Background In this article, we apply a gender-based analysis plus framework to research the housing experiences of older, low-income adults living and aging in Hamilton. Low-income older adults with intersectional identities are at risk of not aging in place due to marginalization and housing instability. Objective Policy currently homogenizes the experience of aging by sidelining intersectional factors that have a bearing on aging well in place. The research aims to develop policy recommendations to address this gap. Methods Several methods captured the housing experiences of low-income older adults, including interviews, participant observation, and arts-based techniques. Findings Findings illustrate how gender and intersectional factors shape both housing trajectories and agentive practices low-income adults utilize to try to age well and in place. These strategies encompass practicing cultural citizenship, which is a claim for inclusion when excluded from mainstream ideals of aging in place. Discussion We provide policy recommendations informed by participants’ lived experiences aimed at promoting equitable aging in place as fundamental to full citizenship.
The COVID-19 pandemic has presented numerous challenges to older adults in Canada, including the ability to volunteer. The purpose of this study is to improve the understanding of the social context surrounding volunteering in Canada, by (a) determining changes in associations between human, social, and cultural capital and volunteering among older adults; and (b) examining the relationship between ethnic minority status and volunteering, using data from the Canadian Longitudinal Study on Aging (CLSA), collected prior to and during the pandemic. This study utilized data from 24,306 CLSA Baseline, Follow-up 1 (FUP1), and COVID-19 Baseline Survey participants (aged 55+). Results confirm a decrease in volunteering during the early stages of the pandemic. Compared to pre-pandemic associations, volunteers during the early stages of the pandemic were more likely to be young-old, male, employed, and not involved in religious activities. Findings provide evidence of pandemic effects on volunteering among older adults in Canada.
Background There is a need to further understand the nature and role of planning for one's lifestyle in retirement.Objective The purpose of this study was to examine retirement planning and how it impacts perceived preparedness and satisfaction with the retirement transition, as well as to explore personal experiences of retirement.Methods Canadians (n = 748) fully or partly retired participated in an online survey that included quantitative questions about perceived retirement preparedness and satisfaction and open-ended questions about retirement goals, fears, challenges, and advice.Findings Results determined that while both financial and lifestyle planning were significant predictors of higher perceived preparedness, only lifestyle planning was a significant predictor for satisfaction. Overall, no gender differences were detected. Open-ended comments highlighted the importance of planning for one's lifestyle in retirement, including meaningful activities and social connections.Discussion Individualized career advising as well as group-based educational programs or peer-assisted learning initiatives appear warranted to support people in planning for their lifestyle in retirement. Context Il est necessaire de mieux comprendre la nature et le role de la planification du mode de vie a la retraite.Objectif L'objectif de cette etude etait d'examiner la planification de la retraite et son incidence sur la preparation percue et la satisfaction a l'egard de la transition a la retraite, ainsi que d'explorer les experiences personnelles de la retraite.Methodes Des Canadiens (n = 748) totalement ou partiellement retraites ont participe a une enquete en ligne comprenant des questions quantitatives sur la preparation et la satisfaction percues a l'egard de la retraite, ainsi que des questions ouvertes sur les objectifs, les craintes, les defis et les conseils en matiere de retraite.Resultats Les resultats ont montre que la planification financiere et la planification du mode de vie etaient des predicteurs significatifs de meilleures perceptions de preparation, mais que seule la planification du mode de vie etait un predicteur significatif de satisfaction. Dans l'ensemble, aucune difference entre les sexes n'a ete decelee. Les commentaires ouverts ont souligne l'importance de planifier son mode de vie a la retraite, y compris des activites et des relations sociales enrichissantes.Discussion Une orientation professionnelle individualisee, ainsi que des programmes educatifs de groupe ou des initiatives de formation assistee par les pairs semblent justifies pour aider les gens a planifier leur mode de vie a la retraite.
