Changing demographics and hospital downsizing have placed increasing demands on the home care sector. Many of those receiving in-home care are seniors whose chronic conditions require a collaborative approach. Both providers' paternalistic orientations toward senior clients and seniors' passivity within provider–client interactions have the potential to undermine relationship building. While the former has been documented, how seniors perceive relationship building within the home has received little attention. The purpose of this study was to explore seniors' perspectives on relationship building with in-home providers, focusing particularly on the facilitators of and barriers to this experience. Applying interpretive phenomenology, in-depth interviews were conducted with a purposeful sample of senior clients and an immersion/crystallization analysis strategy was used to elicit the findings. Findings revealed that seniors perceived relationship building as a dynamic process that encompassed facilitators and barriers at both individual and contextual levels. The interpretive findings afford several insights into building provider–client relationships within the in-home context.

In an age of globalization and privatization, local governments and municipalities are searching to define their social role and place. In an aging society such as Canada, arguing that promoting the legal rights of older persons should be part of the legal authority of the municipal government is not simple. It is easier to abide by the position that, without an efficient centralized machinery, social and environmental problems will remain unsolved or unaddressed.

This article presents a different understanding of the place of municipal government in Canada. The goal of this article is to present an original legal-policy argument: It is time for local communities and local governments in Canada to use their legal authorities to enact local bylaws that define and establish the rights of their older citizens. The argument maintains that local municipalities hold the legal power and the social potential to make a significant contribution in the legal sphere for promotion of the rights of older people, and that this power has been neglected.

The article supports the argument on three pillars: (1) an empirical analysis of bylaws in different municipalities across Canada; (2) a socio-legal analysis of the advantages of municipal law as a tool for social change; (3) a case analysis of a recent municipal legal reform in British Columbia.

Despite the focus on burden of caregiving in gerontological research, studies have shown that few caregivers are overly burdened. This article compares predictors of role-specific burden and two quality-of-life measures among caregivers experiencing heavy care demands to assess role-impact on each. The study included 92 community-based caregivers on Vancouver Island. Predictors included primary stressors, personal resources, and socio-demographic factors. Demands of caregiving emerged as the most significant correlate of role-specific burden and was important for overall well-being indirectly, through burden. Resilience was an important correlate of all three outcomes. Over the year of the study, caregivers improved in all three outcomes examined, but we were unsuccessful in predicting that change. Findings suggest caregivers can both be burdened and simultaneously experience good or high well-being, pointing to the importance of not generalizing from studies restricted only to caregiver burden in making recommendations about these people's overall lives.

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults aged 50 years and over were read a series of vignettes and asked if they were able to identify a community organization or agency that they may turn to in that situation. They were also asked about their most important sources of information about CSSs. The findings show that, using a vignette methodology, awareness of CSSs is much lower than previously thought. The most important sources of information about CSSs included information and referral sources, the telephone book, doctors' offices, and word of mouth.

This study compares the normative expectations of 1315 Québécois survey-takers about the responsibilities of spouses and ex-spouses, on the one hand, and adult children and stepchildren, on the other hand, regarding the support they are to offer an elderly family member with incapacities. The comments of survey-takers in relation to fictional yet concrete scenario descriptions provided a basis with which to identify respondents' expectations along with the social factors surrounding these expectations. The results of this survey suggest that the nature and scale of support-related expectations vary according to the family tie with elderly relative. Expectations toward spouses are high and unmitigated, whereas expectations toward ex-spouses and adult stepchildren appear to be limited. Expectations toward adult children are more pronounced than those exhibited toward stepchildren. Where offspring are specifically concerned, expectations are strongly influenced by the given context; for this category of survey-taker, the demands of support should not interfere with their family life and career.

Assessing the burden linked to caring for the frail elderly is becoming an important issue in rehabilitation. The purpose of this study was to translate/validate the Montgomery Borgatta Caregiver Burden Scale into French for use in Canada. This easy-to-use questionnaire evaluates aspects of burden such as objective, subjective stress and subjective demand burden. The instrument underwent: 1) parallel translation/back-translation; 2) expert's committee review leading to an experimental version; 3) pre-test to ensure wording clarity; and 4) study of psychometric properties with bilingual subjects (n = 27) and French-speaking subjects (n = 18). Results suggest that convergence between the original and the French versions is satisfactory for two of the three sub-scales of the MBCBS (ICC 0.83 et 0.96). The test-retest stability coefficients are also very good (ICC of 0.92 et 0.91), as is internal consistency (0.90, 0.66). The objective burden sub-scale correlates moderately with a measure of functional autonomy (SMAF). Results for the subjective burden scale linked to demand are, however, inadequate. All in all, two of the three sub-scales of the French-Canadian version of the Montgomery Borgatta Caregiver Burden Scale demonstrate adequate psychometric properties, thereby favouring its use in geriatric rehabilitation.

