The purpose of this study was to determine the extent to which functional ability was associated with dietary intake in community-living seniors with some activity limitation. In this cross-sectional survey, 145 seniors were recruited from 15 recreation, day programs or seniors' apartment complexes. Dietary intake was assessed with a food frequency questionnaire and evaluated for adequacy with a Diet Score. An Activity Score was derived from 15 questions on basic and instrumental activities of daily living. Demographic, health, psychosocial, functional and behavioural factors that could influence diet intake were measured with standardized, validated scales. Diet Score was significantly and positively associated with income, hearing, education, satisfaction with use of time, number of medications and age. Activity Score, the belief that health affects activity level, shopping behaviour and smoking were negatively and significantly associated with Diet Score. Many factors influence the dietary intake of seniors, including extent of functional limitations. This analysis suggests that the most dependent seniors living in the community consume better diets than those seniors with few limitations; this finding is probably a result of informal and formal support services for these functionally dependent seniors.

This paper overviews the emergence of a philosophy of “consumer-direction” in personal, home, and community care for the disabled elderly in North America and Europe. Consumer direction is associated with direct payment schemes and other mechanisms that support user choices in the purchase of care, user empowerment and independence. To illustrate the strengths and limitations of consumer direction in practice, the paper analyses interview data collected from users and providers of existing care arrangements where elders and families choose and/or hire, supervise, and manage their “own” homecare workers who are self-employed. Interviews conducted separately with care users and providers illustrate how structural and interpersonal power related to financial, social and geographic proximity affect the way independent care arrangements are established, and maintained. Power issues embedded in marketized arrangements suggest the need for caution against wholesale adoption of market principles in social provisions for serving elders.

This study describes the prevalence and characteristics of self-reported unintentional injuries among Canadians aged 55 years and older. Based on the cross-sectional data from the 1994 National Population Health Survey (NPHS), approximately 10 per cent of older adults experienced unintentional injuries serious enough to limit their normal daily activities. Consistent with hospitalization and mortality data, unintentional falls and motor vehicle crashes were reported as the major causes of injury. However, the other predominant causes of unintentional injuries were environmental incidents and being struck by an object. The most common types of injuries were sprains/strains and broken/fractured bones; the greatest number of injuries was to the lower limbs; and the majority of injuries occurred in the home and surrounding area. Unintentional injuries represent a significant health threat among older adults. Self-reported data serve as a different but complementary source of information on unintentional injuries among older adults.

The demographic shift towards an older population in Canada has led to concerns about the increased share of society's resources required to provide health care, social assistance, public pensions, housing, etc. for this group. Preoccupation with this problem, however, has obscured the fact that seniors actively contribute tosociety in many ways, not the least of which is the provision of substantial amounts of unpaid time contributions of various sorts. Using data from the 1992 General Social Survey on Time Use (cycle 7), this paper estimates the amount and market value (at replacement cost) of unpaid help -both informal help to others and formal help to organizations — of individuals age 55 and over. Travel time in connection with unpaid help is also analysed. We find that participation rates and average hours are higher in the informal help sector relative to the formal sector both by age and by gender. The estimates also show that the market value of these contributions is substantial, and that seniors contribute a disproportionate share of the value of unpaid help contributed by all individuals over the age of 25.

Spousal caregivers are the most vulnerable of all caregivers to the stresses associated with the caregiving role, yet they are the least likely of all caregivers to utilize formal support services. This low use of services is poorly understood. To develop insight into this issue, this qualitative study explored how spousal caregivers made sense of the personal experience of living with a memory-impaired partner. The goal was to better understand the interface between this personal experience and the use of formal support services. Information was gathered through the use of unstructured interviews with 14 spouses, most of whom had turned down available formal support services. Analysis of their transcripts revealed the availability of four discourses, or story-lines, for framing the experience. These included two competing story-lines which were used to structure individuals' caring activities and two other competing story-lines which provided the framework for judging one's personal competence within the experience. This paper examines these four discourses and highlights how each influences the meaning associated with the use of formal support services. This analysis makes visible the multiple and sometimes contradictory meanings that service use may have for spouses caring for a memory-impaired partner.

In the shift from inpatient to outpatient care that the province of Quebec is presently experiencing, the prompt assistance offered to older persons in then-domestic environment, is the kind of help that needs to be examined. The pilot project “Vie autonome chez soi” was intended to offer this type of service. The project took place in Montreal during 1990 and offered three services: a warden, a home security system and a telephone service (24–7). The objective of this evaluative study which uses a qualitative methodology is to discuss the implementation and functioning of the pilot project as well as to discover if some of the intended effects had been achieved through the services. Use of the alarm system had a positive impact on security for most of the participants who were still active in the project at the time of the evaluation. The warden services and the 24' security.

This paper analyses data pertaining to falls from a 1995 random survey of 1,285 seniors living in the Capital Regional District of British Columbia. In the preceding six months, 211 (16.5%) people reported falling at least once. The overall rate for women was 18.6 per hundred compared with 13.3 for men. The study also examined relationships between falling and an array of demographic, health, psychological and psychosocial variables. The likelihood of falling increased directly with age and chronic illness, as well as indirectly with age, SES, and gender via chronic illness (i.e. older, poorer women tend to have more chronic illness which then leads to a higher incidence of falling). In turn, falling was directly related to increased dependence, and through it indirectly related to health satisfaction, mental health and a measure of life satisfaction.

