Canada faces a significant challenge in meeting the health care needs of older adults with complex mental and physical health issues. Studies have shown collaborative mental health services to effectively address the diverse health needs of this group. However, an often overlooked yet important aspect of service delivery planning for this population is to ensure that older adults are sufficiently able to access available best-practice services. The article reports on a national consensus-building exercise conducted by the Collaborative Mental Health Initiative—Seniors Working Group to develop a nationally informed framework on the accessibility needs of older adults as they relate to collaborative mental health care. The framework is intended to provide planners, administrators, and providers with an understanding of the unique accessibility needs of older adults across three priority pillars (personal, caregiver, systemic) and to enable them to embed strategies to address these issues within field-based collaborative mental health initiatives.

In the province of Québec, services focusing on the instrumental activities of daily living are delivered to seniors by a combination of non-profit organizations and cooperatives. But do these organizations perform differently? This study asks whether home support cooperatives deliver higher-quality care than non-profit home support agencies. The specific effects of consumer and worker participation on the board of directors are also tested. Data were collected in 2006 and 2007 from 831 individuals receiving home support services from nine cooperatives and nine non-profits. Two consumer-centered measures of quality were used: a summated, 39-point satisfaction score and a 4-point overall quality score. Data were analyzed using ordered logistic regression. Results show that although organizational type was not a predictor of the two quality outcomes, worker involvement in governance was positively associated with the satisfaction score, while consumer involvement was positively associated with the overall quality score.

Leisure represents a positive way to keep relationships satisfactory between caregivers and a person with dementia. Adapted leisure education is a promising approach to assist the family to discover new ways to share good times with their relatives. This study aimed to develop an adapted leisure education program. It included an evaluation of the caregivers’ needs, the program content development, and a pilot study to experiment with the content of the program. Three focus groups of dementia caregivers (n = 19) were conducted to investigate caregivers needs. Based on content analysis of these focus groups and a literature review, the content of the program was developed. The pilot study (n = 4) included a quasi-experimental trial and an implementation evaluation. This study led to the development of an adapted leisure education program that puts caregiver support in a new perspective, focusing on positive aspects rather than the burden of caregiving.

This study investigated the relationships among gender role and self-reported health functioning in a sample of community dwelling older adults. One hundred and two (55 female, 47 male) participants were recruited through seniors’ associations in Windsor, Ontario. Analyses of variance were conducted separately by gender to compare the self-rated physical health functioning, wellness, and life satisfaction of participants differing on classification of their gender role. For older women classified as androgynous, gender role exhibited significant effects on general wellness and life satisfaction, but not on self-reported physical health functioning. In support of Bem’s androgyny model of optimal adjustment, post-hoc analyses revealed that women who rated themselves as androgynous reported better overall wellness levels than their peers. Older men’s self-reported physical health functioning and general wellness did not differ significantly by gender role. Limitations and implications are discussed.

An increasing number of studies have documented the cognitive profile of individuals with mild cognitive impairment (MCI), but few studies have investigated the individuals’ psychological health and personality traits or how these factors interact with cognition. In the present study, 27 healthy older adults and 30 persons with MCI completed questionnaires covering psychological health, morale, personality, self-efficacy, and self-actualization. The results indicated that individuals with MCI are more depressed, anxious, hostile, and have lower morale than matched healthy older adults. Furthermore, our results show a positive association between the level of depression of MCI persons and the severity of their cognitive dysfunctions. In contrast, there were no group differences on measures of personality traits. Thus, while psychological distress is present in persons with MCI, those individuals are not characterized by differences in personality traits relative to older adults who experience no cognitive impairment.

The objectives of this study were to assess the prevalence of fear of falling (FOF) among patients over age 60 with dizziness, falls, or syncope; and to analyze risk factors associated with FOF, including data from the tilt table test. This study included 200 older patients referred to a geriatric outpatient clinic specializing in dizziness, falls, and syncope. The primary outcome measure was the proportion of patients who experienced FOF (yes vs. no) and whether FOF restricted leaving home alone or performing activities of daily living. FOF occurred in 50 per cent of patients in this population. Among these, 44 per cent gave up going out alone and 10 per cent stopped doing basic activities of daily living. Beyond age 75, FOF was associated with recurrent dizziness, depression, and symptoms on standing, but not prior falls.

With this study we set out to determine if differences exist across culture change models (CCM) in relation to formal caregivers’ perceived access to empowerment structures and reported provision of individualized care. We recruited staff working in facilities that had implemented the Eden Alternative, GentleCare, Facility Specific Social Models of Care (FSSMOC), or no CCM. Multivariate analyses of variance (MANOVA) compared these constructs by CCM for each of three caregiver groups (Registered Nurses, Licensed Practical Nurses, and care aides). Results suggest that considerable differences exist between formal caregivers and by CCM. The greater caregivers’ day-to-day contact with residents, the more CCMs appear to affect perceived empowerment and reported provision of individualized care. Findings suggest the greatest benefits existed for staff working in facilities with a FSSMOC. Conversely, in only one instance did responses from staff in Eden Alternative facilities differ from those in facilities with no CCM.

Because public acceptance is critical for the successful integration of nurse practitioners into the Canadian health care system, the current study explored how women of different ages perceive nurse practitioners. Middle-aged women held more positive views of health care professionals in general and were more likely to indicate that they would seek help from nurse practitioners compared to younger and older women. Across all three age groups, respondents were more likely to seek help from physicians than from nurse practitioners, especially for acute (versus preventive) health concerns.