While American literature on sustaining restraint reduction is relatively robust, there is a lack of research published on the same issue in Canadian continuing care (CC) settings. Statistics from Canada's largest publicly funded and operated CC organization have revealed telling patterns in mechanical restraint use. Over a 4-year study period during a campaign to reduce mechanical restraint use, the organizational prevalence dropped from 24.68 per cent to 16.01 per cent. There was substantial variability in restraint prevalence among the organization's 11 centres (range: 0–39.86% of residents restrained) and all but 1 was able to achieve mechanical restraint reduction. Specific facilitators to achieving and sustaining restraint reduction are identified, including small facility size, provision of specialized care (e.g., Alzheimer's disease), and an on-site champion. Specific barriers, such as large facility size and an off-site champion are also discussed.

The demographic aging of the Registered Indian population suggests that the social, economic, and health conditions of older Registered Indians will be increasingly important for communities and policymakers. We have adapted the United Nations Development Program's Human Development Index using data from the Census of Canada and the Indian Register to measure whether improvements seen in the knowledge, standard of living, and health of the Registered Indian population between 1981 and 2001 are also observed among Registered Indians of older ages. The absolute levels of well-being of older Registered Indians were found to have improved, but gaps with other older Canadians had widened, particularly in terms of income and male life expectancy.

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.

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations. The test-retest and inter-observer reliability, the internal consistency, and the discriminent validity were found to be satisfactory. To evaluate the convergent validity with the DOLOPLUS-2 and the clinical relevance of the PACSLAC, it was also completed by nurses during their work shift, with 26 additional patients, for three days per week during a period of four weeks. These results encourage us to test the PACSLAC in a comprehensive program of pain management targeting this population.

In North America, 40–50 per cent of older adults are actively involved as formal volunteers in providing diverse health and human services. We review empirical studies concerning older adults' motivations for volunteering, as well as the health and morale benefits they derive from this expression of altruism. Knowledge of the exact nature and amount of volunteer activity necessary to produce these effects is limited, and studies have yet to identify the behavioural and psychological mechanisms that are implicated. We propose that older adult volunteers may enjoy good health and longevity because being useful to others instills a sense of being needed and valued. We present several theoretical perspectives on the developmental significance of volunteering, discuss the challenges to volunteerism imposed by the baby boom cohort, and identify future research priorities.

This article looks at how The Simpsons' representations of aging, considered ageist and stereotypical by some, can be viewed as a positive look at the elderly that attempts to subvert the same stereotypes that it seemingly employs. The Baby Boom cohort is now seen as an attractive economic group, and as they continue their journey through the life cycle, they are drawing increased attention. A current scholarship exists that investigates the ways that the “aged” are seen, catered to, advertised at, seemingly marginalized, and represented in the larger context of the mass media. Relying primarily on the theoretical musings of Frederic Jameson and Linda Hutcheon, the article constructs a bridge that places The Simpsons squarely within a postmodern aesthetic and, using this rubric, shows how the inherent political nature of parodic irony can help to create an inversion of meaning.

This study examines the baseline characteristics and changes in health status and cost of use of health services associated with use of publicly funded home support services. The analysis includes 122 people 75 years of age or more who were eligible for home support services. Over a 6-month period, one third of the sample used home support services for more than 1hr/week; these seniors had higher rates of depression and cognitive impairment, lower levels of physical and emotional functioning, and less effective coping styles than those who used fewer services. Cognitive impairment explained 17 per cent of the variation in use of home support services. At 6 months, use of home support services for more than 1hr/week by seniors with higher levels of need was associated with lower cost of use of health services and lower levels of improvement in health status. These findings suggest the need for further research to identify efficacious ways of providing home support services to this population to enhance their health status using available resources.

This study examined whether Canada's public pensions (Old Age Security and Canada Pension Plan) provided adequate income for seniors living in Nova Scotia in 2005 to afford a basic nutritious diet. Monthly incomes were compared to essential monthly expenses for four household scenarios: (a) married couple, 80 years and 78 years, in urban Nova Scotia; (b) single male, 77 years in rural Nova Scotia; (c) a couple, 70 years and 65 years, in rural Nova Scotia; (d) widowed female, 85 years, in urban Nova Scotia. The monthly food costs for the four households were CAN$313.32, $193.83, $316.71, and $150.89, respectively. Results showed that both single-member households lacked the necessary funds for a nutritious diet, while living with a partner seemed to protect against inadequate financial resources. These findings illustrate the need to improve Canada's retirement systems to ensure all seniors have adequate financial resources to meet their basic needs—including nutritious food—prevent chronic disease, and ultimately improve quality of life.

Involuntary weight loss (IWL) is common in the North American elderly population and affects as many as 60 per cent of nursing home residents, representing a threat to health and function. Investigation into nutrient provision in a long-term care (LTC) centre showed that mean total energy exposure over the 5-week menu cycle differed significantly between regular and puréed diet orders, with lower mean levels of exposure to all three macronutrients on a puréed diet order. There is sufficient evidence that current LTC menus may provide fewer nutrients in those receiving puréed diets that further investigation in this area is warranted.

Famille et soins aux personnes âgées: enjeux, défis et stratégies [Families and care for the elderly: challenges and strategies] provides an overview of ageing in various societies and particularly in this country, and of the repercussions of this phenomenon in terms of the steadily increasing responsibilities of families one of whose members has become vulnerable as the result of ageing or illness. The author describes the difficulties encountered by natural caregivers and explicates both their needs and the inadequacy of the services made available to them. This fully documented portrait of the situation is accompanied by suggestions for relevant action.