The confluence of rapid population aging and the overwhelming desire of older adults to age in place begs the question: Do our cities support the health and well-being of aging populations? Using a neighbourhood-by-neighbourhood approach, this macro-scale investigation explores the “double risk” that many older adults live with – the potential of being disadvantaged by socio-demographic risk factors (being older, living alone, low income) and by living in an unsupportive built environment. It is an integration of what we know about supportive built form for older adults and applies this knowledge to Canadian cities, using a spectrum approach to classifying built environments. We found that most older adults with socio-demographic risk factors are living in unsupportive built environments in Canada; however, the distribution between built environments along the spectrum and between municipalities reveals a variegated landscape of double risk. Previous research suggests that unsupportive built environments can be supplemented with services, small-scale improvements in the built environment, and larger-scale retrofitting of neighbourhoods. Since the spatial distribution of vulnerability varies greatly within the 33 Canadian cities analysed, it highlights the need for this kind of inquiry to target age-friendly policy interventions.

This study aimed to explore the prevalence of suicidal thoughts and potential associations (i.e., strength and direction) with caregiver characteristics or factors. A targeted survey was distributed to dementia caregivers aged 55+ years. Questions concerning psychological distress, suicidal thoughts while caregiving and antecedents of suicidal behaviours were administered. A sample of 71 French-speaking Canadian caregivers completed the survey between May and October 2019. Among them, 52.1 per cent (n = 37) reported suicidal ideation while providing care to a relative or a friend living with dementia. Caregivers who presented suicidal ideation reported more abusive behaviour toward the care recipient. Caregivers who reported suicidal thoughts were significantly more distressed than caregivers without them on measures of burden, depression, and anxiety. Suicidal thoughts in caregivers are important evaluation targets, primarily for the prevention of suicide, but also because caregivers who report suicidal thoughts also present a heightened risk for abusing the care recipient.

Limited research exists on the experiences of older adults participating in community rehabilitation. Our longitudinal, collective case study explored older adults’ experiences while they engaged in community rehabilitation and home care services, as well as family caregivers’ concurrent experiences. Drawing on interpretive description, we inductively analysed interview data gathered at three points over 3–6 months from six family dyads. Questions focused on activities of daily living, instrumental activities of daily living and other meaningful activities affected by changes in the older adult’s health. From our thematic analysis, three themes emerged: (a) Centring community rehabilitation and home care services around the older adult and family; (b) Understanding the intricate interface of formal and informal supports; and (c) Supporting the meaningful aspects of life. Our findings suggest a metaphor of re-braiding, a reconfiguration of activities that requires increased integration of formal and informal supports within home care and community rehabilitation.

Social participation has tremendous implications for the physical and mental health of older adults. A growing body of Canadian literature has examined social participation among older adults, including frequency of participation; gender, age, and regional differences in participation; and associations with self-perceived health, loneliness, and life dissatisfaction. The current study adds to this important body of research, using a large, nationally representative sample of adults 45–85 years of age (Canadian Longitudinal Study on Aging [CLSA] baseline data [n = 51,338]), to examine nuanced characteristics associated with social participation (socio-demographics, social support, cognitive ability, mental health, physical conditions), frequency of participation, and the relationship between the aforementioned characteristics and frequency of participation. Findings indicated that compared with those who reported infrequent/no participation, more frequent participation was associated with greater social support, higher cognitive abilities, increased satisfaction with life, fewer depressive symptoms, reduced odds of self-reported mood and anxiety disorders, and fewer self-reported physical conditions. Findings highlight the importance of active social participation, and have important implications for the development and implementation of accessible community programs across Canada.

Survivorship of patients placed into long-term care facilities within the Regional Municipality of Hamilton-Wentworth was studied over a seven-year period from 1980 to 1987. All patients had been assessed prior to placement by the Placement and Coordination Service and their computer files served as the data base for this study. Over the seven years, 25 per cent of patients died in each of nursing homes, homes for the aged and lodging homes and over 50 per cent of patients died after being placed in chronic care hospitals. Approximately 10 per cent of the deaths occurred in the first year after placement in the lodging homes, homes for the aged and nursing homes, whereas 25 per cent died in this time in chronic care beds. Survivorship rates of all patients combined differed significantly for males compared with females, but were not significantly different for variables such as age at time of placement, marital status, ambulation, living arrangement, previous location of community versus institutions, and agreement between recommended and final placement. Client's memory at time of placement was associated with survivorship in a nursing home: males with “no recall” and females with “marked confusion” and “no recall” survived longer than those with “normal” memory.

Cet article étudie le vieillissement de la main-d'oeuvre au sein des services publics de la Colombie-Britannique entre 1983 et 1991. Les inscrits aux fichiers annuels de rémunération du personnel du gouvernement ont été répartis selon l'âge, le sexe et la classification d'emploi des employés et par leur utilisation des programmes de maladie à court terme et d'invalidité prolongée. Des données sur la retraite sont également tirées des rapports annuels de la caisse de retraite des services publics. Ces données sont analysées en fonction des tendances en matière de retraite, du taux de rotation de la main-d'oeuvre et des tendances au plan de l'absentéisme. Les résultats révèlent une forte hausse au sein de la catégorie des travailleurs d'âge moyen et une faible augmentation du vieillissement de la main-d'oeuvre. L'embauche d'un plus grand nombre de travailleurs ayant atteint leur mi-carrière et d'un nombre inférieur de jeunes travailleurs conjuguée à des programmes de retraite anticipée ont causé une bulle dans la structure d'âge de la main-d'oeuvre, plutôt que son allongement, comme on peut observer au sein de l'ensemble de la population. Les auteurs discutent ensuite des conséquences à long terme et à court terme en regard de l'utilisation des ressources humaines.

