Social participation has tremendous implications for the physical and mental health of older adults. A growing body of Canadian literature has examined social participation among older adults, including frequency of participation; gender, age, and regional differences in participation; and associations with self-perceived health, loneliness, and life dissatisfaction. The current study adds to this important body of research, using a large, nationally representative sample of adults 45–85 years of age (Canadian Longitudinal Study on Aging [CLSA] baseline data [n = 51,338]), to examine nuanced characteristics associated with social participation (socio-demographics, social support, cognitive ability, mental health, physical conditions), frequency of participation, and the relationship between the aforementioned characteristics and frequency of participation. Findings indicated that compared with those who reported infrequent/no participation, more frequent participation was associated with greater social support, higher cognitive abilities, increased satisfaction with life, fewer depressive symptoms, reduced odds of self-reported mood and anxiety disorders, and fewer self-reported physical conditions. Findings highlight the importance of active social participation, and have important implications for the development and implementation of accessible community programs across Canada.

Older adults have an increased risk of complications or death from influenza. Despite the benefits of vaccination for older adults, vaccination coverage among older adults ages 65 years and over is still below Canada’s national target of 80 per cent. As health–care-seeking behaviours are influenced by several factors, including life satisfaction, we investigated the relationship between life satisfaction and influenza vaccination among older adults. A sample (n = 22,424) from the 2015–2016 Canadian Community Health Survey data was analysed using descriptive and multinomial logistic regression analyses. Higher life satisfaction was associated with a more recent influenza vaccination history. Vaccination differed by gender, age, and self-reported health status, as women, much older adults, and those with the poorest health status were more likely to be vaccinated. The study suggests an association between life satisfaction and influenza vaccination. More research into the factors that impact influenza vaccination in older adults is needed to increase vaccination coverage in the older adult population.

During the early stages of the COVID-19 pandemic, individuals were asked to stay home and restrict outings to limit the spread of the virus. Physical isolation was particularly emphasized for older adults over the age of 60 who, because of their age and related medical conditions, were at increased risk of severe disease and death from the virus. This led to reduced spread of the virus but also to social and emotional health challenges for older adults. Protecting the physical health of older adults was of the utmost importance during the pandemic but supporting social and mental health must not be overlooked. This patient-oriented qualitative study involved 40 interviews with older adults, conducted in the early stages of the pandemic, followed by a thematic analysis. Three themes were derived from the findings: subverted life plan, emotional impacts, and creating a path forward. The findings from this study will help inform current physical and social distancing guidelines during the ongoing COVID-19 pandemic. Moreover, findings indicate that social and emotional challenges with ongoing physical and social isolation must be taken into consideration for future pandemics.

This study examines whether memory intervention programs can mitigate health care costs. Research suggests these programs translate to a decreased intention of older adults who are worried about age-normal memory changes to seek traditional outlets for medical/psychiatric help. We employed a cost-benefit analysis approach to analyze the effectiveness of a memory intervention program within Ontario. We leveraged estimates of decreased intentionality to seek physician care following a community-based memory intervention with physician billing profiles to calculate the potential cost savings to the province’s health care system. The intervention studied was found to reduce provincial health care spending by $6,094 per program group. This amount exceeds $121.25 in direct costs per attendee associated with administering five program sessions. This analysis justifies further research on how community-based memory and aging programs can offer low-cost solutions to help individuals cope with subjective memory complaints and assist the health care system in prioritizing care for aging patients.

Caregivers of persons with dementia and depression experience adverse effects associated with their role. The aim of this scoping review was to identify the challenges faced by caregivers of people with dementia and depression, along with interventions to support them. The MEDLINE®, Embase and PsycINFO databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Grey literature was assessed using the Canadian Agency for Drugs and Technologies in Health’s Gray Matter tool.

The population consisted of caregivers of people with dementia and depression; the concept was to identify the negative impacts that caregivers experience and whether there are interventions to reduce them; the context was any study design targeting family or friends who were caregivers. A total of 12,835 citations were identified; 139 studies were included. Dementia and depression have variable impacts on outcomes experienced by caregivers, including burden/strain (n = 52), depression (n = 27), distress (n = 53), quality of life (n = 5) and health/well-being (n = 9). Pharmacological and non-pharmacological interventions have mixed effects. This study is important considering that depression in people with dementia is associated with caregiver distress. The use of a variety of non-pharmacological interventions could be beneficial to the latter.