This study tested the hypothesis that within older Barbadian adults, sex, education, and occupation type lessen age-related cognitive decline. The analyses used a cross-sectional data set from 1325 people collected in the 2006 SABE Study (Health, Well-being, and Aging). Cognition was assessed as scores in each subdomain of the Mini-Mental State Exam. The loss of a single point in each subdomain was predicted by sex, years of education, job type, and their interactions with age. Results demonstrated that age and protective factors affect each cognitive domain differently. High education combined with mentally complex employment helped maintain cognitive performance in later life. Beneficial lifetime exposures are additive, providing combined benefits. Findings provide insight into public policy aiming to minimize the number of adults with cognitive decline and dementia in Barbados and the Caribbean.
This study examined the associations between residential environment and self-rated mental health (SRMH) among Canadians aged 65 or older ( n = 16,304) and whether education and gender moderated the associations. Data came from the 2018 Canadian Housing Survey. Hierarchical multiple regressions were conducted to test the associations. Analyses revealed that increased dwelling size was associated with better SRMH among older women with high school education. Older adults with higher satisfaction with their dwelling design were more likely to report better SRMH, except for women with some college education. Feeling safer in the community was uniquely associated with better SRMH for men with high school education and women with a university degree. Results confirmed significant associations between specific home and residential environment features and SRMH for each gender-by-education group. Environmental programs designed to improve SRMH for older adult populations should consider within- and between-group diversity.
In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents' health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.
Worldwide, over 55-million people have dementia, and the number will triple by 2050. Persons living with dementia are exposed to risks secondary to cognitive challenges including getting lost. The adverse outcomes of going missing include injuries, death, and premature institutionalization. In this scoping review, we investigate risk factors associated with going missing among persons living with dementia. We searched and screened studies from four electronic databases (Medline, CINAHL, Embase, and Scopus), and extracted relevant data. We identified 3,376 articles, of which 73 met the inclusion criteria. Most studies used quantitative research methods. We identified 27 variables grouped into three risk factor domains: (a) demographics and personal characteristics, (b) health conditions and symptoms, and (c) environmental and contextual antecedents. Identification of risk factors associated with getting lost helps to anticipate missing incidents. Risk factors can be paired with proactive strategies to prevent incidents and inform policies to create safer communities. Plus de 55 millions de personnes sont atteintes de demence dans le monde, et leur nombre triplera d'ici 2050. Les personnes atteintes de demence sont exposees a des risques secondaires aux problemes cognitifs, notamment celui de se perdre. Les consequences negatives de la perte de reperes comprennent les blessures, la mort et l'institutionnalisation prematuree. Dans cette etude de portee, nous examinons les facteurs de risque associes au fait de s'egarer chez les personnes atteintes de demence. Nous avons recherche et selectionne des etudes dans quatre bases de donnees electroniques (Medline, CINAHL, Embase, Scopus) et en avons extrait des donnees pertinentes. Nous avons recense 3 376 articles, dont 73 repondaient aux criteres d'inclusion. La plupart des etudes ont utilise des methodes de recherche quantitatives. Nous avons defini 27 variables regroupees en trois domaines de facteurs de risque : (a) caracteristiques demographiques et personnelles, (b) etat de sante et symptomes, et (c) antecedents environnementaux et contextuels. L'identification des facteurs de risque associes au fait de se perdre permet d'anticiper les incidents de disparition. Les facteurs de risque peuvent etre associes a des strategies proactives pour prevenir les incidents et informer les politiques afin de creer des communautes plus sures.
BACKGROUND:Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials. OBJECTIVE:This study employed a design thinking framework to examine Chinese immigrant caregivers' (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs. METHODS:Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases. FINDINGS:Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs' interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens. DISCUSSION:The co-design process appears to be beneficial in having participants voice both barriers and preferences.
