This study was carried out on a representative sample of elderly people living at home (n = 300), in intermediate faculties (n = 271) and nursing homes (n = 774) from metropolitan, urban and rural areas in the Province of Quebec (Canada) in order to: 1) determine the level of disabilities and resources involved in the care of elderly people living at home or in institutional settings; 2) estimate the costs (public, private, voluntary) of these resources; 3) compare the costs according to the level of disability; and 4) predict the costs associated with disabilities. Results show that there were significant differences but large overlap in the disability level, cognitive status and nursing care needed and received between participants from the three settings. The disability score explained 85 per cent of the variance in nursing care time and 55 per cent (home), 15 per cent (intermediate facilities) and 68 per cent (nursing homes) of the variance in the cost. Nursing care was responsible for most of the cost in all settings. The total societal cost of home care was greater than the cost of intermediate facilities for elderly participants with a disability score over 7.4 and greater even than the cost of nursing homes for a score over 38.7.

New approaches to residential continuing care for frail seniors include a shift toward more social care models that involve hiring multiskilled workers and expectations of family involvement as partners in care. Recall and stylized time-use methods were used to assess the types of tasks and amounts of service provided by family and staff caregivers in three models of care. Findings are that family members provide about 30 per cent of on-site services to residents. Family members spend most time in enhancing well-being, while staff spend most time in housework. Patterns of care differ across Adult Family Living, Assisted Living and Dementia Care settings. Sustainability of these patterns of care depends upon adequacy of staffing and reasonable expectations about family resources.

The growing population of seniors with disabilities experiences unmet support needs and loneliness. Although support deficiencies can be overcome by peers in support groups, most support groups are inaccessible to older adults with limited physical functioning. Accordingly, this project aimed to develop and test the impact of an accessible telephone support group intervention for seniors with disabilities. Six research questions guided the study. Four telephone support groups with five to six participants (n = 23) were created, each with a professional and a peer (senior) leader. The groups met once a week for 12 weeks. Qualitative analyses of the telephone transcripts and post-intervention interviews of participants and leaders revealed decreased support needs, diminished loneliness, and enhanced coping. Selection, training, and support of peer and professional leaders and member control of discussions were important ingredients of successful support groups.

This article is about the life story of a woman who has had a career as caregiver for 25 years. Its purpose is to present the main characteristics of her career as a support person who, since the beginning, has struggled every day to find ingenious ways to meet the challenges of caring for a dependent husband. A daily struggle in which love, learning and public, social and family solidarities all come together. Who is this woman? What motivated her to embark on a career as a caregiver? What does the reality of her many learning experiences reveal? What is her attitude towards the support she receives? These are some of the questions raised in this article. Beyond the answers it may provide, it sheds light on the experience and daily management of caregiving. At the same time, it contributes to a better understanding of the family logic of caring for a dependent person.

Cataract surgery is one of the most frequent surgical procedures experienced by seniors. In Canada, substantial waiting lists for cataract surgery are common. This study systematically studied anxiety among older persons who were waiting for cataract surgery, and factors that may underlie anxiety in this population. Factors examined in relation to anxiety were age, sex, education, medical and ocular problems, previous cataract surgery, concern about wait, previous decisions to delay surgery, length of wait, visual functioning, visual acuity, worry about health, and coping strategies. A random sample (n = 50) of patients on a waiting list for cataract surgery took part in telephone interviews. Patients' ophthalmologists provided preoperative visual acuity. Over one-third of patients reported anxiety within the range reported for panic disorder patients and Beck Anxiety Inventory scores were well above reported norms for seniors. Increased anxiety was found among those with a general tendency to worry about their health, poorer visual functioning, and greater use of palliative coping strategies. The clinical implications of the findings are discussed. The results highlight the importance of assessing anxiety while elderly patients wait for surgery, designing interventions, and providing assistance to those patients found to have elevated levels of anxiety.

The purpose of the study was to identify the determinants of satisfaction with health care for Canadian community-dwelling older adults. A correlational design was used to examine the relationships between socio-demographic indicators, psychosocial variables, health services utilization, and satisfaction with health care in the young-old and old-old. A subsample (N = 2,413) from the 1994/95 National Population Health Survey Supplement was analysed. Hierarchical regression analyses revealed that socio-demographic variables were the best predictors of satisfaction with the national health care system in the young-old. Consultation with health care professionals was the best predictor of satisfaction with the Canadian health care system in the old-old and of health care personally received in both cohorts. Consultations with alternative practitioners was negatively related to satisfaction with health care in Canada and to care personally received in the old-old. The identification of the best determinants of satisfaction with health care can provide useful direction to policy makers, program planners, and practitioners so that more appropriate and effective services can be made available to this population.

The objective of this research is to determine the prevalence and risk factors for primary hypothyroidism in a sample of Canadian seniors. The Canadian Study of Health and Aging (CSHA) was a prevalence survey of seniors living at home and in long-term care facilities (n = 10,263). Detailed clinical examinations were conducted on 2,914 seniors, of which 1,415 had serum TSH levels measured.The ten Canadian Provinces were grouped into five geographic regions (Atlantic, Quebec, Ontario, Prairies and British Columbia). Only seniors who underwent detailed clinical examinations (n = 2,914) are included. Hypothyroidism was defined as seniors taking thyroid hormone replacement or seniors having a serum TSH level greater than 10 mU/L. An estimated 9.6 per cent of seniors had hypothyroidism, 5.1 per cent were inadequately treated and 2.1 per cent were untreated. Age, gender, cultural background, geographic region and place of residence were potential risk factors for hypothyroidism. Hypothyroidism was found to be a prevalent problem in this population.