Dementia is a growing concern in Canada, affecting peoples’ health and raising the cost of care. Between June and October 2019, we conducted an environmental scan to identify primary care models, strategies, and resources for dementia care from 11 pre-selected countries and assess their impact on quality-of-life measures. Search strategies included a rapid scoping review, grey literature search, and discussions with stakeholders. Eighteen primary care-based models of dementia care were identified. Common factors include team-based care, centralized care/case coordination, individual treatment plans, a stepped-care approach, and support for care partners. Five provinces had released a dementia strategy. Evidence of positive outcomes supported primary care-based models for dementia care, although only one model demonstrated evidence of impact on quality of life. Although these findings are encouraging, further research is needed to identify primary care-based models of dementia care that demonstrably improve quality of life for people living with dementia and their care partners.

Evidence of the impact of public reporting of health care performance on quality improvement is not yet sufficient for definitive conclusions to be drawn, despite the important policy implications. This study explored the association of public reporting of performance indicators of long-term care facilities in Canada with performance trends. We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, whereas the other 8 are not publicly reported, between the fiscal years 2011–2012 and 2018–2019. Data from 1,087 long-term care facilities were included. Improving trends were observed among publicly reported indicators more often than among indicators that were not publicly reported. Our analysis also suggests that the association between publication of data and improvement is stronger among indicators for which there was no improvement prior to publication and among the worst performing facilities.

It has been shown that there is disparity in access to long-term care and other services for minority populations. This study assessed long-term care access among older individuals belonging to minority populations including visible, ethnocultural, linguistic, and sexual minorities. Barriers and facilitators influencing admission were identified and evaluated.

A search for articles from 10 databases published between January 2000 and January 2021 was conducted. Included studies evaluated factors affecting minority populations’ admission to long-term care, and non-residents’ perceptions of future admission. This review was registered with PROSPERO: CRD42018038662. Sixty included quantitative and qualitative studies, ranging in quality from fair to excellent. Findings suggest minority status is associated with reduced admission to long-term care, controlling for confounding variables. Barriers identified include discordant language, fear of discrimination, lack of information, and family obligations. Findings suggest that minority populations experienced barriers accessing long-term care and had unmet cultural and language needs while receiving care in this setting.

Directly funded (DF) home care provides funding to home care recipients to coordinate their own care and supports, and is available across all Canadian provinces. Current research on DF home care focuses on the experiences of adults with disabilities self-directing their own care, but less is known about the experiences of family members managing services for adults 55 years of age and older. This article presents findings from a qualitative analysis of 24 semi-structured interviews with older adults and caregivers using the DF program in Manitoba, Canada, focusing on family manager experiences. We identify three themes in the interview data: (1) DF home care enhances choice and flexibility for older people and their caregivers, (2) choice and flexibility reduce caregiver strain, and (3) agency services reduce administrative burden. We discuss the importance of care relationships and the role of family managers. We recommend that traditional home care systems learn from DF, and that increased administrative support would reduce caregiver strain.

The process of admission of, typically, older residents into long-term care (LTC) has been greatly examined from the perspectives of the residents and their family members/caregivers. However, the viewpoint of the administrative staff directly involved has been left relatively unexamined. This article highlights findings from a qualitative study focused on exploring the lived experiences of LTC administrative staff working with residents-to-be and families/caregivers during the admissions process. Data from semi-structured interviews with seven participants indicate that these individuals often take on roles/tasks that go beyond the scope of their official work descriptions. Participants acknowledged the heavy toll of the stressful nature of their work on their health/well-being, but often normalized the pressures as part of their professional, if not personal, responsibilities to help others. Recommendations on improving the admissions process highlighted the lack of critique of the LTC system, despite its responsibility for the challenges that shape their day-to-day work.

Across the globe, long-term care has been under increased pressure throughout the COVID-19 pandemic. This is the first study to examine the experiences and needs of long-term care staff and management during COVID-19, in the Canadian context. Our group conducted online survey research with 70 staff and management working at public long-term care facilities in central Canada, using validated quantitative measures to examine perceived stress and caregiver burden; and open-ended items to explore stressors, ways of coping, and barriers to accessing mental health supports. Findings indicate moderate levels of stress and caregiver burden, and highlight the significant stressors associated with working in long-term care during the COVID-19 pandemic (i.e., rapid changes in pandemic guidelines, increased workload, “meeting the needs of residents and families”, fear of contracting COVID-19 and COVID-19 coming into long-term care facilities, and concern over a negative public view of long-term care staff and facilities). A small subset (13.2%) of our sample identified accessing mental health supports to cope with work-related stress, with most participants identifying barriers to seeking help. Novel findings of this research highlight the significant and unmet needs of this high-risk segment of the population.

