Rates of sexual activity have been found to decline over the life course, as individuals experience marital transitions and the loss of partners, health problems, and decreased sexual interest. This article compares and contrasts earlier- and later-life sexual experiences and examines the changing meanings that older women ascribe to sexuality over the life course. Qualitative data from a study involving 24 women aged 52 to 90 who were remarried after age 50 illuminate a shift, as individuals age, from an emphasis on the importance of sexual intercourse and passion to a greater valuing of companionship, cuddling, affection, and intimacy. Situating the discussion in the context of changing cultural norms and sexual scripts, the article investigates the impact of health conditions on the women's sexual relationships as well as the women's tendency to have later-life sexual experiences more positive than were their earlier sexual experiences.

Based on a qualitative study of home care workers, this paper aims to understand elder abuse of Chinese Canadians. The findings show disrespect is the key form elder abuse takes in the Chinese community. As a culturally specific form of abuse, disrespect remains invisible under categories of elder abuse derived from a Western cultural perspective. Applying a social exclusion framework to understand the dynamic of elder abuse, we argue that as a marginalized racial minority immigrant, an elderly Chinese person's vulnerability to abuse is increased under conditions of social isolation.

The purpose of this study was to examine the relationships of diagnosis and treatment of depression with anhedonic and dysphoric symptom presentation, using the Minimum Data Set 2.0. Participants were from two sectors of long-term care: 70 nursing home residents and 92 residents in a Veterans' Care Service. The samples differed in their sex distribution and in cognition. A series of logistic regressions that controlled for demographics, type of facility, and cognition showed that dysphoric symptoms predicted diagnosed depression, whereas anhedonic symptoms predicted anti-depressant medication use without a concomitant diagnosis. The findings are consistent with a hypothesis that, in long-term care settings, anhedonic symptoms contribute less to a diagnosis of depression than do dysphoric symptoms. However, findings that anhedonic symptoms relate to treatment have implications for care-planning protocols.

The future of mandatory retirement is at least partly driven by changing demographics. In Canada, these demographics include slowing population growth, rapid aging, declining rates of labour force participation, and slowing labour force growth. After reviewing the demographic trends and considering alternate scenarios in labour force participation, we consider the determinants of early departures from the labour force and suggest scenarios that might reverse these trends. With a decline in labour force entrants, delays in early life transitions, and possible reductions in retirement benefits, a trend to retire later would bring mandatory retirement into question.

Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.

The decision to move a family member with dementia to a nursing home is a difficult experience for caregivers. Complex psychosocial factors are involved and knowledge of predictive factors alone is insufficient. Using grounded theory, this study explores the decision-making process with regards to institutionalization, from the perspective of family caregivers. Fourteen people who moved a relative to long-term care in the preceding 6 months were interviewed. Data analysis using comparative analysis and line-by-line dimensional analysis was used to develop a theoretical model of the decision-making process. Three factors within the model were central to the process: (a) caregivers' perceptions of their ability to provide care, (b) caregivers' evaluations of their relatives' ability to make care decisions, and (c) the evolving influence of contextual factors and interactions with healthcare professionals. The contribution of these findings to new conceptualizations of institutionalization is discussed.

Two studies examined predictors of medical care satisfaction in communities in Eastern Canada. Both studies focused on how the roles of pharmacists and physicians are perceived by adults of different ages. Using a survey methodology, Study 1 demonstrated that middle-aged adults, older adults, and community pharmacists differ in the extent to which they rate pharmacists as being important members of the health care team. Specifically, community members value pharmacists as health care providers, and this is especially true for older adults. Using an experimental paradigm, Study 2 examined ratings of medical interaction scenarios, ratings that varied as a function of kind of health professional (pharmacist vs. physician) and type of advice (directive vs. non-directive). Results suggest that older adults may have a more complex set of expectations about their health care interactions than do younger adults and that, for older adults, the factors that determine satisfaction differ across the professions being evaluated.

The utilization of health services by older adults has received increased attention over the past decade, but little is known about how service utilization varies between rural and urban areas. In an era of restructuring and downsizing within the Canadian health care system, there are concerns that rural older adults may be increasingly disadvantaged when it comes to accessing health care. This article examines the utilization of a range of health services by older adults living in urban and rural communities in British Columbia. A major strength of this article is its concurrent focus on a continuum of geographic communities and a broad range of services needed and used by older populations. The research utilizes provincial administrative health data from 48,407 older residents of British Columbia who used services in 1998–1999. Multivariate analyses of co-variance reveal some unique service utilization patterns by geographical area and population.