BACKGROUND:The COVID-19 pandemic highlighted the importance of the care provided by family members and close friends to older people living in long-term care (LTC) homes. Our implementation science team helped three Ontario LTC homes to implement an intervention to allow family members to enter the homes during pandemic lockdowns.OBJECTIVE:We used a variety of methods to support the implementation, and this paper reports results from an Ontario-wide survey intended to help us understand the nature of the care provided by family caregivers.METHODS:We administered a survey of essential caregivers in Ontario, and a single open-ended question yielded a substantial qualitative data set that we analysed with a coding and theming procedure that yielded 13 themes.FINDINGS:The 13 themes reveal deficiencies in Ontario's LTC sector, attempts to cope with the deficiencies, and efforts to influence change and improvement.DISCUSSION:Our findings indicate that essential caregivers find it necessary to take on vital roles in order to shore up two significant gaps in the current system: they provide psychosocial and emotional (and sometimes even basic) care to residents, and they play a monitoring and advocacy role to compensate for the failings of the current regulatory compliance regime.
BACKGROUND:Dancing offers several health and wellness benefits for older adults: it may promote physical literacy (PL) and positively influence the aging process. Yet, limited research considers the perspectives of those with experience working with older adults and in community dance programming.OBJECTIVE:The purpose of this study was to understand program experts' perspectives on how older adult community dance can promote PL and contribute to age-friendly cities and community initiatives.METHODS AND FINDINGS:Four themes were identified from semi-structured interviews with five program experts: (1) expert instructors tailor classes to participants' needs and interests; (2) the heart of what draws us to dancing: authentic experience and social connection; (3) elitist, ableist, and gendered assumptions of dance prevent social inclusion of older adults in dancing spaces; and (4) collaboration across sectors is needed to offer accessible, sustainable, and valued dance programming.DISCUSSION:Recommendations for developing and implementing older adult community dance programming are described.
Résumé Notre recherche visait à mettre en lumière les pratiques bientraitantes des préposées aux bénéficiaires en milieux d’hébergement pour aînés au Québec. L’objet de l’article est de faire ressortir la dichotomie entre les définitions de la bientraitance et son opérationnalisation. Dans la première partie, la notion de bientraitance dans le cadre de deux politiques gouvernementales québécoises est présentée. Ensuite, il est question du travail des préposées aux bénéficiaires en tant que vectrices de cette bientraitance dans la pratique. La troisième partie présente les résultats de notre recherche qui viennent soulever trois constats remettant en cause l’applicabilité des politiques publiques en cette matière : l’absence de reconnaissance d’un métier par définition bientraitant; les injonctions normatives à l’encontre du sens attribué à la bientraitance, et les obstacles organisationnels et sociopolitiques à la bientraitance. Ces constats sont réexaminés à la lumière des écrits dans la discussion, laquelle ouvre sur la notion de maltraitance organisationnelle.
Each year, the Canadian Institutes of Health Research (CIHR) funds the Summer Program on Aging (SPA). The theme of this year's training week, which brought together Canadian graduate students from all disciplines, was multidisciplinary research in old age. This research note presents three thought perspectives from two participants in the 2023 edition of the Summer Program on Aging: 1) issues related to aging are opportunities to transform research paradigms; 2) collaborative research must be societal, reaching beyond the restricted circle of academia; 3) the equity, diversity and inclusion criteria incorporated in research projects must be reflected within the organizations conducting the research.
This study aimed to (a) investigate the associations between indices of stress severity across the lifespan (early, middle, late life) and cognitive function among community-dwelling older adults, and (b) examine whether a healthy lifestyle composite score comprised of physical activity, healthy diet adherence, social engagement, sleep quality, and mindful relaxation moderates the associations between lifespan stress severity and cognitive function. Participants ( n = 226, M age = 68.2 ± 6.5, 68.1% female) completed questionnaires to measure stress and lifestyle behaviours, and three online neurocognitive tasks. No direct associations between stress severity and cognition were found. The healthy lifestyle composite score moderated the associations between early, midlife, and late-life stress severity and inhibitory control. Exploratory analyses suggest that this moderating effect may be sex-dependent. Despite study limitations and the need for additional research, findings provide preliminary support for the role of lifestyle behaviours in enhancing older adults’ resilience to the effects of stress on cognitive health in a sex-specific manner.
