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

Waitlists for long-term care (LTC) continue to grow, and it is anticipated aging populations will generate additional demand. While literature focuses on individual-level factors, little is known about system-level factors contributing to LTC waitlists. We considered these factors through a scoping review. Inclusion/exclusion included publication year (2000-2022), language, paper focus, and document type. A total of 815 abstracts were identified, only 17 studies were included. Through qualitative content analysis, 10 key factors were identified: (1) waitlist management styles, (2) inconsistent standards of admission, (3) personnel shortage, (4) insufficient community-based care, (5) inequitable distribution of services, (6) lack of system integration, (7) unintended consequences of insurance plans, (8) ranking preferences, (9) the debate of supply and demand, and (10) financial incentives. Targeting interventions to address waitlist management, community-based care capacity, and demographic trends could improve access. More research is needed to address system-level barriers to timely LTC access.

Background: Dancing offers several health and wellness benefits for older adults: it may promote physical literacy (PL) and positively influence the aging process. Yet, limited research considers the perspectives of those with experience working with older adults and in community dance programming.

Objective: The purpose of this study was to understand program experts' perspectives on how older adult community dance can promote PL and contribute to age-friendly cities and community initiatives.

Methods and findings: Four themes were identified from semi-structured interviews with five program experts: (1) expert instructors tailor classes to participants' needs and interests; (2) the heart of what draws us to dancing: authentic experience and social connection; (3) elitist, ableist, and gendered assumptions of dance prevent social inclusion of older adults in dancing spaces; and (4) collaboration across sectors is needed to offer accessible, sustainable, and valued dance programming.

Discussion: Recommendations for developing and implementing older adult community dance programming are described.

Background: The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults.

Objective/methods: This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used.

Findings: Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals.

Discussion: Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.

In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents' health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.

Nutritional care is a critical, yet often overlooked component of quality care in long-term care (LTC) that is linked to culture, socialization, and residents' psychological and physiological well-being. Given that several COVID-19 infection control protocols affected nutritional care, this study aimed to understand employees' experiences of these changes. Seven semi-structured interviews were conducted with Saskatchewan healthcare employees from several disciplines, all of whom had a role in supporting nutritional care in LTC. The resulting interview transcripts were analyzed using reflexive thematic analysis. Three main themes characterized the interviewees' reflections: regression to an institutional mealtime environment, unrealistic expectations, and concern for residents. Given the centrality of nutritional care to quality of life, strategies tailored to support staff in providing relationship-centered nutritional care must be further articulated to maintain standards of care for LTC residents in future outbreaks and epidemics.

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.

Worldwide, over 55-million people have dementia, and the number will triple by 2050. Persons living with dementia are exposed to risks secondary to cognitive challenges including getting lost. The adverse outcomes of going missing include injuries, death, and premature institutionalization. In this scoping review, we investigate risk factors associated with going missing among persons living with dementia. We searched and screened studies from four electronic databases (Medline, CINAHL, Embase, and Scopus), and extracted relevant data. We identified 3,376 articles, of which 73 met the inclusion criteria. Most studies used quantitative research methods. We identified 27 variables grouped into three risk factor domains: (a) demographics and personal characteristics, (b) health conditions and symptoms, and (c) environmental and contextual antecedents. Identification of risk factors associated with getting lost helps to anticipate missing incidents. Risk factors can be paired with proactive strategies to prevent incidents and inform policies to create safer communities.

Background: There is a need to further understand the nature and role of planning for one's lifestyle in retirement.

Objective: The purpose of this study was to examine retirement planning and how it impacts perceived preparedness and satisfaction with the retirement transition, as well as to explore personal experiences of retirement.

Methods: Canadians (n = 748) fully or partly retired participated in an online survey that included quantitative questions about perceived retirement preparedness and satisfaction and open-ended questions about retirement goals, fears, challenges, and advice.

Findings: Results determined that while both financial and lifestyle planning were significant predictors of higher perceived preparedness, only lifestyle planning was a significant predictor for satisfaction. Overall, no gender differences were detected. Open-ended comments highlighted the importance of planning for one's lifestyle in retirement, including meaningful activities and social connections.

Discussion: Individualized career advising as well as group-based educational programs or peer-assisted learning initiatives appear warranted to support people in planning for their lifestyle in retirement.

This study aimed to (a) investigate the associations between indices of stress severity across the lifespan (early, middle, late life) and cognitive function among community-dwelling older adults, and (b) examine whether a healthy lifestyle composite score comprised of physical activity, healthy diet adherence, social engagement, sleep quality, and mindful relaxation moderates the associations between lifespan stress severity and cognitive function. Participants (n = 226, M_age = 68.2 ± 6.5, 68.1% female) completed questionnaires to measure stress and lifestyle behaviours, and three online neurocognitive tasks. No direct associations between stress severity and cognition were found. The healthy lifestyle composite score moderated the associations between early, midlife, and late-life stress severity and inhibitory control. Exploratory analyses suggest that this moderating effect may be sex-dependent. Despite study limitations and the need for additional research, findings provide preliminary support for the role of lifestyle behaviours in enhancing older adults' resilience to the effects of stress on cognitive health in a sex-specific manner.