In 1988 the Alberta government introduced a new resident classification system to measure the nursing care requirements of long-term care facility residents, and to provide case-mix information for a new funding system. This article describes the conceptual and methodological development of the system. Specific steps in the development process were to (1) define key care domains reflecting the major types of assistance required by long-term care residents; (2) identify indicators of care requirements within each care domain; (3) develop criteria for determining which items to include in the final version of the Resident Classification Form; (4) develop decision rules for combining scores on individual items in order to group residents into categories; and (5) test the psychometric properties of the classification system. The classification system has seven categories ordered from low to high in terms of nursing care requirements and a measure of nursing resource use.

This study assessed changes in older peoples' levels of perceived respect between the 1970s and the 1980s using data from the Aging in Manitoba Study. A longitudinal analysis was conducted for Manitobans, age 65 and over, who were interviewed in the mid 1970s and subsequently reinterviewed in the early 1980s. Changes in perceived respect scores for those who survived into the 1980s, and who provided ratings at both interviews (n = 776), were assessed in a repeated measures ANOVA. Significant increases were found in the mean level of respect for some ethnic groups, namely for the British, French, and German. A subsequent analysis indicated that the reported improvements in perceived respect could not be explained by participation in the study. These results may suggest that over the decade, the social climate of the elderly population in Manitoba has improved, at least for some ethnic groups.

Cet article discute des limites auxquelles il faut faire face quand la notion de risque devient le facteur-clé dans une évaluation clinique. Ainsi, on présente la capacité de se choisir une place en centre d'accueil, pour illustrer la façon dont le problème est défini. En l'absence de composante évaluative, il est démontré que l'information habituellement recueillie ne peut être utilisée pour évaluer les risques sans y inclure un élément normatif. Une discussion concernant la nature du risque montre que les orientations normatives sont inhérentes à la perception du risque. Les principaux inconvénients, de permettre que les résultats soient étroitement rattachés à la notion de risque, sont de deux ordres: (1) les probabilités des risques ne sont pas connues et (2) les enjeux, chargés de valeurs, demeurent inconnus.

There is great interest in identifying psychological and social variables associated with depressive symptoms in older adults. The goal of this article is to review the literature on the relationship between social support and depressive symptoms in the elderly and to identify the mechanisms involved in this relationship. The review indicates that both structural and functional dimensions of social support are inversely related to depressive symptoms in elderly persons. In addition, there is evidence supporting both the main effect model and the buffering effect model of social support. It is unclear, however, whether observation of these effects depends on the type of measure used to assess social support. A better understanding of the relationship between social support and depression requires the consideration of more precise dimensions of social support as well as the nature of the Stressors experienced by older people.

L'objectif principal de cette recherche était de déterminer si les embêtements de la vie quotidienne sont plus fortement reliés au bien-être physique et psychologique chez les personnes âgées que les événements majeurs. Les modèles de prédiction du bien-être physique et psychologique ont été déterminés en fonction de la contribution des embêtements et des événements majeurs ainsi que d'autres variables incluant l'évaluation subjective de la santé. Deux cents personnes âgées ont rapporté les événements majeurs des trois dernières années et les embêtements survenus au cours du dernier mois. Les sujets ont également évalué leur état de santé et le degré d'incapacité dans les activités quotidiennes conséquente à chacune de leurs maladies chroniques. Des analyses de régression multiple par étapes ont montré que (1) l'évaluation subjective de la santé, l'incapacité dans les activités quotidiennes et la fréquence des embêtements sont reliées au bien-être physique et que (2) le bien-être psychologique est associé à la fréquence des embêtements, l'âge et l'incapacité dans les activités de la vie quotidienne. La fréquence des événements majeurs récents ne contribue pas significativement à l'un ou l'autre des modèles. Des résultats similaires ont été obtenus selon que l'Échelle des Embêtements ou seulement les items de cette échelle qui ne correspondent pas à des symptômes étaient utilisés dans les analyses de régression. Les résultats suggèrent que la fréquence des embêtements est plus fortement reliée au bien-être chez les personnes âgées que la fréquence des événements majeurs.

In 1988 the Alberta government introduced a new resident classification system to measure the care requirements of residents in the province's long-term care facilities, and to provide case-mix information for a new funding system. This paper presents the results of the first province-wide classification process, including data for both nursing homes and auxiliary hospitals on the distribution of residents by classification indicators and categories. Data on facility case-mix indices are also presented. The results show that throughout the nursing home and auxiliary hospital system there was substantial heterogeneity in resident care requirements. Comparing across facility type, there were fewer differences between nursing homes and auxiliary hospitals in the distribution of residents on behavioural indicators than there were on indicators of physical care requirements. The paper concludes by discussing policy and planning implications of the 1988 results and the classification system more generally.

The aim of the present study was to examine the effect of stressors and other factors on psychotropic drug consumption among the elderly, with an emphasis on individual rather than social factors. Respondents were recipients of a home care program that focusses on personal care rather than health-related care. Data were derived from two in-home interviews (one week apart) of 99 users of psychotropic drugs residing in a socially deprived suburb of a major Canadian city. The initial path-analytic model explained a significant amount (19%) of variance in the amount of drug use. Age, sex, attitudes towards psychotropic drug use, and life events were the predictors which remained in our trimmed model of drug use which explained 17 per cent of the variance. The results suggest that younger individuals reported greater drug use than older respondents. Positive attitudes towards psychotropics and being female were associated with the highest level of drug use. Path analysis did not support our hypothesis of a stress-related mental health model of drug use and, instead, raised important questions regarding social factors. Several explanations for the results are discussed. Suggestions for future study and clinical implications are offered.

This paper examines the social networks and patterns of social interactions of two relatively neglected marital status groups of elders, namely the ever-single and the separated/divorced. Drawing on data from the 1985 General Social Survey conducted by Statistics Canada, comparisons are made both between and among the 224 ever-single and 126 separated/divorced Canadians aged 65 and over. When controlling for age, gender, education and health status, ever-single individuals tend to have smaller family networks, a similar number of friends, and similar living arrangements as the separated/divorced. In-person contact with siblings is significantly associated with being ever-single while no differences emerge for contact with other relatives or with friends. Differences among the ever-single and among the separated/divorced are also assessed.