being (loneliness, life satisfaction, self-efficacy, social support, and depression), and (c) demographics (age, income, education) Significant correlations emerged between the three clusters of measured variables Controlling for demographic differences, Internet use and self-efficacy remained significantly related Among the sample of older adults, individuals who used the Internet more had higher perceptions of self-efficacy than those who used the Internet rarely or not at all

Aging in rural Canada: a retrospective and review.

Abstract: Research on rural aging has developed considerably since publication of the book Aging in Rural Canada (Butterworths, 1991). The purpose of this article is twofold: to provide a retrospective on issues in rural aging from this book, and to review Canadian literature on rural aging since its publication. The review highlights new directions in conceptual definitions of rural, and in issues of social engagement, independence, family and social networks, and rural services and health. Two main research lenses are evident. The marginalization lens focuses on rural seniors with health problems, but has not included those marginalized by poverty or gender. The aging-well lens focuses on contributions and engagement, but has omitted research on social relationships and quality of family interaction. The report includes a call for interrogation about interaction between people and place, and for understanding issues of rural diversity and processes of rural aging.

Social support, caregiving, and aging.

Abstract: This article reviews the international English-language literature on social support and caregiving in gerontology since the early 1990s. The literature has grown, but consensus on the terms' meaning and measurement is lacking. Interest is ongoing in practical help, in benefits of social support, and in demands and negative outcomes for caregivers, with growing but less emphasis on more theoretical questions, on negative outcomes from the receipt of support, and on positive consequences of providing care. Nevertheless, social support is duly recognized as a social determinant of health and receiving attention at policy levels - both are significant shifts from two decades ago and add to the interest this area will receive from researchers in coming decades. There remain many unanswered questions regarding the changing societal context, but it is clear that the social support of others - throughout our lives including old age - will continue in the future, albeit in ever-changing forms.

Naturalistic Study of Winter Driving Practices by Older Men and Women: Examination of Weather, Road Conditions, Trip Purposes, and Comfort

Abstract: La plupart des etudes sur les pratiques de conduite des aines sont basees sur des donnees d’autoevaluation ; aucune n’a examine objectivement leurs habitudes de conduite hivernale. Nous avons utilise des appareils electroniques associes a des journaux de voyages, des cartes numeriques et des archives meteorologiques, afin d’examineretudier les modes de conduite des personnes âgees de 65 a 91 sur deux semaines consecutives entre novembre 2008 et mars 2009. La conduite de nuit differait selon le mois, montrant l’importance des facteurs saisonniers, en particulier la quantite de lumiere du jour. Bien que 69 pour cent de notre echantillon ait conduit les jours de mauvais temps, les aines ont montre etre significativement plus susceptibles de faire des voyages a des fins sociales ou de divertissement les jours de beau temps, et ils ont entrepris des voyages plus longs les jours offrant de bonnes conditions routieres. Les scores de confort de conduite, notamment pour la conduite de nuit, etaient lies de maniere significative aux indicateurs multiples de l’exposition et des habitudes, y compris au rayon autour du domicile. Comparativement aux hommes, les femmes ont obtenu des scores de conduite significativement plus bas, et ont ete moins susceptibles de conduire quand les conditions meteorologiques et routieres etaient defavorables. Abstract: Most studies on seniors’ driving practices are based on self-reports; none have objectively examined winter driving patterns. We used electronic devices, together with trip logs, digital maps, and weather archives, to examine the driving patterns of seniors aged 65 to 91 over two consecutive weeks between November 2008 and March 2009. Night driving differed by month showing the importance of seasonal factors, particularly the amount of daylight. Although 69 per cent of the sample drove on days with adverse conditions, seniors were significantly more likely to make trips for social/entertainment purposes on days with good weather, and out-of-town trips on days with good road conditions. Driving comfort scores, particularly for night driving, were significantly related to multiple indicators of exposure and patterns, including radius from home. Compared to men, women had significantly lower driving comfort scores and were less likely to drive on days with adverse weather and road conditions.

