La maltraitance organisationnelle envers les personnes aînées est présente dans différentes organisations, y compris dans le secteur de la santé et des services sociaux. Elle peut entraîner des conséquences négatives importantes sur la santé mentale et physique, ainsi que la qualité de vie, des personnes aînées qui la subissent. L’objectif de cet article est de présenter les enjeux éthiques liés à la maltraitance organisationnelle perpétrée envers les personnes aînées qui reçoivent des services de soutien à domicile. Une approche d’inspiration phénoménologique utilisée auprès d’ergothérapeutes pour identifier les enjeux éthiques de leur pratique a mené à une analyse des enjeux éthiques spécifiquement liés à des situations de maltraitance organisationnelle. Quinze ergothérapeutes (n=15) œuvrant en soutien à domicile au Québec ont été rencontrés dans le cadre d’entretiens individuels. L’analyse a été effectuée en utilisant une perspective écologique. Les résultats de l’analyse révèlent plusieurs enjeux éthiques complexes de nature micro, méso et macrosystémiques, dont l’abandon administratif des bonnes pratiques, l’accès déficitaire aux services, la chosification de l’aîné, la dépersonnalisation des services et la tolérance des violences.

Our qualitative descriptive study compared how older patients and their informal caregivers experienced the care transition from acute care or rehabilitation to home. We recruited patients 65 years of age or older, or their informal caregivers, from in-patient units within acute care hospitals and rehabilitation facilities to participate in semi-structured interviews. We identified emergent themes via thematic analysis. In all, 16 patients and four patient caregivers participated. Across all care settings, caregivers were integral in facilitating the transition as well as experiencing variable discharge preparation, health care providers’ optimizing transitions, and missed care and medication discrepancies at transition points. Orthopedic and rehabilitation patients more commonly voiced prior transition experiences in discharge preparation, including having to unexpectedly coordinate and wait for outpatient services. Differing responses between acute care and orthopedic settings suggest that transitional care practices and policies favor an individualized approach that considers patients’ previous experiences, needs, and care expectations.

This article sets out to analyze how older women understand grandmotherhood. In-depth interviews were conducted with 25 elderly women from Quebec with diverse lives (widowed, married, single, with or without children) drawn from three generations (65–74 years, 75–84 years, 85 years and over) according to principles of qualitative analysis using grounded theory. Based on a constructivist approach, results highlight the evolution of images of grandmotherhood offering the benefit of emotional, playful and comforting roles. This analysis also reveals multiple ways of being a grandmother and commitments that vary according to three principal factors: (1) the personality and life trajectory of the grandmothers; (2) the family situation and role of crisis in the family; and (3) the degree of intimacy with grandchildren. There follows a discussion on the place and role of the family in the lives of older women today.

The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8 occupational therapists or physiotherapists. Three types of barriers were found: caregiver-related, patient-related and systems-related. Four themes for facilitating pain management were identified: (a) caregivers knowing the patient, (b) family support, (c) caregivers demonstrating understanding and compassion, and (d) teamwork by caregivers. Formal caregivers practising in long-term care institutions encounter a multitude of barriers that hinder the adequate assessment and treatment of pain, such as caregiver beliefs and knowledge and cognitive impairment in patients. Innovative strategies and strong political will are needed to overcome them.

Five semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.

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.