Despite a recognition of religion as a resource for coping in later life, few studies have examined how religion is summoned to cope with the stressors of late-life immigration. Drawing upon data generated in a phenomenological study of the aging-out-place experience, this article presents a hermeneutic analysis of textual extracts addressing 10 Sri Lankan-born late-life immigrants’ Buddhist beliefs and practices, and how these beliefs and practices contributed to coping with immigration stressors. Four shared experiences facilitated through religious engagement were revealed: religious engagement as a source of purpose, making meaning of suffering and experiencing hope, non-attachment, and connecting to the past and the ethnoreligious community. Late-life immigrants drew on religious engagement to remain resolute amidst adversities, thus reinforcing the importance of culturally responsive milieus and services to support religion-focused coping. Findings are interpreted in relation to Pargament’s (1997) theory of religious coping.

Most Canadians with dementia die in long-term care (LTC) facilities. No data are routinely collected in Canada on the quality of end-of-life care provided to this vulnerable population, leading to significant knowledge gaps. The Quebec Observatory on End-of-Life Care for People with Dementia was created to address these gaps. The Observatory is a research infrastructure designed to support the collection of data needed to better understand, and subsequently enhance, care quality for residents dying with dementia. This article reports on the main steps involved in setting up the Observatory, as well as a pilot study that involved 172 residents with dementia who died between 2016 and 2018 in one of 13 participating facilities. It describes the data gathered, methodological changes that were made along the way, feedback from participating facilities, and future developments of the Observatory.

Public health measures associated with coronavirus disease (COVID-19) have accelerated the adoption of virtual health care across Canada. We explore the opportunities that virtual care presents in achieving the Quadruple Aim and challenges to navigate, through the lens of care for older adults. In particular, we recommend virtual care-related policies related to older adults that address (a) limited uptake among the socio-economically disadvantaged, (b) user-centered design of virtual care technologies, and (c) integration of iterative evaluations to ensure equitable and efficient achievement of desired outcomes. As virtual care accelerates forward, we must not leave older Canadians behind.

Online interventions for older adults should be tailored to their unique needs to increase the efficacy of and adherence to the intervention. The agile development cycle is a dynamic model to solicit and incorporate feedback from older adults during the design process. We combined this approach with the framework of Harvard University’s clinical and translational phases that provide a clear structure for evaluating new health programs before they are offered in the community. We based our online memory program on the empirically validated in-person Memory and Aging Program. The aim of the present study was to combine the agile development cycle with the clinical and translational phases framework to develop and pilot an online memory program tailored to the unique needs of older adults. Study 1 involved piloting individual program modules on site and integrating participant feedback into the program’s design to optimize usability. Study 2 involved two sequential pilots of the program accessed remotely to evaluate preliminary clinical outcomes and obtain feedback for iterative modifications. Plans for further validation and limitations are discussed. The successful application of the agile development cycle implemented in this series of studies can be adapted by others seeking to offer online content for targeted end users.

This study explored how a subsection of Canadians perceive older adults’ vaccines through a qualitative analysis of comments posted in response to national online news articles. We used reflexive thematic analysis to analyse 147 comments from 31 news article comments sections published between 2015 and 2020 from five different national online news sources (CBC, National Post, Global News, Globe & Mail, and Huffington Post Canada) that focused on three older adults’ diseases and vaccines: influenza, pneumococcal pneumonia, and herpes-zoster. Three themes encompassed the similarities and differences in how these three diseases were discussed: (1) the importance of personal experiences on stated stance in vaccine uptake or refusal, (2) questioning vaccine research and recommendations, and (3) criticisms of the government’s unequal vaccine opportunities across different Canadian provinces. Our findings identified that perceptions regarding older adult vaccination were dependent on the vaccine type, and, therefore, we make suggestions for future researchers to build on our findings, particularly the need not to treat the research subject of “older adults’ vaccines” as one entity. Gaining a better understanding of how older adults’ vaccines are perceived in Canada will enable public health professionals to develop effective communication strategies that should ultimately improve vaccination rates for older adults.