Canada's Aging Population (1986) Redux

Abstract: Canada’s Aging Population par Susan McDaniel etait le livre inaugurale dans la serie Butterworths sur le vieillissement dans les annees 1980. Ceci a ouvert une industrie d’expansion dans la recherche sur le vieillissement. Maintenant, on sait beaucoup plus sur les processus – a la fois individuels et collectives – qui font partie du vieillissement. Maintenant, on peut faire des projections plus fiables de la population future. Cela dit, les mythes et les malentendus persistent – en particulier sur les implications politiques du vieillissement de la population. Il semble que les memes craintes et les memes angoisses se repetent maintes fois. Il reste une deconnexion entre nos connaissances croissantes au sujet de la population et les medias ou les reponses politiques. Canada’s Aging Population by Susan McDaniel was the inaugural book in the Butterworths series on aging in the 1980s. It opened a “growth industry” in research on aging. Much more is known now about the processes, both individual and collective, that are part of aging. More reliable projections of future population can now be made. That said, myths and misunderstandings – particularly about the policy implications of population aging – persist. It seems that the same fears and anxieties occur again and again. The disconnect remains between our growing knowledge about population aging and media or policy responses.

An Exploration of Search Patterns and Credibility Issues among Older Adults Seeking Online Health Information

Abstract: The Internet is an important resource for health information, among younger and older people alike. Unfortunately, there are limitations associated with online health information. Research is needed on the quality of information found online and on whether users are being critical consumers of the information they find. Also, there is a need for research investigating online use among adults aged 65 and over - a rapidly growing demographic of Internet users. The current study presents important descriptive data about the search patterns of older adults seeking online health information, the types of health topics they research, and whether they consider credibility issues when retrieving online health information. A comparison is also made between search strategies used in printed text and hypertext environments. The results, which have implications with respect to credibility issues, highlight the need to increase awareness about critical searching skills among older adult Internet users.

Psychosocial issues in Engaging Older People with Physical Activity Interventions for the Prevention of Falls

Abstract: This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of planned behavior is used as a framework for the review on how knowledge (a prerequisite), attitudes, subjective norms (the social context), and perceived behavioral control (confidence) promote or inhibit the intention to carry out activities to prevent falls. The review is supplemented with evidence for self-identity to influence intention, and the article concludes with a discussion of the recommendations made by the Prevention of Falls Network Europe for engaging older people in falls prevention.

The role of culture and diversity in the prevention of falls among older Chinese people.

Abstract: This grounded-theory study explored the perceptions of Chinese older people, living in England, on falls and fear of falling, and identified facilitators and barriers to fall prevention interventions. With a sample of 30 Chinese older people, we conducted two focus groups and 10 in-depth interviews in Mandarin or Cantonese. Interview transcripts, back translated, were analyzed using N6. Constant comparative analysis highlighted a range of health-seeking behaviors after a fall: Chinese older people were reluctant to use formal health services; talking about falls was avoided; older people hid falls from their adult children to avoid worrying them; and fatalistic views about falls and poor knowledge about availability and content of interventions were prevalent. Cost of interventions was important. Chinese older adults valued their independence, and cultural intergenerational relations had an impact on taking action to prevent falls. Cultural diversity affects older adults' acceptance of fall prevention interventions.

Revisiting widowhood in later life: changes in patterns and profiles, advances in research and understanding.

Abstract: This analysis reviews the ways in which both the experience of widowhood in old age and the nature of research on widowhood have changed since the publication of the book Widowhood in Later Life in 1991. Patterns of decline in widowhood in both its duration and incidence in later life are examined. Widowhood research has advanced conceptually by moving beyond understanding widowhood solely in terms of role loss. Life course perspectives, and concepts of multiple narratives and of resilience, have also contributed to the field. New methodologies, including prospective and longitudinal designs involving larger data sets, and more in-depth qualitative studies, have advanced our understanding of complexities and variations in widowhood. These include issues of gender and ethnocultural diversity, as well as the intersection of wealth, health, and class. This article also examines how patterns of labour force affiliation, social policy, and the changing nature of marriage shape widowhood in later life.

