Caregivers of demented patients are under significant stress along with physical, psychological or social problems. Standardized and validated instruments are required for measuring consequences of caregiving or efficacy of support interventions. Reliability of French translation of these instruments has to be verified in order to confirm their psychometric properties. The goal of the present study is to assess reliability of the French translation of three instruments designed for evaluation of caregivers of demented patients. The Zarit's Burden Interview (BI) is a 22-items scale measuring the subjective burden of the caregiver. The Revised Memory and Behavior Problems Checklist (RMBPC), a 53 item scale, measures frequency of memory and behaviour problems of demented patients and the caregiver's reaction to these problems, which is another mean of burden assessment. The Alzheimer's Disease Knowledge Test (ADKT) assesses knowledge of caregivers about demented diseases and resources available using 20 multiple choice questions. A reliability study was conducted on a sample of 40 caregivers. The caregivers were questioned twice, the second time after one (N = 26) or eight (N = 14) weeks. The BI internal consistency (Cronbach alpha) yielded a coefficient of 0.85 and test-retest reliability (intra-class correlation coefficient) was 0.89. The RMBPC's Cronbach Alpha was 0.93 for frequency and 0.94 for reaction. Intra-class correlation coefficients were 0.77 (frequency) and 0.90 (reaction) for RMBPC and 0.71 for ADKT.

Elder abuse has mainly been studied in the family setting. This research looks at elder abuse in public nursing homes in Quebec. It studies the meaning that middle-management practitioners give to their work. This article shows how the method used to collect the information is directly chosen in regard to epistemological and paradigmatic concerns as well as in accordance with the questions addressed in the research. It exposes specific thoughts regarding this study done by semi-structured in-depth interviews. It presents results gathered by this method. It concludes with a reflexion on qualitative methods as ways of gaining knowledge on the human aging process.

Les concepts de compétence, d'autonomie et d'authenticité sont examinés. Diverses définitions du terme « autonomie » sont distinguées, et les auteurs prétendent que deux d'entre elles n'englobent aucun concept différent de la compétence mentale (la capacité de prendre des décisions) et de l'authenticité. L'accent est mis sur la distinction des questions de capacité et de compétence, et sur des cas où une intervention salutaire est justifiée.

The relationship between family cohesion, perceived control, received social support types (emotional, informational, and tangible), and the coping strategies used by mothers of separated or divorced offspring was examined. Data were obtained from 84 mothers aged 45 to 78 (M age 61). Two multiple regression analyses were conducted with avoidant coping (focus on and venting emotion, behavioural disengagement, mental disengagement) and active coping (active coping, planning, positive reinterpretation and growth) serving as criterion variables. Greater use of avoidant coping was associated with low family cohesion, low perceived control, and high received emotional support. In addition, greater use of active coping was associated with high received emotional support.

Cet article examine un problème courant, soit la perte, totale ou partielle, des facultés chez les aînés, et donne quelques exemples fictifs de stratégies pour y faire face. La première partie du texte porte sur certains ouvrages traitant du désoeuvrement, notamment une nouvelle de Carol Bly intitulée «Gunnar's Sword,» et le roman de David Malouf An Imaginary Life. La seconde partie de cet essai compare deux romans récents décrivant le quotidien des aînés, soit Adele at the End of the Day, de Tom Marshall, et The Remains of the Day, de Kazuo Ishiguro. Tous les ouvrages examinés sont évalués selon leur contribution à la compréhension du vieillissement et leur succès sur le plan littéraire.

This study examined whether off-target verbosity should be conceptualized as a distinct process from high levels of talkativeness in every day social situations. The relationship of age to these speech styles was also determined. The responses of 125 community-based elderly adults to a life-history interview were independently rated by two research assistants for the frequency and extent of off-target verbosity. The participant's activities in daily life, including talkativeness, were independently rated by the participants themselves, 125 similar-aged peers and 10 professional workers acquainted with the participants. Confirmatory factor analysis supported a model postulating off-target verbosity and talkativeness as two largely independent latent factors. Age was associated with the verbosity factor. The results were interpreted as indicating that off-target verbosity cannot be explained by the same processes that underlie social talkativeness. Possible mechanisms of the verbosity factor were discussed.

Gerontologists have regarded retirement as a negative event and seldom have investigated the successful retiree or older worker. This study provided descriptive data about both of these groups by triangulating quantitative and qualitative methods. Twenty-one retired and 30 employed professionals over the age of 60 were assessed for general levels of well-being and life satisfaction. They were then interviewed about the meaning and significance of their careers, and the strategies used to cope with job-related problems. Results showed both groups to be involved in meaningful social relationships, and well-adjusted and satisfied with their current lives. Differences between the groups emerged from the interviews: Employed professionals valued the prestige and challenge of a career; retirees mentioned supportive interpersonal relationships and the need to complete a job. Workers also mentioned delegating authority and establishing networks as valuable coping strategies. Some disciplinary differences were also noted within each group. These results underscore the usefulness of blending qualitative and quantitative data in research on work and retirement.