Behavioural treatments are recommended first-line for insomnia, but long-term benzodiazepine receptor agonist (BZRA) use remains common and engaging patients in a deprescribing consultation is challenging. Few deprescribing interventions directly target patients. Prescribers' support of patient-targeted interventions may facilitate their uptake. Recently assessed in the Your Answers When Needing Sleep in New Brunswick (YAWNS NB) study, Sleepwell (mysleepwell.ca) was developed as a direct-to-patient behaviour change intervention promoting BZRA deprescribing and non-pharmacological insomnia management. BZRA prescribers of YAWNS NB participants were invited to complete an online survey assessing the acceptability of Sleepwell as a direct-to-patient intervention. The survey was developed using the seven construct components of the theoretical framework of acceptability (TFA) framework. Respondents (40/250, 17.2%) indicated high acceptability, with positive responses per TFA construct averaging 32.3/40 (80.7%). Perceived as an ethical, credible, and useful tool, Sleepwell also promoted prescriber-patient BZRA deprescribing engagements (11/19, 58%). Prescribers were accepting of Sleepwell and supported its application as a direct-to-patient intervention.
Background The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults.Objective/Methods This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used.Findings Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals.Discussion Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care. Context La pandemie de COVID-19 a cree de nombreux defis pour les soins aux patients hospitalises, notamment l'isolement des patients et la limitation des visites a l'hopital. Bien que les technologies de communication, telles que les appels video ou les textos, puissent reduire l'isolement social, leur mise en oe uvre pose des problemes, en particulier pour les personnes agees.Objectif/Methodes Cette etude a utilise une methodologie mixte pour comprendre les defis auxquels sont confrontes les patients hospitalises et pour explorer les points de vue des patients, de leur famille et des prestataires de soins de sante concernant l'utilisation des technologies de communication. Des sondages ont ete menes et des groupes de discussion ont ete organises.Resultats Les patients ayant acces aux technologies de communication ont percu davantage d'effets negatifs sur leur bien-etre, mais moins sur les resultats de l'hospitalisation, par rapport a ceux qui n'y avaient pas acces. La plupart des prestataires de soins de sante estiment que la technologie pourrait ameliorer les programmes proposes, la qualite des liens des patients avec les autres et l'acces aux aides a la transition des soins. Les groupes de discussion ont mis en evidence les difficultes liees a l'infrastructure technologique dans les hopitaux.Discussion Les resultats de notre etude pourraient contribuer aux efforts visant a adopter les technologies de communication de maniere appropriee afin d'ameliorer la qualite des soins aux patients hospitalises et des soins de transition.
Throughout aging, adults with an intellectual disability (ID) experience many changes likely to influence their ability to carry out their daily activities and their social roles. A good understanding of their points of view on that matter appears crucial to better adapt services to their needs. This research aimed to better understand how people with ID perceive their possibilities of social participation as they age. Individual interviews and a participatory workshop were conducted with adults aged 40 to 75 in Quebec City. The analysis of their discourse allowed the identification of their points of view relating to three themes - namely, their capacities, the possibilities of exercising their social participation, and the support received. To conclude, recommendations are proposed to ensure that practices support their social participation through the advancing age.
The quality of care provided to people living with Alzheimer's Disease (AD) depends, in part, on the ability of professionals to identify the extent of awareness in patients. The present research focused on professional caregivers' representations concerning patients' awareness of disorders in residents of long-term care institutions diagnosed with AD. The predictive power of anosognosia on healthcare professionals' burden was also investigated. Anosognosia for construction and initiation impairments (r= 0.40, p = 0.0164; r = 0.32, p = 0.052) was correlated with caregivers' burden. Professionals tended to form representations of patients as being unaware of their condition, including in the absence of anosognosia. Indeed, anosognosia scores did not predict professionals' estimates, except for the overall anosognosia score (chi(2) = 3.38, p = 0.066). However, caregivers overestimated patients' cognitive performances, as measured via the Misawareness protocol (caregiver predictions/actual performances: DC = 12.32, p <0.0001).