Factors that Influence Physical Activity in Long-term Care: Perspectives of Residents, Staff, and Significant Others

Abstract: Physical activity has been linked to positive health outcomes for frail seniors. However, our understanding of factors that influence the physical activity of residents in the long-term care (LTC) setting is limited. This article describes our work with focus groups, one component of a multi-component study that examined factors influencing the physical activity of LTC residents. Residents, significant others, and staff from nine LTC facilities participated in these focus groups. Analysis of group discussions revealed three themes reflecting factors that mitigate the provision of physical activity: (a) inadequate support for physical activity, (b) pervasive institutional routines, and (c) physical environment constraints. All participants considered physical activity important to health preservation. Individual, structural, and environmental factors affected the quantity and quality of physical activity accessed by residents. These findings confirm the need to develop practical strategies and ways to address modifiable barriers and embed physical activity into LTC systems of care.

Lifting the 'violence veil': examining working conditions in long-term care facilities using iterative mixed methods.

Abstract: Le present document se concentre sur les methodes mixtes nous avons utilise pour comprendre conditions de travail de leur travailleurs dans les etablissements de soins de longue duree Nous avons mene une enquete aupres des syndiques travailleurs de sante en Ontario ( n = 917), et une autre enquete dans trois provinces ( n = 948) et quatre pays Scandinaves ( n = 1625) Neuf groupes de discussion avec les Canadiens ont eu lieu; les repondants ont ete presentes avec des questions du sondage et aussi descriptive des resultats statistiques et ont ete demande: "Est-ce le reflet de votre experience?" Les contraintes de temps pour les travailleurs et la frequence des experiences des travailleurs de la violence physique et attentions sexuelles non desirees sont signales Nous discutons comment de le facon dont nous utilise des methodes qualitatives et quantitatives ete iteratif Nous avons trouve pas seulement la coherence des donnees mais aussi la divergence des donnees qui montrent comment une culture de la violence dans les etablissements de soins de longue duree est acceptee par les travailleurs comme d'habitude Comment le constat de la violence structurelle vu le jour et la signification profonde, le contexte et les idees qui proviennent de la combinaison de nos methodes iteratives sont discutees Abstract: We conducted a mixed-methods study - the focus of this article - to understand how workers in long-term care facilities experienced working conditions We surveyed unionized care workers in Ontario ( n = 917); we also surveyed workers in three Canadian provinces ( n = 948) and four Scandinavian countries ( n = 1,625) In post-survey focus groups, we presented respondents with survey questions and descriptive statistical findings, and asked them: "Does this reflect your experience?" Workers reported time pressures and the frequency of experiences of physical violence and unwanted sexual attention, as we explain We discuss how iteratively mixing qualitative and quantitative methods to triangulate survey and focus group results led to expected data convergence and to unexpected data divergence that revealed a normalized culture of structural violence in long-term care facilities We discuss how the finding of structural violence emerged and also the deeper meaning, context, and insights resulting from our combined methods

Unintentional Falls in Older Adults: A Methodological Historical Review

Abstract: PubMed lists over 6,000 references (700 reviews) on unintentional falls in older adults. This article traces key methodological milestones in the application of epidemiologic methods since the earliest publications in the late 1940s. Within the context of advances in case definition, sampling, measurement, research design, and statistical analysis, the article reviews estimates of frequency of occurrence, risk factor associations, morbidity and mortality consequences, demonstration of the multiple risk factor theory of falls using fall prevention interventions, and the challenges of fall risk prediction models. Methodological explanations are provided for observed heterogeneities, and the case is presented for moving beyond undifferentiated lists of risk factors by focusing on balance and gait as the factors through which the mechanistic effects of distal risk factors can be understood. Moreover, the case is made to advance our statistical analyses by looking at interactions among intrinsic risk factors and between intrinsic, extrinsic, and environmental factors.

Elder abuse and neglect in Canada: the glass is still half full.

