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Rural and Urban Canadians with Dementia: Use of Health Care Services*

Published online by Cambridge University Press:  31 March 2010

Dorothy A. Forbes ,
Debra Morgan  and
Bonnie L. Janzen
Dorothy A. Forbes*
Affiliation:
School of Nursing, University of Western Ontario
Debra Morgan
Affiliation:
Institute of Agricultural, Rural, and Environmental Health, University of Saskatchewan
Bonnie L. Janzen
Affiliation:
Department of Community Health and Epidemiology, University of Saskatchewan
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Dorothy A. Forbes, R.N., Ph.D., School of Nursing, University of Western Ontario, Room H33, Health Sciences Addition, London, ON N6A 5C1. ([email protected])
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Abstract

The purpose of this research was to examine the characteristics of older Canadians with dementia (compared to those without dementia), their use of health care services, and the impact of place (rural/urban) on use of services. Andersen and Newman's Behavioural Model of Health Services Use (1973) guided the study. A cross-sectional design used data from the Canadian Community Health Survey (CCHS) Cycle 1.1 (N=49,995 older Canadians; those with dementia =313). Results indicated that among Canadian females between the ages of 50 and 64, those with dementia were more likely than those without dementia to live in rural areas. Among females 80 years of age and over, those with dementia had higher levels of education and income than those without dementia. In addition, a higher proportion of white than of visible minority Canadians was afflicted with dementia. The results further suggest that Canadians with dementia primarily required support services and that they were more likely than persons without dementia to report that their health care needs were unmet. It is recommended that publicly funded national home care programs be expanded to ensure that the supportive services needed by this population are available.

Résumé

La présente recherche analyse les caractéristiques de Canadiens âgés souffrant de démence (comparativement à d'autres qui n'en souffrent pas), les services de soins de santé auxquels ils avaient recours, et la relation entre l'endroit où ils habitent (rural ou urbain) et leur utilisation de ces services. Behavioural Model of Health Services Use d'Andersen et Newman (1973) a servi de guide lors de cette étude. Une étude transversale a utilisé des données de l'Enquête sur la santé dans les collectivités canadiennes (ESCC) – Cycle 1.1 (N=49,995 Canadiens âgés; souffrant de démence =313). Les résultats ont indiqué que, parmi les femmes canadiennes âgées de 50 à 64 ans, celles souffrant de démence étaient plus susceptibles de vivre dans une région rurale que celles qui n'en étaient pas atteintes. Chez les femmes de 80ans et plus, celles souffrant de démence étaient plus instruites et avaient un meilleur revenu que celles qui n'en souffraient pas. En outre, une plus grande proportion de Canadiens blancs que de Canadiens faisant partie des minorités visibles étaient touchés par la démence. Les résultats suggèrent aussi que les Canadiens souffrant de démence demandaient avant tout des services de soutien et qu'ils étaient davantage susceptibles que les personnes ne souffrant pas de démence de déclarer que leurs besoins en soins de santé n'étaient pas satisfaits. Il est recommandé d'élargir les programmes nationaux publics de soins de santé afin de s'assurer que les services de soutien requis par cette population sont disponibles.

Keywords

aginghealth care service userural and urbanAlzheimer disease and related dementiaCanadian Community Health Surveyvieillissementutilisation des services de soins de santérural et urbainmaladie d'Alzheimer et démence afférenteEnquête sur la santé dans les collectivités canadiennes
Type
Research Note/Note de recherche
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 25 , Issue 3 , Fall/Automne 2006 , pp. 321 - 330
Copyright
Copyright © Canadian Association on Gerontology 2006

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Footnotes

*

This research was supported by a Saskatchewan Health Research Foundation Grant to the first author and a CIHR NET grant to the second author. The authors would like to acknowledge Dr. H. Jay Biem, for his initial contribution to the manuscript, and Shelley Peacock, Jennifer Adamson, and Olivia Chadwick, who were research assistants on this project.