Waitlists for long-term care (LTC) continue to grow, and it is anticipated aging populations will generate additional demand. While literature focuses on individual-level factors, little is known about system-level factors contributing to LTC waitlists. We considered these factors through a scoping review. Inclusion/exclusion included publication year (2000-2022), language, paper focus, and document type. A total of 815 abstracts were identified, only 17 studies were included. Through qualitative content analysis, 10 key factors were identified: (1) waitlist management styles, (2) inconsistent standards of admission, (3) personnel shortage, (4) insufficient community-based care, (5) inequitable distribution of services, (6) lack of system integration, (7) unintended consequences of insurance plans, (8) ranking preferences, (9) the debate of supply and demand, and (10) financial incentives. Targeting interventions to address waitlist management, community-based care capacity, and demographic trends could improve access. More research is needed to address system-level barriers to timely LTC access. Les listes d'attente pour les soins de longue duree continuent de s'allonger, et on s'attend a ce que le vieillissement des populations amplifie la demande. Alors que la litterature se concentre sur les facteurs individuels, on sait peu de choses sur les facteurs systemiques qui contribuent aux listes d'attente pour les soins de longue duree. Nous avons mene une etude de portee pour examiner ces facteurs. Les criteres d'inclusion et d'exclusion etaient l'annee de publication (2000-2022), la langue, le theme de l'article et le type de document. Au total, 815 resumes ont ete recenses, mais seules 17 etudes ont ete retenues. L'analyse qualitative du contenu a permis de repertorier 10 facteurs cles : 1) styles de gestion des listes d'attente, 2) manque d'uniformite des criteres d'admission, 3) penurie de personnel, 4) insuffisance des soins communautaires, 5) repartition inequitable des services, 6) manque d'integration des systemes, 7) consequences involontaires des regimes d'assurance, 8) criteres de priorisation, 9) debat sur l'offre et la demande, et 10) incitatifs financiers. Des interventions ciblees visant la gestion des listes d'attente, les capacites de soins communautaires et les tendances demographiques pourraient ameliorer l'acces. D'autres etudes sont necessaires pour remedier aux obstacles systemiques a l'acces aux soins de longue duree dans des delais raisonnables.
Baby boomers were at the forefront of profound social changes in sexual attitudes and many have expressed a desire to remain sexually active throughout their life course. The purpose of this survey study was to assess the perceived preparedness of Ontario's long-term care (LTC) homes to meet the changing sexuality needs and expectations of LTC residents. We examined sexuality-related attitudes, including in the context of dementia, among 150 LTC administrators. Participants also completed a questionnaire assessing their experiences and perceptions regarding existing and anticipated supports, barriers, and priorities. Most participants demonstrated positive sexual attitudes; however, multiple challenges to meeting residents' sexuality needs were noted, including assessing capacity to consent, limited privacy, staff training, conflicting attitudes, and a lack of adequate policy and guidelines. Challenges are broad and significant and considerable attention is required to meet the expectations of the next generation of LTC residents, including gender and sexual minority elders.
Towards developing more effective interventions for fall-related injuries, this study analysed a novel database from six retirement home facilities over a 4-year period comprising 1,877 fallers and 12,445 falls. Falls were characterized based on location, activity, injury site, and type, and the database was stratified across four levels of care: Independent Living, Retirement Care, Assisted Care, and Memory care. Falls most occurred within the bedroom (62.8%), and during unknown (38.1%), walking (20.2%), and transfer tasks (14.6%). Approximately one in three (37%) of all falls resulted in an injury, most commonly involving the upper limb (31.8%), head (26.3%), and lower limb (22.2%), resulting in skin tears (35.3%), aches/pains (29.1%), or bruises (28.0%). While fall location, activity, and injury site were different across levels of care, injury type was not. The data from this study can assist in targeting fall-related injury prevention strategies across levels of care within retirement facilities.