Abstract: Cet article examine les developpements dans le domaine de la maltraitance et de la negligence des aines depuis la publication de Elder Abuse and Neglect in Canada (Butterworths, 1991). Les arguments presentes ici sont de deux ordres : d’abord, nous n’avons aucune idee de la taille ou de la nature du problemes de la violence et de la negligence dans la communaute ou dans les institutions et, d’autre part, nous ne savons pas comment resoudre ces problemes ou leurs questions connexes qui ont ete masques par la rhetorique et le recyclage de l’information pendant les 20 dernieres annees. C’est le temps d’avancer au-dela de la « phase de sensibilisation ». Ce a quoi nous devons nous attaquer a l’avenir est aussi evident aujourd’hui qu’il ne l’etait il y a 20 ans. Notre connaissance est incomplete parce qu’il nous manque le type d’enquetes dont le besoin se fait le plus urgent: les etudes de prevalence dans la communaute et les institutions, un developpement theoriquement solide, et des essais cliniques randomise pour tester a la fois nos interventions socialement et juridiquement. This article reviews developments in the field of elder abuse and neglect since the publication of Elder Abuse and Neglect in Canada (1991). The arguments made here are twofold: first, we have no idea of the size and nature of the problem of abuse and neglect in the community or in institutions; second, we do not know how to solve these problems or their attendant issues that have been masked by rhetoric and the recycling of information for the past 20 years. It is time to move forward from the “awareness phase”. What we must tackle in the future is as obvious now as 20 years ago. Our knowledge is incomplete (i.e., our glass remains half full) because we lack the type of investigations we most urgently need: prevalence studies in the community and institutions, serious theory development, and random clinical trials to test our interventions both socially and legally.

Poverty Variations among the Elderly: The Roles of Income Security Policies and Family Co-Residence

Abstract: Despite a rapid overall decline in poverty among older people since the 1970s, poverty among elderly immigrants is persistently high in Canada. Using data from the 2006 Canadian Census of Population, this article presents results of a study on the poverty of elderly immigrants in comparison to the Canadian-born elderly population. Results from logistic regression analysis suggest that a large portion of the higher poverty rates among elderly immigrants can be explained by the lack or inadequacy of state income support. Nevertheless, the high poverty levels among elderly immigrants are mitigated by financial assistance from their kin. This article concludes by highlighting the role of family support as a coping strategy for escaping poverty and by assessing two mechanisms of state intervention that could improve the economic well-being of elderly immigrants.

Impact of age, and cognitive and coping resources on coping.

Abstract: RESUME Afin d’explorer la valeur predictive des ressources congnitives et de coping pour le coping centre sur le probleme et sur 1’emotion en prenant en compte 1’âge, nous avons recueilli des donnees aupres d’adultes vivant a domicile et âges de 20 a 90 ans. Nous avons fait 1’hypothese que 1’âge, le stress percu, 1’auto-efficacite, la capacite de memoire de travail, et la flexibilite mentale sont des facteurs predisant le coping. Nous avons recueilli des donnees en utilisant des versions francaises de 1’echelle de stress percu (PSS), d’autoefficacite (GSE) et un questionnaire de coping (WCC). Les evaluations cognitives ont inclus le subtest des empans envers-endroit (WAIS), et les parties A et B du Trail-Making Test (TMT). Dans les analyses multivariees, ni le deficit de memoire de travail, ni le deficit de la flexibilite mentale ne predisent significativement le coping centre sur le probleme. L’âge ne predit que le coping centre sur le probleme. L’auto-efficacite predit le coping centre sur le probleme alors que le stress percu predit le coping centre sur 1’emotion. Nos resultats ont confirme que le coping centre sur 1’emotion resterait stable avec 1’âge. Le Coping centre sur le probleme augmente avec 1’âge et depend essentiellement de la confiance des participants concernant leur capacite a resoudre des problemes (i.e., 1’auto-efficacite). Abstract: To explore the predictive value of cognitive and coping resources for problem- and emotion-focused coping with age, we collected data from community-dwelling adults between 20 and 90 years old. We hypothesized that age, perceived stress, self-efficacy, working-memory capacity, and mental flexibility were predictors of coping. We collected data using French versions of the Perceived Stress Scale, General Self-Efficacy Scale, and Way of Coping Checklist. Cognitive assessments comprised the WAIS III digit-span subtest and the Trail Making Test parts A and B. In multivariate analyses, neither working-memory nor mental-flexibility deficit predicted problem-focused coping. Age was found to predict only problem-focused coping. Self-efficacy predicted problem-focused coping, and perceived stress predicted emotion-focused coping. Our results confirmed that use of an emotion-focused coping style would not significantly change with age. Problem-focused coping increases with age and depends primarily on participants’ confidence in their ability to successfully solve problems (i.e., self-efficacy).