Statistics concerning the aging of Quebec's population raise the question of the changes in the lifestyle of elderly people. What do these people do? What trends are emerging in the ways in which they occupy themselves? Are there constraints to the practice of some activities? To answer these questions, we have prepared a summary of many documents collected during a research project on the leisure activities of Quebec's elderly. These documents show that Quebec's elderly are in a better financial position today, retire earlier from work and are more active than their predecessors. Rates of participation in most physical, cultural and educational activities, in volunteer work and the proportion of elderly people who travel have increased during the 1980s. Thus, it seems that leisure is now a fundamental dimension of the life of these people. But elderly people cannot do all the activities they would like because of constraints which limit or prohibit them. If these constraints were eliminated, elderly people would be more active. Researchers should therefore continue to study changes affecting the pattern of activities of elderly people and at the same time, social practitioners should help them to remain active as long as possible.

A census was taken on 26 long-term care facilities in the Ottawa-Carleton Region comprising 3, 825 residents to estimate the point prevalence of cognitive impairment or dementia. Nurses familiar with the residents identified those who had either memory impairment or dementia (according to DSM III criteria). A validation of the data obtained through the census was carried out on a stratified, random sample of residents. The long-term care facilities were stratified by level of care and by size. From each of the three strata, 11 facilities were randomly selected then a 10 per cent random sample with replacement (411 residents) was determined. The validation survey consisted of interviewing residents using two screening instruments, interviewing the nurse using two behavioural instruments and a chart audit. On the census the prevalence for cognitive impairment in the surveyed group was 67 per cent compared to 61 per cent for the whole resident population. The sensitivity and specificity for cognitive impairment was calculated at 84 and 70 per cent respectively. The prevalence of dementia in the surveyed group was 61 per cent compared to a census estimate of 52 per cent for the whole resident population. The overall sensitivity of the census for dementia was 95 per cent and the specificity was 83 per cent. The results indicated that a census undertaken with standardized definitions, by knowledgeable staff directly involved with patient care is a reasonably effective method for estimating the prevalence of persons with dementia in long-term care facilities.

Chemical dependency in the elderly has been recognized as a serious problem since the early 1960s. Few practitioners however, have developed intervention or treatment programs for this age group. The Elders Health Program, a research demonstration project, established the fact that the problem of enabling behaviours had to be addressed. Active family and professional enablers became significant factors influencing the design of intervention and treatment programs.

Des approches humanistes sont essentielles pour explorer les principales politiques touchant la gérontologie et la gériatrie. Cet article décrit comment l'approche de « l'éthique publique, » c'est-à-dire l'examen des principales valeurs sous-tendant et orientant le procédé d'élaboration des politiques publiques, peut nous faire davantage comprendre les politiques ayant trait au vieillissement. Pour illustrer cette analyse, des exemples tirés d'une étude comparative entre le Canada et les États-Unis sont fournis. Parmi les éléments analysés, on trouve d'abord les principales valeurs sociales formant la toile de fond de cette étude, particulièrement l'opposition entre l'individualisme et le collectivisme. Ensuite, la définition et la résolution des problèmes reposent à la fois sur les faits et les valeurs. Elles impliquent une discussion sur les facteurs sociaux intervenant dans la « crise » du vieillissement, notamment la polarisation des gens en groupes d'âge et la rationalisation des ressources destinées aux soins de la santé. Finalement, la nature du débat public et du discours moral, en qualité de procédé guidant l'élaboration de politiques publiques, est étudiée, et les répercussions quant à l'importance des valeurs dans l'élaboration de nouvelles politiques à venir sont également considérées. Le procédé d'élaboration des politiques publiques, notamment la manière dont il relève les défis associés à une population vieillissante, en dit long sur la cohésion et l'intégrité sous-jacentes de notre société et sur le degré d'humanisme que l'on trouve au sein des principales politiques et institutions sociales.

This paper reports on an assessment of participant observation used for evaluation in a structured and gerontolgoical field context. Participant observation was used to evaluate whether a search conference was a viable means for older persons to identify community needs and create an ongoing community organization to address them. I attended planning meetings, the conference and a follow-up meeting. Observations were recorded in field notes and analysed to identify the decision-making processes. These older persons successfully engaged in a health promotion process whereby they exercised decisive direction in identifying and addressing health and social needs of importance to them. These results attest to the flexibility and applicability of participant observation in structured field settings with older persons who were circumstantially difficult to survey by other means. Participant observation is an effective method of collecting data on the process of how groups of older persons respond to a defined task through several observation points in time.