Causes of falls in older adults are common, multifactorial, and can lead to significant injury. This before-and-after study evaluated the benefits of a Fall Prevention Mobile Clinic (FPMC) in reducing the risk of falling in older adults in British Columbia, Canada. Four hundred seventy-six participants (average age of 83.6 years) enrolled in the study and were followed for 12 months after attending the FPMC. At 12-month follow-up, the mean percentage uptake of fall prevention recommendations was 48.8 per cent (SD = 25.7%), the Timed Up and Go mobility measure improved from a median of 19.04 seconds to 17.45 seconds and the number of participants falling decreased from 64.8 per cent (in the 12 months before attending the clinic) to 55.6 per cent (in the 12 months after attending the clinic) (p = .012). After attending the FPMC, participants acted on recommendations, improved mobility and decreased their risk of future falls.

The purpose of this study was to measure the impact of a leisure education/ counseling workshop on the leisure motivation, participation and satisfaction of a group of 27 senior citizens. The content of the workshop was based largely on the value clarification technique. The data, analysed using the t-test, indicate the workshop's limited impact on the dependent variables measured.

Psychological treatment of depression in the elderly has recently benefited from the development of the cognitive approach. In particular, cognitive psychotherapy seems well adapted to and accepted by older people. In this article, we attempt to show the course of this type of psychotherapy in the case of a 79 year-old depressive woman in our Cognitive Therapy Unit for Elderly. We emphasize the therapeutical setting and the content of the sessions, the techniques used, the changes that occurred, and finally, the therapeutic alliance is described. Although some negative views about psychotherapy with older people are not totally abandoned, this vignette is a good illustration of the benefits for the patient and the highly enriching work for the therapist.

Online delivery is new to the field of music therapy (MT). This research investigated older adults’ perceived quality of MT online by certified music therapists. In this feasibility study, applying both process and outcome assessments, nine older adults volunteered to participate. Zoom was used, and a virtual music therapy (VMT) kit was developed as a resource. Surveys and observed technical difficulties revealed that perceived quality varied slightly by level of technical difficulty experienced; however, overall mean perceived quality was 7.2 out of 9. Post-study interviews revealed three main themes: (a) individual experiences with VMT, (b) individuals’ suggestions for further development of VMT sessions, and (c) individuals’ personal outcomes from VMT sessions. Participants reported overall positive experiences with VMT. Despite a slight decline in perceived quality when more technical difficulties were present, each participant reported a desire for more sessions, and they would recommend it to others.

An analysis is made concerning the relation of different factors to client transfer between levels of care in an area-based system of long-term care for the elderly and the disabled. Special emphasis is given to the transfer from non-institutional to institutional care. The analysis uses data collected through the application of the ASIM monitoring system from 1985 to 1991 in the municipality of Solna, Sweden. Factors analysed include age, sex, marital status, co-habitation, accessibility of housing, informal social support and different aspects of disability. Multivariate analysis regarding factors related to institutionalization — i.e. transfer from domiciliary care or sheltered housing to residential home or long-term hospital care/nursing home — showed level of disability, staff assessment of appropriate level of care and age to be the most significant factors. Dementia was the strongest individual disability factor with functional disability and incontinence also having some influence on the probability of transfer. Deficiencies in the social environment in terms of living alone, inadequate housing accessibility or lack of social support did not show up — presumably because they were adequately compensated for by the public home help services

In this article we analyse the rates at which those admitted to hospital with acute myocardial infarction (AMI) receive aggressive treatment, assess how those rates have changed over time, and ask whether there is evidence of age discrepancies. Estimates made on the basis of data from an administrative database that includes discharges from all acute care hospitals in Ontario for selected years, from 1995 to 2005, indicate that there are strong and persistent age patterns in the application of medical technology. Results showed that to be true even after controlling for the higher rates of co-morbidities among older patients and variations across hospitals in practice patterns.

Hospitals may transfer seniors with a hip fracture to various rehabilitation settings. Knowing the relationship between hospital teaching status and post-acute rehabilitation setting may help evaluations of the transfer from acute care. The purpose of this study was to determine the relationship between hospital teaching status and rehabilitation destination following acute care in seniors with a hip fracture. Hospital separations were linked with home care records to identify hip fractures and hospital-based or home care rehabilitation (n = 806). Two logistic regression models determined the likelihood of transfer to any rehabilitation destination and to hospital-based versus home care rehabilitation. Teaching hospitals were no more likely than non-teaching hospitals to discharge patients to any rehabilitation (OR 1.20, 95% CI 0.88,1.65). However, among those referred to rehabilitation, the odds of discharge to hospital-based versus home care rehabilitation were almost four times greater for patients in teaching hospitals (OR 3.76, 95% CI 2.23, 6.37). The results are consistent with the availability of post-acute rehabilitation in the planning area. Future study of post-acute rehabilitation outcomes should consider hospital teaching status as an indicator of how hospital-based factors may affect the utilization of post-acute rehabilitation.