Economic Security in an Aging Canadian Population

Abstract: Recent research indicates that today's retirees are doing very well in terms of their replacement ratios and that Canadian poverty rates among the elderly are low relative to other Organization for Economic Co-operation and Development (OECD) countries. Government-sponsored plans have been strengthened either through explicit expansion - for example, the Guaranteed Income Supplement (GIS) - or through the reform of the Canada/Quebec Pension Plans (C/QPP). Also important is the maturation of employer-sponsored pension plans, although coverage rates are down. Future generations of retirees may not achieve the standard of living that exists today, however, which is a concern. The author argues that today's economic security programs are affordable and that their costs could be stabilized if the retirement age were raised.

Falls Risk Factors: Assessment and Management To Prevent Falls and Fractures

Abstract: Falls and fragility fractures are common, dangerous, and important public health challenges. They are best understood as geriatric syndromes with close relation to frailty and other aging-related health problems. They are associated with many risk factors, in all health domains - physical, psychological, social, and environmental. At a population level, the challenge is to improve the health and well-being of all older people to reduce the incidence of falls. At a clinical level, the challenge is to assess the individual risk factors and apply evidence-based individually tailored, multifactorial interventions. The most powerful component is strength-and-balance exercise training.

Older People in Canada: Their Victimization and Fear of Crime

Abstract: Older people are more affected by fear of crime and the possibility of victimization, despite their being at lower risk of harm, than any other population group in Canada. Crime, victimization, and fear are not experienced uniformly among older Canadian citizens and residents, partly because older people do not form a homogeneous group. Being part of an ethnic, religious, or sexual minority, or being mentally frail, can have an impact on an individual's perceptions and experience of risk. This analysis explores older people's victimization and fear of crime, while it highlights the lack of consistency in the available data.

Unmet Need for Assistance to Perform Activities of Daily Living and Psychological Distress in Community-Dwelling Elderly Women

Abstract: Community-dwelling seniors increasingly require physical assistance to perform the activities of daily living (ADL). To examine the possible association of this need with psychological distress, we conducted a prospective cohort study of community-dwelling people age 75 and older in Montreal, Canada. We report the results for women only (n = 530). Multivariable linear regression was used to examine the association between met and unmet need in instrumental ADL (IADL) and personal ADL (PADL) with concomitant psychological distress. Unmet IADL need was associated with elevated psychological distress [β = 0.42 (95% CI: 0.26, 0.60)], as was met IADL need [β = 0.19 (95% CI: 0.06, 0.33)], but not met and unmet PADL need. The full model explained 32.8 per cent of the total variance in psychological distress. Receiving assistance to meet IADL needs is associated with elevated psychological distress. Not receiving assistance, however, is associated with even greater distress.

The geographic mobility of elderly Canadians.

Abstract: The monograph Changing Residence: The Geographic Mobility of Elderly Canadians (Northcott, 1988) reviewed the research that had been done up to the mid-1980s on the geographic mobility of older persons in Canada and elsewhere The purpose of this article is to provide an update and overview of developments in the study of the geographic mobility of seniors since the mid-1980s with a particular emphasis on Canada In this review, we first examine progress over the past 25 years in research about seniors’ geographic mobility and focus on three topics: the relocation and geographic concentration of seniors, seasonal migration (“snowbirds”), and international migration Second, we assess the current status of research on elder migration in Canada Finally, we identify future challenges and unanswered questions, and make suggestions for future research

Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

Abstract: 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.

Exploring the influence of income and geography on access to services for older adults in British Columbia: a multivariate analysis using the Canadian Community Health Survey (Cycle 3.1).

