Canadian Journal on Aging-Revue Canadienne Du Vieillissement最新文献

The devastating impacts of the COVID-19 pandemic highlighted the missing voices of families and residents in long-term care (LTC) decision-making and policy processes. Family and resident councils constitute one method of raising these voices, but there is currently a gap in evidence of how to promote the effectiveness of these councils. We conducted five focus groups and two interviews with LTC home leaders, residents, family members, and advocates in British Columbia using a participatory approach integrating knowledge-users throughout the research process. Using a framework analysis, we found modifiable (communication, structure, recruitment/engagement, council leadership, culture/attitudes, and resources/supports) and non-modifiable factors (medical complexity of residents and short lengths of stay) affecting council effectiveness. We discuss strategies implemented by knowledge-users to address modifiable effectiveness factors and construct a preliminary tool (a 35-question survey) that operationalizes and identifies areas that can increase council effectiveness in practice to ensure that their voices are heard in LTC decision making.

Cumulative exposure to anticholinergic and sedative medications has been associated with worsening physical function in older adults. We evaluated the feasibility of measuring physical function using wearable devices and explored the impact of reducing the anticholinergic and sedative medication burden in a pilot study of community-dwelling adults aged 60 years and older. Evaluations included the 10-meter walk test (10MWT), the Short Physical Performance Battery (SPPB), and the mini-BESTest. Two participants/month were recruited in one clinic in 2022. The five participants had a median age of 67, a median DBI of 1.7, and four were female. The feasibility analysis showed that the 10MWT and SPPB tests were completed on 12/12, and the mini-BESTest on 11/12. An exploratory analysis showed clinically meaningful improvements in gait speed (mean +0.18 m/s) and SPPB (mean +2.2 points). We showed the feasibility of measuring physical function by wearable devices during deprescribing of anticholinergic and sedative medications.

Background: Pandemic-related restrictions in nursing homes have undermined the critical role that family and friend caregivers play in enhancing resident quality of life.

Objective: We examined how family caregiver access restrictions in nursing homes were implemented and how they impacted the mutual well-being of and relationships between residents and their caregivers over time. Methods Between March 2021 and march 2022, 24 'designated caregivers' in Atlantic Canada were interviewed three times.

Findings: We identified changes in family relationships and activities over time, constricted support networks, the increasing need for advocacy and monitoring, and the generally negative cumulative impacts of restrictions, especially during residents' end-of-life. Subsequent adaptations to access restrictions allowed caregivers to contribute to essential monitoring, care relationships, and advocacy roles.

Discussion: We argue that the role of designated caregivers in nursing homes must be maintained during public health emergencies to ensure resident's supportive family relationships and general well-being.

The purpose of the current study was to understand the prevalence and patterns of cannabinoid use among LTC residents across Canada. We gathered data on cannabinoid prescriptions among LTC residents for one year before and after recreational cannabis legalization. Multi-level modelling was used to examine the effects of demographic and diagnostic characteristics on rates of cannabinoid prescription over time. All prescriptions were for nabilone. There was a significant increase in the proportion of residents prescribed nabilone following the legalization of recreational cannabis in Canada. Residents with relatively more severe pain (based on the Minimum Data Set pain scale), a diagnosis of depression, or a diagnosis of an anxiety disorder were more likely to have received a nabilone prescription. Our results provide valuable information regarding the increasing use of synthetic cannabinoids in LTC. The implications for clinical practice and policy decision-makers are discussed.

Cette note de recherche vise à présenter comment la science-fiction fut utilisée dans un projet de recherche pour coconstruire une vision commune de la robotique sociale favorisant la participation sociale des personnes aînées. Une recherche-action a été réalisée à l'aide de deux forums d'informateurs-clés regroupant des personnes aînées animés à partir d'extraits d'œuvres cinématographiques de science-fiction dans le but de stimuler leur réflexion. Une analyse de contenu thématique de ces forums a permis de mettre en évidence la contribution de l'usage de la science-fiction dans le cadre de cette démarche de recherche. Trois contributions complémentaires de la science-fiction ont été identifiées, soit 1) les illustrations; 2) les comparaisons et 3) le déclenchement de réflexions.

