Client-responsive behaviours occur commonly among residents in long-term care (LTC) settings; direct-care staff, however, receive little education, support, or opportunities to discuss and collaborate on managing such behaviours. Our participatory action project introduced mental health huddles to support staff in discussing and managing client-responsive behaviours in long-term care. This research project engaged direct-care staff (e.g., personal support workers, registered practical nurses, housekeeping staff, and registered nurses) in learning how to use these huddles. Staff workers used huddles as a forum to stay informed, review work, problem solve, and develop person-centered action plans. Fifty-six huddles occurred over a 12-week period; two to seven direct-care staff participated in each huddle. Focus groups indicated improved staff collaboration, teamwork, support, and communication when discussing specific responsive behaviours. Huddles provided LTC staff with the opportunity to collaborate and discuss strategies to optimize resident care. Further research on how huddles affect resident care outcomes is needed.

The need for home care is increasing in Canada, yet little is known about the home care experience of clients and their families. Uncovering the meaning of the home care experience is an important step towards developing understanding and public awareness. We explored the experiences of home care using arts-based methods and individual interviews with 11 participants (one client and 10 family caregivers). Participants discussed the numerous ways formal home care and family caregiving affected their lives, how they coped with these effects, their experiences in hospitals or assisted living facilities, and aspects of the home care experience they liked or disliked. Participants agreed that home care facilitated a better quality of life for families and clients, although they acknowledged some challenges with it. The artistic outputs produced by participants facilitated interview dialogue and fostered understanding of key themes within the research team.

Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults’ explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18–24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.

Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients’ homes), as well the negotiation of external relationships in the HBPC field, require further investigation.

The objectives of this three-phased investigation were to (1) characterize existing recreational programming opportunities for tenants residing in assisted living (AL) and (2) gather perceptions on factors influencing activity program planning and delivery. Using an integrated knowledge translation framework during a one-year collaboration, we targeted 51 publicly funded AL sites from two health authorities in British Columbia. We conducted an activity calendar review, staff survey, and interactive symposia to identify factors that enabled or restricted recreational programming. From the information obtained, we determined that all AL sites delivered recreational programming. Although exercise and physical activity opportunities were perceived as having high importance, most activities were social. Staff reported confidence in delivering this type of programming and believed it met the holistic needs of tenants, including their mental well-being, and fostered a sense of community. Future avenues for increasing physical activity of AL tenants should address individual, site, and organizational characteristics.

The present study was conducted to determine whether anxiety among community-dwelling elders is associated with cognitive decline over a period of one year as well as to verify whether there are sex differences in the association between anxiety and cognitive decline. Participants (n=1942) were community-dwelling adults aged 65–96 years assessed at study entry (T0) and one year later (T1). Anxiety was identified with a semi-structured interview and cognitive functioning was assessed using the Mini-Mental State Examination. Results revealed that the presence of a clinically significant anxiety disorder did not predict cognitive decline in men and women. Subclinical anxiety symptoms predicted cognitive decline in women only. Moreover, for men, the presence of symptoms from at least two anxiety disorders predicted cognitive decline. For women, cognitive decline was predicted by the presence of symptoms from one anxiety disorder only. Overall, the results illustrate the role of anxiety in cognitive decline in community-dwelling older adults.

The implementation in Ontario of 15 primary-care–based interprofessional memory clinics represented a unique model of team-based case management aimed at increasing capacity for dementia care at the primary-care level. Each clinic tracked referrals; in a subset of clinics, charts were audited by geriatricians, clinic members were interviewed, and patients, caregivers, and referring physicians completed satisfaction surveys. Across all clinics, 582 patients were assessed, and 8.9 per cent were referred to a specialist. Patients and caregivers were very satisfied with the care received, as were referring family physicians, who reported increased capacity to manage dementia. Geriatricians’ chart audits revealed a high level of agreement with diagnosis and management. This study demonstrated acceptability, feasibility, and preliminary effectiveness of the primary-care memory clinic model. Led by specially trained family physicians, it provided timely access to high-quality collaborative dementia care, impacting health service utilization by more-efficient use of scarce geriatric specialist resources.

Heart failure (HF) is common among long-term care (LTC) residents, and may account for 40 per cent of acute-care transfers. Canadian Cardiovascular Society HF guidelines endorse standard therapies; yet LTC residents are less likely to receive treatment. This qualitative study employed focus groups to explore perceptions, from 18 physicians and nurse practitioners in three Ontario homes, on HF care practices and challenges. For example, participants reported challenges with HF diagnostic skills and procedural knowledge. They also identified the need for interprofessional collaboration and role clarification to improve HF care and outcomes. To address these challenges, multimodal interventions and bedside teaching are required. Leadership was viewed as essential to improve HF care. Several concerns arose regarding knowledge gaps and clinical deficits among primary-care providers who manage heart failure in LTC residents. Multimodal, clinically focused educational and interprofessional solutions are needed to improve HF care in long-term care.

This mixed-methods study evaluated the effect of a community-engaged arts program on the physical, emotional, and social well-being of seniors. Weekly workshops were offered over a three-year period at community centers where artists worked with four groups of seniors to produce a collective art piece or performance for public presentation. Participants completed pre- and post- questionnaires, and group interviews were conducted at the program’s end. Paired t-test analyses indicated that seniors experienced improvement in perceived overall health, experience of pain, and sense of community. Interpretive descriptive analysis of the group interviews revealed six themes that informed understanding : (1) providing structure and discipline; (2) facilitating coping; (3) requiring hard work and effort; (4) bringing out one’s artistic side; (5) promoting social involvement; and (6) making a contribution. These results are consistent with previous research and contribute to further understanding of how community-engaged arts can benefit the well-being of older people.