Abstract: Les recherches existantes sur les modes d'utilisation des soins de sante des Canadiens âges suggerent que habituellement le revenu ne restreint pas l'acces d'une personne. Cependant, le role que joue le revenu en influencant l'acces aux services de sante par les personnes âgees vivant en milieux ruraux est relativement inconnu. Cet article examine la relation entre le revenu et l'utilisation des services de sante chez les personnes âgees dans les zones rurales et urbaines de la Colombie-Britannique. Les donnees ont ete extraites de l'Enquete sur la sante dans les collectivites canadiennes (ESCC) de Statistique Canada, cycle 3.1. Avec une regression multivariable, on a examine l'influence du revenu sur l'accessibilite de 3 424 personnes âges de 65 ans et plus. Les resultats suggerent que (1) de faible revenu n'influence pas l'acces aux services de soins de sante, et (2) que cela est vrai pour les adultes âges urbaines et ruraux. Dans tous les cas, les predicteurs les plus importants et coherents d'acces sont ceux qui ont mesure le besoin de soins de sante. Abstract: Existing research on the health care utilization patterns of older Canadians suggests that income does not usually restrict an individual's access to care. However, the role that income plays in influencing access to health services by older adults living in rural areas is relatively unknown. This article examines the relationship between income and health service utilization among older adults in rural and urban areas of British Columbia. Data were drawn from Statistics Canada's Canadian Community Health Survey, Cycle 3.1. Multivariate regression techniques were employed to examine the influence of relative income on accessibility for 3,424 persons aged 65 and over. Results suggest that (1) relative income does not influence access to health care services; and (2) this is true for both urban and rural older adults. The most important and consistent predictors of access in all cases were those that measured health care need.

Subjective Well-Being In Later Life: 20 years after the Butterworths monograph series on individual and population aging.

Abstract: This article discusses developments in theory and research on happiness two decades after publication of Psychological Well-Being in Later Life (Butterworths, 1991) by Albert Kozma, Michael Stones, and Kevin McNeil. Major empirical advances include new knowledge about contributions to happiness resulting from genetically related effects and personality. Personality traits have stronger relationships with happiness than was apparent 20 years ago and contribute to covariance between happiness and some of its predictors. Evolving emphases in research include the ways in which genetically related effects influence how people shape, and react to, their environment.

L’accès des aînés francophones aux foyers de soins en milieu minoritaire, un enjeu linguistique en santé et mieux-être

Abstract: Access to long-term nursing homes by French-speaking seniors in minority situations is a very real problem. However, few studies have been conducted on this subject. We wanted to better understand this issue in New Brunswick while taking into account the language aspect. In this article, we will present the problem based on different issues encountered by Francophones in minority situations and by giving an overview of the studies conducted on French-speaking seniors in minority situations. We will then address the issue related to the rights of French-speaking senior to receive services in French in nursing homes by analyzing briefl y the province’s legal requirements. Furthermore, we will present the regulatory framework of nursing homes in New Brunswick. Finally, we will provide a geographic analysis of existing New Brunswick nursing homes while taking into account the language aspect, the levels of service and the distribution of French-speaking seniors within the territory.

A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region.

Abstract: Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with better care quality. Accordingly, we conducted a cross-sectional survey of nursing home directors of care in Vancouver Coastal Health, a large health region in British Columbia. The survey addressed staffing levels and organization, physician access, end-of-life care, and factors influencing facility-to-hospital transfers. Many of the modifiable organizational characteristics associated in the literature with potentially avoidable hospital transfers and better care quality are present in nursing homes in British Columbia. However, their presence is not universal, and some features, especially the organization of physician care and end-of-life planning and services, are particularly lacking.

À mots couverts: le regard des aînés et des soignants sur la communication quotidienne et ses manifestations d’âgisme implicite

Abstract: The aim of this exploratory study was to better understand interpersonal communication between frail elders and caregivers in the context of long-term care giving. In addition, in light of the Communication Accommodation Theory, the goal was to determine the extent to which communication can be a transmitter of ageism, particularly of implicit ageism. A total of 26 semi-structured interviews were conducted among elders and caregivers of a Quebec long-term care facility. Results suggest a close convergence between the perception of seniors and caregivers in regards to a quasi total absence of daily communication and moreover, in regards to the highly instrumental nature of this same communication. Finally, results of the content analysis also suggest that implicit ageism is indeed reflected in interpersonal communication between frail elders and caregivers.