Background:Ontario's Fixing Long-Term Care Act, 2021 requires long-term care (LTC) licensees to immediately notify police of any alleged, suspected, or witnessed abuse, neglect, or other conduct that may constitute a criminal offence. This study examines compliance with mandatory police notification requirements using publicly available Ministry of Long-Term Care (MLTC) inspection reports. Methods:We conducted a qualitative analysis with descriptive quantitative summaries of MLTC inspection reports issued in 2024. A 20% random sample of Ontario LTC homes was selected, and all associated inspection reports (N = 457) were retrieved. Using predefined keywords ("abuse," "neglect," "police"), relevant reports were identified (n = 193) and analyzed thematically to examine legislative compliance, documentation of police involvement, and enforcement responses. Results:Twenty-one of 193 reports (10.8%) mentioned police and were the focus of our analysis. In 16 of 21 reports, there were accounts of abuse and/or neglect, including theft, fraud, and physical and sexual assault, but police were only notified and dispatched to an LTC home in 2 of the 16 reports (12.5%). The remaining 14/16 cases (87.5%) involved incidents of resident-involved abuse or neglect where police were not contacted. Four of 21 reports (19%) involved noncompliance pertaining to required qualifications and missing or falsified police record checks. The final report cited a prior, second-hand account of police involvement for alleged resident aggression. Conclusion:This study provides the first review of compliance practices of LTC licensees in Ontario and their legal duty to report incidents of abuse, neglect, and other suspected criminal activity to police. Inconsistencies in documentation and variation in violations issued for comparable incidents suggest that these events are often addressed within regulatory or clinical frameworks, with limited documented engagement of criminal processes.
Background:Hearing loss is experienced by two-thirds of hospitalized older adults and is associated with poor access to healthcare and negative health outcomes. Personal hearing amplifiers (PHAs) are evidence-based assistive devices provided in many hospitals to improve accessibility. However, studies note difficulties in implementing the appropriate use of PHAs. This study seeks to identify barriers and facilitators in using PHAs by healthcare providers in an academic hospital. Methods:An ethnographic interview protocol was developed and used to guide voluntary semi-structured interviews with 33 geriatricians, nurses and other allied health professionals, and patient-facing volunteers at Mount Sinai Hospital. The audio interviews were transcribed verbatim and a reflexive thematic analysis was performed. Finally, member checking was completed by sharing results with interviewees who consented to re-contacting and interest-holders within the hospital's geriatrics program to receive feedback. Results:Thematic analysis revealed that regardless of profession, PHAs were perceived as valuable yet underutilized. Under this overarching theme, three key themes were identified around PHA use: barriers to accessibility and availability, lack of designated responsibility, and lack of integration into clinical practice. These findings highlight both the facilitators and barriers associated with implementing PHAs. Discussion:PHAs are important accessibility tools, and this study has identified barriers and facilitators to their use by healthcare providers and volunteers communicating with patients with hearing loss. These findings lay the groundwork to test future interventions to promote the increased uptake of PHA devices and greater access to healthcare for older patients experiencing hearing loss.
Background:Falls are a leading cause of injury and loss of independence among older adults. While gait-monitoring technologies offer promise for early fall risk detection, adoption is hindered by usability, cost, and integration challenges. Few studies incorporate perspectives from both patients and providers to inform user-centred design. Objective:To identify barriers, facilitators, and design considerations for implementing gait-monitoring and fall-assessment technologies among older adults, caregivers, and healthcare providers. Methods:A qualitative needs assessment was conducted with older adults (≥65 years), caregivers, and healthcare providers in British Columbia, Canada. Participants were recruited via REACH BC, community organizations, and professional networks. Data collection included demographic surveys, standardized questionnaires (EuroQol 5-Dimension 5-Level (EQ-5D-5L), Patient Activation Measure (PAM-13), Fall Efficacy Scale), and semi-structured interviews. Thematic analysis was performed using NVivo 12. Results:Twenty-nine older adults/caregivers participated. Most reported slight-to-moderate functional limitations and high engagement in self-care. Four key themes emerged: (i) navigating health and fall prevention-proactive self-management but access barriers; (ii) embracing and questioning health technologies-interest tempered by complexity and perceived relevance; (iii) openness to gait monitoring and boundaries of trust-conditional acceptance, privacy concerns; (iv) designing for real lives-preferences for comfortable, discreet, affordable devices and integration into clinical workflows. Providers valued continuous data but cited cost, patient tech-readiness, and actionable output as critical. Conclusion:Stakeholders expressed interest in gait-monitoring technologies that are affordable, discreet, easy to use, and respectful of autonomy. Aligning device design with both personal comfort and clinical utility, and addressing privacy and integration challenges, may improve adoption and support safe aging in place.
Background Older adults with motoric cognitive risk syndrome (MCR) exhibit impairments in dual-task mobility. Non-pharmacological interventions, such as physical exercise and cognitive strategies, have been proposed to mitigate physical and cognitive decline. However, the effectiveness of combining these approaches remains unclear. Objective To evaluate the effects of instability resistance training (IRT) performed with or without mindfulness on mobility under single- and dual-task conditions and fall- related outcomes in older adults with MCR. Methods In this parallel-group randomized controlled trial, 56 community-dwelling older adults with MCR (≥65 years) were allocated to IRT or combined with mindfulness (IRT + Mind). Both groups trained twice weekly for 24 weeks. Primary outcomes included single- and dual-task Timed Up and Go (TUG). Secondary outcomes were dual-task cost, concern about falling (Falls Efficacy Scale–International), and balance confidence (Activities-specific Balance Confidence Scale). Outcomes were analyzed using generalized mixed models. Results For single-task TUG, a significant main effect of time was observed (p < .001), with similar improvements in both groups (0.62–0.80 s). Dual-task TUG performance improved over time for both cognitive conditions, with significant group × time interactions favoring the IRT group (p ≤ .049). Dual-task cost did not change significantly. Balance confidence improved significantly over time in both groups (mean increase ≈14 points; p < .001), whereas concern about falling remained unchanged. Conclusion IRT improved mobility and confidence in balance in older adults with MCR. The addition of mindfulness did not provide incremental benefits, suggesting that motor-based training alone is sufficient to promote functional gains in this population.