Les ouvrages actuels portant sur la gérontologie soutiennent qu'une renégociation des rôles maritaux et des pouvoirs relatifs se produit chez les couples d'aînés. Ils ne tiennent toutefois pas compte des facteurs structuraux entravant l'apport de changements dans la structure de ces couples. En examinant les politiques publiques des années 1930 et 1940 concernant le programme canadien de pensions de vieillesse, on constate un préjugé systémique et souvent conscient favorisant l'application de ce programme de façon à maintenir la hiérarchie traditionnelle des pouvoirs, fondée sur le sexe, chez les couples d'aînés. Certains aînés ont réagi en modifiant leur statut marital afin de bénéficier au maximum des avantages des politiques publiques.

The goal of the study was to investigate the issue of informed consent for mental capacity. Seventeen clients referred to the Competency Clinic at the Baycrest Centre for Geriatric Care were interviewed after the assessment had been completed. Their responses to questions regarding the reasons for and possible consequences of the assessment indicated a range of understanding and of capacity to give informed consent. The results are discussed in terms of the appropriateness of having a fairly low threshold for informed consent in situations where other capacities are already in question.

The performance of seven Parkinson patients on a discrete pursuit tracking task was studied under alleviated (medicated) and unalleviated (non-medicated) conditions, and compared with the performance of seven non-Parkinson subjects matched for age and gender. All subjects completed 2,000 responses on the tracking task, which provided variations in directional probability and the distance to be moved. Overall, results suggested that once given sufficient practice to learn a novel task, and when under drug control, Parkinson patients were not significantly different from their age-matched controls. Two exceptions where Parkinson patients evidenced slower responses were noted: (a) their ability to make decisions when movement direction was less predictable: and (b) when they had to readjust their motor responses after an unexpected movement error.

Qualitative knowledge on ethnicity and aging remains sparse and needs to be expanded. Qualitative research suggests a promising route to better understanding of different ethnic groups as well as of intra-ethnic group diversity. However, such research is not problem-free. This paper presents three interview scenarios, discusses a number of problems noted in the existing literature as well as some problems the author has encountered in the course of research and raises important issues relating to conducting interviews with ethnic seniors for qualitative studies.

In the past, the focus of the literature concerning the comparison between quantitative and qualitative research has been on the relative warrants of the methodology of each approach. The aim of this essay is to reformulate this argument in terms of paradigmatic perspectives. In this respect, descriptions of the realist paradigm which determines quantitative methods and the constructivist paradigm which determines qualitative methods are laid out. It is shown that these paradigms are essentially incommensurate and direct comparisons are counter-productive. It is, in addition, suggested that the choice of one paradigm over the other is more a distinction between the relative values of research exactitude and research sufficiency and, as such, a question of believability.

Based on a hypothesis that the cause of Alzheimer's Disease (AD) is multifactorial, we explored the possible links between the geographical distribution of 102 subjects diagnosed as “definite,” “probable” or “possible” cases at the onset of the disease and the social ecology of the Chicoutimi-Jonquière (CJ) urban area in the Saguenay region of Québec. We were also interested in the level of education of the 74 “definite” and “probable” cases. The use of factor analysis (principal components) and cluster analysis (Ward method) made it possible for us to identify socioeconomic zones and homogeneous social areas in CJ. The first results indicate that on the one hand, the male/female ratio of the cases differs statistically from that of the at-risk age group in the general population. The disease affects more women than men. On the other hand, there is significant social differentiation in CJ. Nevertheless, the 102 subjects are randomly distributed among the three socio-economic zones as well as among the eight social areas. Analysis of the geographical distribution of “definite” and “probable” cases also suggests a random distribution. The random nature of the distribution of subjects is confirmed by a very strong correspondence between the distribution of cases observed when counting them by enumeration area or census tract and Poisson's theoretical distribution. There was a significant difference between the subjects' level of education and that of the 65 years old and over in the reference population. A more in-depth case-control study might shed more light on this aspect.

Growing Up starts from the premise that once the family nest is empty and professional activities have ceased, an elderly person is still a growing person. Even if specialists in human development who have dealt with this subject can enlighten us, the wisdom of certain characters in the New and Old Testaments can guide us in a special way. In reading the Bible, priests, pastoral counsellors and seniors will discover a companion which can help them in their reflections and which can also serve to guide pastoral interventions.

Jacques Laforest provides an introduction to gerontology viewed as an interdisciplinary field of study and reflection on old age. Old age is defined from a developmental perspective as two opposite yet complementary processes: those of decline and growth. The final stage of life is marked by an existential crisis of one's identity, autonomy and belonging. Researchers and specialists from all disciplines are invited to contribute towards an understanding and a resolution of this crisis. The purpose of this publication is to initiate the process of integrating knowledge and reflections on gerontology. This goal is achieved.