References

Andersen, R. (1995, March). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Science, 36, 1–10.Google ScholarPubMed
Andersen, R., & Newman, J.F. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly Health and Society, 51, 95–124.CrossRefGoogle ScholarPubMed
Béland, Y. (2002). Canadian Community Health Survey: Methodological overview. Health Reports, 13(3), 9–14 (Statistics Canada Catalogue 82-003).Google ScholarPubMed
Boyle, M.H., Furlong, W., Feeny, D., Torrance, G.W., & Hatcher, J. (1995). Reliability of the Health Utilities Index-Mark III used in the 1991 Cycle 6 Canadian General Social Survey Health questionnaire. Quality of Life Research, 4, 249–257.CrossRefGoogle ScholarPubMed
Canadian Nurses Association (1998). National home and community care for Canadians. A brief to the Honourable Allan Rock PC, MP, Minister of Health, Canadian Nurses Association, Ottawa.Google Scholar
Canadian Study of Health and Aging Working Group (1994a). Canadian Study of Health and Aging: Risk factors for Alzheimer's disease in Canada. Neurology, 44, 2073–2080.CrossRefGoogle Scholar
Canadian Study of Health and Aging Working Group (1994b). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899–913.Google Scholar
Canadian Study of Health and Aging Working Group (1994c). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging, 13(4), 470–487.CrossRefGoogle Scholar
Chappell, N.L., & Penning, M.J. (1996). Behavioural problems and distress among caregivers of people with dementia. Ageing and Society, 16, 57–73.CrossRefGoogle Scholar
Forbes, D.A., Stewart, N., Morgan, D., Anderson, M., Parent, K., & Janzen, B. (2003). Individual determinants of home-care nursing and housework assistance. Canadian Journal of Nursing Research, 35(4), 14–36.Google ScholarPubMed
Forbes, D.A., & Janzen, B.L. (2004). A comparison of rural and urban users and non-users of home care in Canada. Canadian Journal of Rural Medicine, 9(4), 227–235.Google Scholar
Hawranik, P. (2002). Inhome service use by caregivers and their elders: Does cognitive status make a difference? Canadian Journal on Aging, 21(2), 257–271.CrossRefGoogle Scholar
Hendrie, H.C., Hall, K.S., Pillay, N., Rodgers, D., Prince, C., Norton, J., et al. (1993). Alzheimer's disease is rare in Cree. International Psychogeriatrics, 5, 1993.CrossRefGoogle ScholarPubMed
Hulley, S.B., Cummings, S.R., Browner, W.S., Grady, D., Hearst, N., & Newman, T.B. (2001). Designing clinical research. 2nd ed.Phildadephia, PA: Lippincott.Google Scholar
Keating, N., Fast, J., Frederick, J., Cranswick, K., & Perrier, C. (1999). Eldercare in Canada: Context, content and consequences. Ottawa: Statistics Canada.Google Scholar
Loewenstein, D.A., Arguelles, S., Bravo, M., Freeman, R.Q., Arguelles, T., Acevedo, A., et al. (2001). Caregivers' judgments of the functional abilities of the Alzheimer's disease patient: A comparison of proxy reports and objective measures. Journal of Gerontology: Psychological Sciences, 56B(2), P78–P84.CrossRefGoogle Scholar
Markle-Reid, M., & Browne, G. (2001). Explaining the use and non-use of community-based long-term care services by caregivers of persons with dementia. Journal of Evaluation in Clinical Practice, 7(3), 271–287.CrossRefGoogle ScholarPubMed
Mitura, V., & Bollman, R. (2003). The health of rural Canadians: A rural–urban comparison of health indicators. Rural and Small Town Canada Analysis Bulletin, 4(6) (Catalogue 21-006-XIE).Google Scholar
Morgan, D., Semchuk, K., Stewart, N., & D'Arcy, C. (2002). Rural families caring for a relative with dementia: Barriers to use of formal services. Social Science and Medicine, 55(7), 51–64.CrossRefGoogle ScholarPubMed
Munro, B.H. (2001). Statistical methods for health care research. Philadelphia, PA: Lippincott.Google Scholar
National Advisory Council on Aging (2003). Interim report card: Seniors in Canada 2003. Ottawa: Author.Google Scholar
Ostbye, T., & Crosse, E. (1994). Net economic costs of dementia in Canada. Canadian Medical Association Journal, 151, 1457–1464.Google ScholarPubMed
Romanow, R.J. (2002). Building on values: The future of health care in Canada. Ottawa: Commission on the Future of Health Care in Canada.Google Scholar
Rupnik, C., Thompson-James, M., & Bollman, R.D. (2001). Measuring economic well-being of rural Canadians using income indicators. Ottawa: Statistics Canada, Agricultural Division (Catalogue no. 21-601-MIE01045).Google Scholar
Sherbourne, C.D., & Stewart, A.L. (1991). The MOS Support Survey (Medical Outcomes Study Social Support Survey). Social Sciences and Medicine, 32, 705–714.CrossRefGoogle Scholar
StJohn, P.D., Havens, B., van Ineveld, C.H.M., & Finlayson, M. (2002). Rural–urban differences in health status of elderly Manitobans. Canadian Journal of Rural Medicine, 7(2), 89–93.Google Scholar
Smale, B., & Dupuis, S. (2002). Highlights: Preliminary results from the study on needs of caregivers of persons with Alzheimer disease or a related dementia and community support services in Ontario. Waterloo, ON: Murray Alzheimer Research and Education Program/Alzheimer Society of Ontario/Caregivers' Association of Ontario.Google Scholar
Statistics Canada (2002a). The Canadian Community Health Survey Cycle 1.1: Health regions. Retrieved 19 October 2002 from www.statcan.ca/english/concepts/health/regions.htm.Google Scholar
Statistics Canada (2002b). Canadian Community Health Survey (CCHS) Cycle 1.1: Derived variable (DV) specifications. Ottawa: Author.Google Scholar
Statistics Canada (2002c). CCHS Cycle 1.1 (2000–2001): Public use microdata file documentation. Ottawa: Author.Google Scholar
Statistics Canada (2004). Table 105-0114: Canadian Community Health Survey urban–rural profile, by sex, Canada, provinces and territories, every 2 years. Retrieved 28 December 2004 from http://cansim2.statcan.ca/cgi-win/CNSMCGI.EXE.Google Scholar