Registered nurses (RNs) and licensed practical nurses (LPNs) provide the skilled component of nursing care in Canadian residential long-term care facilities, yet we know little about this important workforce. We surveyed 309 RNs and 448 LPNs from 91 nursing homes across Western Canada and report descriptively on their demographics and work and health-related outcomes. LPNs were significantly younger than RNs, worked more hours, and had less nursing experience. LPNs also experienced significantly more dementia-related responsive behaviours from residents compared to RNs. Younger LPNs and RNs reported significantly worse burnout (emotional exhaustion) and poorer mental health compared to older age groups. Significant differences in demographics and work- and health-related outcomes were also found within the LPN and RN samples by province, region, and owner-operator model. These findings can be used to inform important policy decisions and workplace planning to improve quality of work life for nurses in residential long-term care facilities.

This qualitative study explores the experiences of older adults participating in a creative visual arts program at a residential care facility in Victoria, British Columbia. A narrative inquiry approach was used to conduct face-to-face interviews with 10 residents and three program staff in addition to the systematic observations of program activities and an arts exhibit. The findings reveal the program fostered a sense of community among participants and enhanced their sense of self-worth as artists. A public art exhibition at a community centre underlined the value of residents’ artwork and gave meaning and purpose to their involvement in the program. Findings show the importance of arts programs in fostering creativity in later life and illustrate how people living in institutions can experience multiple dimensions of the self through artistic forms of expression. This study highlights the need to increase access to arts programs for individuals living in residential care.

Growing demand for beds in government-subsidized long-term care (LTC) homes in Ontario is causing long waitlists, which must be absorbed by other residential alternatives, including unsubsidized retirement homes. This study compares Ontario’s LTC homes and retirement homes for care services provided, funding regimes, and implications of differential funding for seniors. Descriptive data for both types of homes were collected from public and proprietary sources regarding service offerings, availability, costs, and funding. Overlaps exist in the services of both LTC and retirement homes, particularly at higher levels of care. Although both sectors charge residents for accommodation, most care costs in LTC homes are publicly funded, whereas residents in retirement homes generally cover these expenses personally. Given waitlists in Ontario’s LTC homes, many seniors must find residential care elsewhere, including in retirement homes. Several policy alternatives exist that may serve to improve equity of access to seniors’ residential care.

The purpose of the study was to identify self-perceived gaps in gerontological competencies among recreation staff in long-term care homes in Ontario. Two sets of gerontological competencies, in an online survey, were distributed to recreation staff working in 500 long-term care homes. There were 487 recreation staff members who completed the questionnaire. The questionnaire contained questions regarding staff’s current competencies and competencies that they recalled learning prior to entering the workforce. Factors that were perceived to contribute to confidence in gerontological competencies were experience, continuing education, in-service training sessions, and education. Understanding the gaps in gerontological competencies is required for enhancing therapeutic recreation education and continuing education.

Social isolation, given its established association with mortality, and risk of poor physical and/or mental health over the life course, has attracted the attention of researchers. However, such measures have been highly variable and often lack conceptual clarity. This study, which drew on a conceptual framework for classifying social isolation measures, provides a rationale for the development and validation of a composite Social Isolation Index (SII) using the Canadian Longitudinal Study on Aging (CLSA), together abbreviated as CLSA-SII. CLSA-SII was developed using standard methodology for developing other measures, including the multimorbidity resilience and successful aging indices. Associations of the CLSA-SII and four key outcome variables (life satisfaction scale, depression, perceived mental health, and perceived health) were performed using regression analyses. Associations between the CLSA-SII index and the four outcome variables resulted in statistically significant moderate associations in the expected direction, and are consistent with prior research, demonstrating good concurrent validity.

Aging and immigration have significantly shaped the population composition in Canada, where immigrants make up increasingly large proportions of the older adult population. This scoping review examines the existing knowledge surrounding older immigrants’ access to, and utilization of, primary care physicians, who play a pivotal role in the delivery of primary care, preventive care, and mental health care. We applied Arksey and O’Malley’s five-stage framework to search databases for Canadian-based, peer-reviewed English-language articles on the topic and examined 31 articles in detail. Three focus areas emerged: access and utilization of primary care, health promotion and cancer screening, and utilization of mental health services. Older immigrants face intertwining access barriers related to health literacy, language, culture, health beliefs, spatial inequality, and structural circumstances. The review provides a thorough understanding of the status of access to care among older immigrants in Canada, and yields policy implications to address their unmet health needs.

Objective: To conduct a formative evaluation of a transitional intervention for family caregivers, with assessment of feasibility, acceptability, appropriateness, and potential benefits. Methods: The intervention aimed to provide emotional support, information on community resources, and information and support for development of coping skills for the caregivers of patients aged 65 and older who were to be discharged home from an acute medical hospital admission. We used a one-group, pre- and three-month post-test study design. Results: Ninety-one patient-caregiver dyads were recruited. Of these, 63 caregivers (69%) received all five planned intervention sessions, while 60 (66%) completed the post-test. There were significant reductions in caregiver anxiety and depression following the intervention, and high rates of satisfaction. Discussion: This transitional intervention should be further evaluated, preferably with a control group, either as a stand-alone intervention or as one component of a comprehensive transitional intervention for older patients and their caregivers.

This longitudinal mixed-method study examined the types of help provided by caregivers to optimize participation of older adults with cognitive deficits post-stroke (care recipients), and how these types of help varied with caregiver’s burden. Twelve family caregivers of care recipients post-stroke completed a burden questionnaire and semi-structured interviews one month, three months, and six months following care recipient’s discharge home from acute care, rehabilitation, or day hospital. Care recipients completed cognitive tests and a social participation questionnaire. Types of help caregivers provided differed according to the amount of daily living support, degree of concern for care recipient’s well-being, and impact on caregivers’ social life. Interestingly, types of help fostering care recipient’s social participation, self-esteem, and abilities were unrelated to a negative impact on caregivers’ social life. Understanding how different types of help relate to caregiver burden could improve the types of help to optimize care recipients’ social participation without overburdening caregivers.

This study explored the efficacy of aerobic training (AT) in mitigating white matter hyperintensity (WMH) progression and whether these changes are sex dependent. This was an exploratory analysis of a randomized controlled trial assessing the effect of AT on cognition in people with vascular cognitive impairment. Participants were randomized to a 6 month AT or usual care (control [CON]) group. A subset completed magnetic resonance imaging to quantify WMH volume. Using an analysis of covariance model, we found a significant sex × group interaction (p = .03). Over the 6 month study, AT females demonstrated greater WMH progression than CON females (p = .05). Among males, there was no significant between-group difference (p = .31). Within the AT group, males demonstrated significantly less WMH progression than females (p = .01) at 6 months. Therefore, the effects of AT on WMH progression may vary by sex; that is, AT may curtail WMH progression in males but not females.

Hearing loss is highly prevalent in older adults and can pose challenges for neuropsychologists, as assessment and intervention procedures often involve orally presented information which must be accurately heard. This project examined the hearing status of 20 clients (mean age = 71 years) in a hospital-based outpatient neuropsychology clinic, and explored whether information about hearing loss informed neuropsychologists’ clinical practice. A research assistant administered a brief hearing screening test to each participant. Four treating neuropsychologists were asked to comment on their client’s hearing status before and after being shown their client’s hearing screen test results. Screening revealed that the majority of participants had at least mild hearing loss, and that the neuropsychologists were relatively accurate (60%) at estimating their clients’ hearing status. Neuropsychologists used information about a client’s hearing status to make recommendations that clients pursue audiologic services, and to educate clients and family members about hearing loss and communication.