This study examines the perceptions of childlessness reported by 287 childless respondents aged 55 and over who were part of a larger study (n - 678) on aging and social support. Sixty-seven per cent (n = 193) report advantages to childlessness and 64 per cent (n = 185) report disadvantages. Qualitative data show that key perceived advantages are fewer worries or problems, financial benefits, greater freedom, and career flexibility. The major disadvantages are lack of companionship/being alone/loneliness, lack of support and care when older, and missing the experience of parenthood. Bivariate and multivariate analyses of the effects that gender, marital status, age, and childless status (childless by choice or by circumstance) have on the perceived advantages and disadvantages of having no children show that there is variability in perceived advantages only. When we compare specific perceived advantages and disadvantages to related experience, only some perceived benefits (financial advantage) are associated with actual experience. Findings are discussed in the context of actually experiencing costs and benefits versus sharing widely-held beliefs about childlessness.

The Échelle d'adaptation de la personne âgée à sa résidence (ÉAPÂK) aims at identifying the elderly people experiencing difficulties of adjustment to their nursing homes. The validation of this scale was carried out on 37 women aged 65 to 97 living in a nursing home for three months and more. Participants answered ÉAPÂR twice at a one-week interval, The Échelle de dépression gériatrique, the Activités de la vie quotidienne section of the OAES and the Échelle de désirabilité sociale Marlowe-Crowne Form C were also administered in order to complete the validation process. The scale showed a test-retest reliability of 0.65 (p < 0.01), an internal consistency of a = 0.69 at time 1 and a construct validity with the Échelle de dépression gériatrique of -0.41 (p < 0.05). ÉAPÂR therefore does contribute to the identification of elderly women experiencing adjustment difficulties.

This article examines the process which allows caregivers to combine employment and eldercare. Using an interactionist approach, the authors present the factors which determine this process, based on a qualitative study with 25 caregivers. The article proposes that the effects of eldercare on employment are the result of the degree to which caregivers manage to maintain balance between different life spheres: personal and social life, family life, caregiving and employment. This balance is achieved by a complex process of co-ordination, negotiation, and mediation which the authors call “juggling work” and which itself is determined by a series of factors, conditions and contextual elements.

This study examines the links between four organizational features of private housing for older persons (service level, perception of environmental control level, tolerance level of caregivers toward seniors and their input in decision making) and the social integration of seniors. This last variable is assessed according to four indicators: presence or absence of meaningful relationships, satisfaction with social life, feeling of loneliness and number of contacts with neighbours. The results obtained by analysing the logistic or ordinal regression and the odd ratio associate two of the four organizational variables studied to most of the social integration indicators irrespective of the subjects' vulnerability level. The two features are service level and perception of environmental control level.

This study explored middle-aged, university educated women's views of their own future aging, using a combination of qualitative and quantitative techniques. Seventy-four university graduates, aged 45 to 65, were interviewed about their views of aging and their employment histories. They also completed questionnaires measuring personality, self-efficacy, well-being, depression and social support. Content analysis of interview responses revealed that most women were optimistic about their own old age and expected overall stability in themselves, their financial situation and their relationships, with an improvement in the area of leisure. Positive expectations of stability were associated with satisfaction with oneself and past accomplishments. A typology of accommodation to future aging, derived from the data on women's expectations and preparations, captured four patterns of cognitive, affective and behavioural dynamics. Women with different accommodation types differed primarily on well-being, neuroticism and employment histories.

In the past two decades the Supreme Court of Canada made apparently contradictory rulings on mandatory retirement. In 1982, the Court ruled that mandatory retirement for firefighters at age 60 violated provincial human rights laws; in 1990, it found that forced retirement for university faculty and others at age 65 was constitutional. An analysis of the decisions shows that the Court relied on the stereotype of older workers as being less competent than younger workers, and failed to provide older workers with protection against age-based discrimination. A number of the key mandatory retirement cases deal with university faculty and may yet have unanticipated consequences, such as strengthening the role of academic tenure. The unwillingness of the Supreme Court to eliminate mandatory retirement means that ad hoc arrangements driven by changing life cycles, employer needs, demographic changes and legislative actions will continue to arise.

Relatively little is known about the factors in Canada which lead to osteoporosis and its concomitant fractures. The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study which will estimate the incidence and prevalence of declining bone mass and fractures. The impact of osteoporosis in Canada will be assessed, including regional variation and the effect of various risk factors. The study will provide information for developing prevention programs. The cohort has been drawn from a random population-based sample of non-institutionalized men and women 25 years old or more and living within 50 km. of nine cities in Canada. Through telephone interviews 9,423 participants have been recruited. All answered an extensive questionnaire, and had physical measurements related to bone quality taken. This paper details the CaMos baseline and five-year follow-up protocol.

This study examined the attitudes of independently living older persons aged 65 and over towards informal and formal care on the basis of an eight-item scale “receptivity towards informal support”. Further, the relationship between these attitudes and the preferences for care arrangements in various (hypothetical) care-need situations differing in type of care needed and the expected duration is investigated. Beyond the previous experience with receiving care, and individual and social characteristics of older persons, the attitudes towards care showed themselves to be a strong predictor of the care preferences of older people. The authorities might use the attitude towards care as a steering instrument for altering older persons' preferences for and use of services in the long term.

A review of the guide Vouloir changer: Une approche axée sur le client traitant de l'usage d'alcool et de médicaments chez les aines. After describing the main ideas, the author presents the strengths and weaknesses of this guide. The quality of clinical information and the expertise of the authors and collaborators in the area of drug addiction are noted. A weakness in theoretical and scientific precision is indicated, however. It is also mentioned that some concepts could have been affected in the translation. While underlining the usefulness of this document, the author of the review made suggestions that could have perhaps improved the presentation of the material.