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

Background: Ontario seniors face a range of challenges as they age, including financial, physical and social barriers. Addressing these challenges is essential to improving the health and well-being of older adults in the province. Objective: The discussion proposes that naturally occurring retirement communities (NORCs) offer a viable and safe alternative to formal retirement communities and evaluates how NORCs can support seniors when examined through the lens of the social determinants of health.

Methods: The analysis focuses on the role and impact of NORC-specific service programming, distinct from NORCs themselves, and assesses their potential in mitigating age-related challenges faced by seniors in Ontario.

Findings: NORC-specific service programs have shown success in supporting senior wellness and improving quality of life. These service address key social determinants of health and demonstrate potential for broader application across Ontario's NORCs.

Discussion: The discussion recommends increased attention from governments and policymakers, including efforts to identify NORCs across Ontario, expand affordable and accessible housing options for seniors, and invest in health and social supports. Strategic development of NORC programs can play a significant role in building capacity and delivering targeted wellness services to seniors.

Engaging residents of long-term care homes (LTCHs) in their home's environment, programs, and operations is required in some jurisdictions and could improve resident quality of life and other outcomes. This scoping review summarized existing research on resident engagement in LTCH organizational design and governance, including associated enablers, barriers, approaches, and outcomes. The database search yielded 5,580 records (after deduplication), and 62 articles covering 59 studies were included. These studies predominantly described Residents' Councils (n = 38; 64%) and enablers or barriers pertaining to resident and home perspectives, as well as implementation and sustainability infrastructure. Few studies described approaches to considerations of resident diversity (n = 8; 14%) or the presence of dementia and/or cognitive impairment (n = 12; 20%). Ten studies reported quantitative data evaluating resident engagement, and only four with resident-reported outcomes. Robust, evidence-informed frameworks that are co-designed with residents, staff, and others in the LTCH sector are needed to engage residents in their LTCHs.

Most persons living with dementia in Canada reside at home, relying on support from family and/or friends as caregivers. Evidentially, knowledge gaps exist when trying to understand how caregivers and persons living with dementia can be better supported in their community and health care environments. This research examined the effect of aging in place with a focus on providing a comprehensive understanding of the barriers to aging in place for persons living with dementia and their caregivers using the social-ecological model. Fourteen caregivers were recruited to participate in one-on-one semi-structured interviews. The subsequent theme, they do not make it easy, emphasizes issues faced with community and societal domains of aging in place care. These findings shed light on the unmet needs of persons living with dementia and their caregivers while aging in place, as well as the need to address systemic barriers to sincerely promote aging in place for all persons.

The COVID-19 pandemic highlighted significant vulnerabilities in long-term care (LTC) homes, severely impacting residents and care partners. This study investigates how care partners of older adults living in Ontario LTC homes perceived residents' experiences during the COVID-19 pandemic, and how those perceptions shaped their own caregiving experiences. Using critical ethnography, we identified four key themes: (a) masks and miscommunication, (b) loneliness and loss, (c) from interaction to isolation, and (d) loss of the advocacy role. Supportive actions included transparent masks, increased allied health professionals, and enriching daily programs. These findings emphasize the need for policies that balance infection control with the emotional and social needs of LTC residents, addressing power imbalances, ageism, and systemic inequities.

Loneliness is a major health concern for immigrant older adults. This study explores social influences on loneliness in neighbourhoods among immigrant older adults across five major urban centres in Ontario and Alberta, Canada. Data were collected from 435 older immigrants who participated in the Inclusive Communities for Older Immigrants (ICOI) Project. Data were analysed using multiple linear regression (MLR) to identify the influences of neighbourhood factors, family support, duration of residency in Canada, English proficiency, and gender. Results indicate that increased engagement in ethnic enclaves, not being reliant on transportation for social interactions, and perceptions of neighbourhood cohesion are associated with a significant reduction in loneliness. These associations remain significant after accounting for family support and language proficiency. This calls for further research into the interconnections among interpersonal factors, neighbourhood-level factors, and family and community-level support to address key influences on loneliness in this population.

Background: Cognitive and behavioral factors contribute to the mitigation of stress-related health outcomes in later life. Given that stress management interventions for older adults are an important target for healthcare, there is a need for a relatively short and standardized assessment tool to comprehensively measure stress and coping in later adulthood while minimizing the burden on participants. The Stress Assessment Inventory (SAI), a 123-item measure designed to assess stress and coping resources in younger adults.

