Background: There is little empirical research into lay definitions of frailty. Objectives: (1) To explore the definitions of frailty among older men, and (2) to explore if these definitions match commonly used clinical definitions of frailty. Methods: Analysis of open-ended questions to survey data from a prospective cohort study of older airmen. The definitions of frailty were elicited, and grouped according to themes. Results: 147 men responded (mean age: 93). There was considerable heterogeneity in older men’s’ definitions of frailty, and no theme of frailty was predominant. The most common theme was impairment in activities of daily living. Older men’s’ definition of frailty was not consistent with any commonly used medical theory of frailty. Conclusions: Most older men think frailty is important, but their definitions are not consistent. Frailty may be a heterogeneous experience, which different people experience differently.

In this qualitative study, I followed an approach to examine perceptions about retirement, using an interview guide informed by the life course perspective, among 26 men and women who had retired from positions as chief executive officers. Three key themes emerged: (1) the importance of productivity and networking as participants rose up the corporate ladder; (2) the sense of having a “best before” date and experiencing societal pressures to retire; and (3) struggles with feeling insignificant in retirement while desiring personal fulfillment through continued engagement in paid work. These findings shed light on the value of using a life course perspective to examine retirement as both a personal experience and as a social phenomenon. Findings also contribute to theoretical understandings of productive aging by illustrating how preconceptions about productivity contrast with ideations of a leisure-filled retirement in ways that can foreshorten the employment contributions of some individuals.

Unregulated care aides provide most of the direct care to nursing home residents. We previously reported the first demographic profile of care aides in Western Canada through the Translating Research in Elder Care (TREC) longitudinal research program (2007–2022) in applied health services. Here we describe demographic, health, and work life characteristics of aides from 91 nursing homes in Western Canada. Demographics and work life varied significantly across health regions and facility owner-operator models. Our longitudinal cohort of aides from Alberta and Winnipeg had higher emotional exhaustion (a negative attribute), professional efficacy (a positive attribute), and experience of dementia-related responsive behaviours from residents. Overall, results indicate little improvement or worsening of care aide health and quality of work life. Coupled with limited provincial or national initiatives for workforce planning and training of these workers, this signals a long-term care system ill-prepared to care effectively for Canada’s aging population.

Medical issues facing the aging population are of growing concern with consequences for patients and their caregivers. This study determined the indirect and out-of-pocket costs incurred by the caregivers of elderly patients in Canadian Intensive Care Units (ICUs). Primary family caregivers were surveyed capturing out-of-pocket costs, hours of work, and hours of leisure forgone in providing patient care while the patient was in the ICU. Total costs of care per month were reported across caregiver sex, age, and geographic region. Average out-of-pocket costs were $791 (2016 Canadian dollars) in the first month of ICU care. The mean total cost to family caregivers per patient was $162 per day. Male primary caregivers had higher mean out-of-pocket costs than female caregivers. Subsidization programs covering expenses such as travel, meals, accommodation, and parking are needed to support family caregivers of elderly ICU patients who are incurring considerable out-of-pocket costs.

Informal caregivers often experience high stress levels with little support, especially in rural settings. With a mixed-methods approach, this research explored experiences of rural informal caregivers, including how social identification as a caregiver, social interactions, and formal and informal coping support related to perceived stress. Major focus group themes (n = 8) included lacking available services, balancing challenges, unmet practical needs, and strong community identity. Survey data (n = 22) revealed that perceived coping support (e.g., having someone to turn to), social interactions, and caregiver identity (e.g., perceiving the role as important to one’s self-concept) were associated with lower life upset stress, but only caregiver identity was associated with managing the personal distress and negative feelings associated with caregiving stress. Results suggest that, although available rural services may fall short, other options might alleviate caregiver stress, including facilitating access to coping support, encouraging social interactions, and enhancing caregiver social identity.

This study identified factors affecting seniors’ ability to self-manage their health following an Emergency Department (ED) visit. Surveys (n = 380) completed by older adults and their caregivers in the ED assessed their understanding of information provided. Interviews (n = 51) completed with a participant subsample up to four weeks post-ED visit examined self-management factors. Perceived understanding of the information (“Yes, definitely”) received in the ED was greater at the time of the visit (91%) than at follow-up (71%). Patients reported self-management was influenced by communication with ED staff, understanding of post-discharge expectations and the health condition(s), caregiver availability, and various external factors. Caregivers also identified support for caregivers and patient resistance to recommendations. Senior-friendly strategies (e.g., recommendations in writing, confirmed understanding of recommendations), particularly those related to identifying those at risk and needing greater transitional supports, and greater access to and integration with community supports could enhance post-ED self-management.

We aimed to understand clinical decision-making processes that influence the orientation of older patients after hospital discharge. We compared discharge decisions (i.e., discharge home, or nursing home stay) of the hospital team with those of an expert panel. Both panel and hospital team made their decisions independently. The blind study included 102 patients (mean age: 83.13 ± 6.74). There is a statistically significant difference between expert and hospital team decisions (p < .001; kappa coefficient: 0.468). Panel decisions were more closely associated with isolation (p = .018), reliable caregivers (p = .004), social problems (p = .001), and behavioural symptoms perceived as aggressive (p = .001). Both decision processes considered refusal of care (p = 0,025 and 0.016 respectively) and social problems (p = .001 and < 0.001 respectively). Discharge planning models differ depending on the country, team and patient’s condition. Our study suggests more precise evaluation of patients’ needs.

“Theory of Mind” (ToM) is the capacity to deduce other persons’ cognitive and emotional states. Studies investigating affective ToM in healthy older adults and in persons with Alzheimer’s disease have reported contradictory results, although evidence indicates that advanced age (Ruffman, Henry, Livingstone, & Phillips, 2008) and Alzheimer’s disease (Elferink, van Tilborg, & Kessels, 2015) do not affect the ability to identify or infer different emotions to the same extent. To evaluate affective ToM abilities in these populations, we asked 63 individuals (17 with Alzheimer’s disease) to infer the emotional states of characters presented without facial details in emotional situations. We observed similar results in healthy younger and older adults, but poorer performance in persons with Alzheimer’s disease for disgust, sadness, and surprise, but not for anger, fear, and joy. Results suggest that persons with Alzheimer’s disease have difficulties in inferring several emotional states from contextual information without facial cues.

Exercise has potential to mitigate morbidity in knee osteoarthritis (OA). Participants with knee OA were randomized to a Square-stepping Exercise (SSE) group (2x/week for 24 weeks) or a control group. We assessed the feasibility of SSE and its effectiveness on symptoms (WOMAC), balance (Fullerton), mobility, and walking speed at 12 and 24 weeks. The SSE group had a 49.3% attendance rate and trended toward improvement in the 30-second chair stand at 12 (F = 1.8, p = .12, ηp2 = 0.16), and 24 weeks, (F = 3.4, p = .09, ηp2 = 0.18), and walking speed at 24 weeks, compared to controls. There were no differences in symptoms or balance. The low attendance and recruitment demonstrated limited feasibility of SSE in adults with knee OA. Trends suggest the potential for SSE to improve lower extremity functional fitness and walking speed. SSE should be further studied for effectiveness on symptoms and balance, in addition to improving feasibility.