Despite the negative effects on older adults, resident-to-resident aggression (RRA) remains a complex and understudied problem. Few interventions exist that address this issue by promoting goodwill. Using the intervention mapping approach, the evaluation of the test phase of the pilot Program GIFT in private seniors' residences (PSRs) (Quebec, Canada) was conducted through qualitative interviews with 25 residents, 21 staff members, and 4 managers. The results indicate that the program achieved its objectives of promoting goodwill, although the strategies to manage RRA and intervention tools were more difficult to integrate into the PSRs' culture. Obstacles and facilitators were reported. Recommendations were identified to enhance the program's content, promote it more effectively, and ensure long-term sustainability. This research is the first endeavour to develop, test, and evaluate the test phase of a pilot program co-created with residents, staff members and managers of PSRs, aiming simultaneously at promoting goodwill and countering RRA.

Dans le contexte pandémique de la COVID-19, les personnes aînées se sont retrouvées confinées et isolées, et ce, même dans le cadre d'un milieu de vie collective. Cet article fait état d'une étude de la portée sur les bienfaits d'un chœur intergénérationnel pour personnes aînées et les stratégies à considérer pour sa mise en place. L'analyse de 16 études sur ce sujet a permis de se familiariser avec les résultats, les recommandations et les pistes de recherche en lien avec le bien-être et le sens de satisfaction que retirent les personnes aînées qui participent à un chœur, de même que des interventions en chant choral à privilégier. De plus, cette activité qui est peu couteuse et bénéfique est considérée comme une intervention de nature préventive qui contribue au bien-être des personnes aînées et à leur prise en charge pour un vieillissement en santé. Par ailleurs, les résultats suggèrent de continuer à documenter l'efficacité des stratégies proposées pour les améliorer ou les adapter afin de maximiser les effets positifs d'une telle activité sur le bien-être physique, social, émotionnel et cognitif des personnes aînées.

Persons living with dementia are at risk of becoming lost. While return discussions after missing incidents are common with children, these discussions are seldom done with persons living with dementia. Our objective was to describe the use of return discussions with persons living with dementia according to the literature and practice. We conducted a scoping review using 19 databases to locate scholarly and grey literature on return discussions, followed by 20 semi-structured interviews with first responders and service providers in Canada and the United Kingdom (UK). Eleven scholarly and 94 grey sources were included, most from the UK, related to missing children, none included persons with dementia. According to participants, although there was no standardized procedure, there were themes about conditions that facilitate return discussions. This was the first study to examine return discussion practice in dementia, and results can inform development of evidence-based protocols.

The COVID-19 pandemic challenged older adults' health behaviours, making it even more difficult to engage in healthy diets and physical activity than it had been prepandemic. A resource to promote these could be social support. This study uses data from 136 older adults (M_age = 71.39 years, SD = 5.15, range: 63-87) who reported their daily fruit and vegetable consumption, steps, and health-behaviour-specific support from a close other every evening for up to 10 consecutive days. Findings show that on days when participants reported more emotional support than usual, fruit and vegetable consumption and step counts were higher. Daily instrumental support was positively associated with step counts, only. Participants receiving more overall emotional support across the study period consumed more fruit and vegetables; no parallel person-level association was found for overall steps. There were no significant interactions between dyad type and support links for our outcomes.

Despite societal perceptions of older adults as vulnerable, literature on resilience suggests that exposure to adversity and resources gained with life experience contribute to adaptation. One way to explore the nature of resilience is to document assets supporting adaptation. Interviews were conducted with older adults living in Canada at two time points during the COVID-19 pandemic, September 2020-May 2021 (T1) and January-August 2022 (T2). Reflexive thematic analysis was completed to report on what older adults identified as assets and how they understood the value of those assets for resilience. Participants indicated that the potential value of their contributions went largely untapped at the level of the community but supported individual and household adaptation. In line with calls for an all-of-society approach to reduce disaster risk and support resilience, creating a culture of inclusivity that recognizes the potential contributions of older adults should be paired with opportunities for action.