Objective: The objective of this study was to examine the psychometric properties of the SAI in 294 older adults.

Methods: The SAI was evaluated on its dimensionality, reliability, and validity.

Findings: A shortened SAI is proposed for older adults, with good internal consistency and criterion validity. The Revised SAI was found to have a three-factor model that captures Adaptive Cognitive Resources, Maladaptive Behavioral and Cognitive Habits, and Adaptive Health Habits.

Discussion: The current study supports the use of the Revised SAI in community-dwelling older adult populations as a comprehensive tool to assess stress and coping for use by researchers and healthcare professionals.

Ensemble pour le plaisir ! (EPLP) est un programme ayant pour objectif d'amener les personnes vivant avec un trouble neurocognitif et leur proche aidant à retrouver des moments de plaisir au sein de leur relation. Appuyé par la théorie du comportement planifié d'Ajzen, le présent article vise à analyser la démarche d'implantation du programme EPLP au sein de milieux communautaires et de soulever les facteurs d'influence menant au changement de comportement des parties prenantes. Les résultats montrent que bien que les attitudes, les normes et la notion de contrôle soient favorables à l'intention de changer le comportement, des ressources médiatrices telles que le financement et le mentorat par l'équipe de recherche sont essentielles à l'implantation pérenne du programme.

La présente étude de méthode mixte explore les perceptions et attentes relatives aux hypnotiques et produits de santé naturels (PSN) chez les personnes âgées. Vingt-quatre personnes d'en moyenne 76 ans dont 58 % étaient des femmes ont participé à des entrevues semi-structurées. La moitié était des utilisateurs d'hypnotiques. Selon leur score de l'index de sévérité de l'insomnie, 54 % des participants avaient une insomnie légère, 38 % modérée et 8 % sévère. Les participants s'attendaient que les médicaments permettent un endormissement rapide, un sommeil ininterrompu et une augmentation de sa durée. Ils souhaitaient avoir des sensations comme la détente ou l'absence de pensées durant leur sommeil. Les sensations désirées au réveil comprenaient le calme, le bien-être et la satisfaction. Dans l'analyse de combinaison, les thèmes de la quantité de sommeil et le temps de latence court sont des critères d'efficacité les plus fréquemment cités autant chez ceux souffrant d'insomnie légère que modérée à sévère. L'absence d'éveils nocturne était l'autre critère d'efficacité plus fréquemment mentionné chez ceux ayant une insomnie légère alors que la sensation de bien-être au réveil était celui pour ceux ayant une insomnie modérée à sévère.

Positive health outcomes are realized when individuals receive interprofessional care, which also includes collaboration with family and care providers. We used social network analysis to explore interprofessional care networks and experiences of independent, community-dwelling older adults and how they perceive collaboration between different medical and non-medical network members. Twenty-three participants were interviewed and asked to name individuals contributing to their health and well-being (network of care) and position them in a concentric circle to reflect the relative strength of relationships. The average network size was 11. Closest relationships were with spouses, children, and family physicians. Relationship strength with network members was marked by frequency, accessibility, longevity, and impact of interactions. Participants were ardent self-advocates for their care, but reported few apparent episodes of collaboration between network members. Our study highlights that coordinated and collaborative care for independent community-dwelling older adults is lacking and does not routinely engage non-medical network members.

There are limited data on chiropractic care for older adults, specifically from medically underserved communities. This study describes the characteristics, clinical management, and patient-reported outcomes of older adults with spinal pain who present for chiropractic care at a publicly funded community health centre serving marginalized populations. This retrospective analysis utilized quality assurance data from chiropractic encounters at Mount Carmel Clinic between January 2011 and June 2020 of adults aged 45 and older. Descriptive statistics summarized the study population and their self-reported pain severity scores. Student's t-tests and repeated-measures ANOVA explored relationships between pain outcomes, age, and clinical characteristics. The sample included 240 middle-aged (45-59 years) and older adults (≥60 years) who recorded baseline and discharge pain scores following chiropractic treatment. Over half of middle-aged participants self-identified as Indigenous or as people with disabilities. Statistically and clinically important improvements in pain were noted across spinal regions and extremities for both cohorts.