Research on the relationships between health care aides (HCAs) and families of clients has been situated mainly in long-term care settings and includes scant findings about the perceptions of HCAs. Based on the findings of a larger qualitative study using a grounded theory approach, this paper addresses the topic of HCA–family relationships in complex continuing care (CCC). In-depth individual interviews with eight HCAs and a follow-up focus group with HCAs from three CCC facilities were analysed. Building relationships with families entailed “being there for them and their relatives”, while maintaining relationships involved “dealing with disappointments”. Factors influencing building and maintaining HCA–family relationships included “having supportive team members”, “having resources available”, and “functioning within care-team hierarchies”. The findings highlight the importance of minimizing the unit and organizational factors that disrupt HCA–family relationships.

Innovations in information and communication technologies are changing society, but only 1 in 15 Canadian seniors used a computer at the turn of the millennium (Statistics Canada, 2000). Furthermore, about 1 in 5 Canadian seniors has difficulty hearing, seeing, or communicating. The primary goal of the study was to investigate the relationship between hearing impairment and the use of information and communication technologies by older adults. A questionnaire about use of technologies was administered to 135 older adults and hearing was measured using audiometry. Hearing was found to be related to the extent of use of communication technologies, especially newer and more specialized technologies. Those with hearing loss who did not use a hearing aid did not use other technologies as much as peers with good hearing or hearing-aid users. Overall, the extent of and ability to use information and communication technologies was greater for the study sample than in previous findings for a national sample; however, the patterns of usage of various technologies and the factors influencing use were similar in the two samples. Recommendations are made for future research, health education programs, and universal design.

People frequently express comparative optimism; that is, they believe they are less likely than average to experience negative events. The aim of the present study is, first, to observe whether people of more than 65 years are still optimists when they evaluate driving-related risks; and second, to test the assumption that older drivers show less optimism when they compare themselves with average-age drivers than when they compare themselves with same-age drivers. Our results reveal that drivers of more than 65 years do, indeed, express comparative optimism, but, contrary to our expectation, only in a limited number of cases does the age of the comparison target appear to have an effect. These results are particularly discussed in terms of self-image enhancement.

Despite the focus on burden of caregiving in gerontological research, studies have shown that few caregivers are overly burdened. This article compares predictors of role-specific burden and two quality-of-life measures among caregivers experiencing heavy care demands to assess role-impact on each. The study included 92 community-based caregivers on Vancouver Island. Predictors included primary stressors, personal resources, and socio-demographic factors. Demands of caregiving emerged as the most significant correlate of role-specific burden and was important for overall well-being indirectly, through burden. Resilience was an important correlate of all three outcomes. Over the year of the study, caregivers improved in all three outcomes examined, but we were unsuccessful in predicting that change. Findings suggest caregivers can both be burdened and simultaneously experience good or high well-being, pointing to the importance of not generalizing from studies restricted only to caregiver burden in making recommendations about these people's overall lives.

Assessing the burden linked to caring for the frail elderly is becoming an important issue in rehabilitation. The purpose of this study was to translate/validate the Montgomery Borgatta Caregiver Burden Scale into French for use in Canada. This easy-to-use questionnaire evaluates aspects of burden such as objective, subjective stress and subjective demand burden. The instrument underwent: 1) parallel translation/back-translation; 2) expert's committee review leading to an experimental version; 3) pre-test to ensure wording clarity; and 4) study of psychometric properties with bilingual subjects (n = 27) and French-speaking subjects (n = 18). Results suggest that convergence between the original and the French versions is satisfactory for two of the three sub-scales of the MBCBS (ICC 0.83 et 0.96). The test-retest stability coefficients are also very good (ICC of 0.92 et 0.91), as is internal consistency (0.90, 0.66). The objective burden sub-scale correlates moderately with a measure of functional autonomy (SMAF). Results for the subjective burden scale linked to demand are, however, inadequate. All in all, two of the three sub-scales of the French-Canadian version of the Montgomery Borgatta Caregiver Burden Scale demonstrate adequate psychometric properties, thereby favouring its use in geriatric rehabilitation.

In Canada, the care provided by families occurs in an increasingly multiethnic context. Against this backdrop, the present qualitative study aims to explore the needs/expectations and solutions not only of (female) natural caregivers of an elderly relative hailing from Haiti (presented in terms of tracking cases) but also of remunerated home care providers - all with a view to developing a culturally sensitive service offering. As such, this study works from a conceptual framework centring on the negotiation of a common area of agreement between the stakeholders involved (i.e., natural caregivers and home care providers). To this end, focus groups and individual interviews were conducted among 15 caregivers and 37 home care providers. The three recurrent themes emerging from the data analysis concern, in context, the needs/expectations and solutions surrounding the experience of service use, barriers to use, and the relationships between natural caregivers and home care providers. The statements of both groups evidenced a consistency of views and have thus provided a basis for developing some recommendations acceptable to all stakeholders from the perspective of making culturally-based adjustments to the service offering.

This study examines the baseline characteristics and changes in health status and cost of use of health services associated with use of publicly funded home support services. The analysis includes 122 people 75 years of age or more who were eligible for home support services. Over a 6-month period, one third of the sample used home support services for more than 1hr/week; these seniors had higher rates of depression and cognitive impairment, lower levels of physical and emotional functioning, and less effective coping styles than those who used fewer services. Cognitive impairment explained 17 per cent of the variation in use of home support services. At 6 months, use of home support services for more than 1hr/week by seniors with higher levels of need was associated with lower cost of use of health services and lower levels of improvement in health status. These findings suggest the need for further research to identify efficacious ways of providing home support services to this population to enhance their health status using available resources.

Involuntary weight loss (IWL) is common in the North American elderly population and affects as many as 60 per cent of nursing home residents, representing a threat to health and function. Investigation into nutrient provision in a long-term care (LTC) centre showed that mean total energy exposure over the 5-week menu cycle differed significantly between regular and puréed diet orders, with lower mean levels of exposure to all three macronutrients on a puréed diet order. There is sufficient evidence that current LTC menus may provide fewer nutrients in those receiving puréed diets that further investigation in this area is warranted.

Famille et soins aux personnes âgées: enjeux, défis et stratégies [Families and care for the elderly: challenges and strategies] provides an overview of ageing in various societies and particularly in this country, and of the repercussions of this phenomenon in terms of the steadily increasing responsibilities of families one of whose members has become vulnerable as the result of ageing or illness. The author describes the difficulties encountered by natural caregivers and explicates both their needs and the inadequacy of the services made available to them. This fully documented portrait of the situation is accompanied by suggestions for relevant action.