Despite its global importance and the recognition of dementia as an international public health priority, interventions to reduce stigma of dementia are a relatively new and emerging field. The purpose of this review was to synthesize the existing literature and identify key components of interventions to reduce stigma of dementia. We followed Arksey and O’Malley’s scoping review process to examine peer-reviewed literature of interventions to reduce dementia-related stigma. A stigma-reduction framework was used for classifying the interventions: education (dispel myths with facts), contact (interact with people with dementia), mixed (education and contact), and protest (challenge negative attitudes). From the initial 732 references, 21 studies were identified for inclusion. We found a variety of education, contact, and mixed interventions ranging from culturally tailored films to intergenerational choirs. Findings from our review can inform the development of interventions to support policies, programs, and practices to reduce stigma and improve the quality of life for people with dementia.

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults aged 50 years and over were read a series of vignettes and asked if they were able to identify a community organization or agency that they may turn to in that situation. They were also asked about their most important sources of information about CSSs. The findings show that, using a vignette methodology, awareness of CSSs is much lower than previously thought. The most important sources of information about CSSs included information and referral sources, the telephone book, doctors' offices, and word of mouth.

Les approches de soins centrées sur la personne sont de plus en plus recommandées en vue d’améliorer la qualité des soins de longue durée. Au Québec (Canada), l’approche relationnelle de soins a été implantée dans plusieurs établissements. Cette étude porte sur le point de vue des soignants formés sur l’utilité de cette approche ainsi que sur leur capacité à la transférer en pratique. Des questionnaires comportant des questions ouvertes ont été administrés un mois après la formation (n=392). Les réponses ont été catégorisées selon une approche qualitative. Les répondants perçoivent que certaines dimensions de l’approche sont hors de leur portée ou s’opposent à leurs croyances. Ils rapportent des pressions liées aux contraintes temporelles, à leurs collègues ainsi qu’aux familles des résidents. Ces résultats indiquent que la formation ne suffit pas à transformer les pratiques. Il faut également agir sur les croyances des individus ainsi que sur les situations de travail

Chinese older adults may be at increased risk of social isolation and loneliness, and a fragmented understanding exists about the challenges they face for social participation in their neighbourhoods and communities. A scoping review was undertaken to describe the current knowledge on social isolation and loneliness in urban-dwelling Chinese older adults living in Western societies to inform future research, practice, and policy in Canada. Nineteen articles met the inclusion criteria. The World Health Organization’s age-friendly community framework contextualized the study findings. Studies identified issues related to (1) social participation; (2) community support and health services; (3) housing; (4) community and information; (5) respect and social inclusion; (6) outdoor spaces and public buildings; (7) civic participation and employment; and (8) transportation. Social isolation and loneliness is a growing concern in this population in Canada, and additional research is needed to identify its scope and effective interventions.

De nombreuses recherches concluent que les aidants naturels de personnes âgées en perte d'autonomie éprouvent un fardeau associé à leur situation. Les principaux facteurs influençant ce fardeau sont ici passés en revue et regroupés en quatre catégories: variables liées aux tâches effectuées par l'aidant, caractéristiques de la personne âgée, caractéristiques de l'aidant et variables interactionnelles caractérisant la relation entre l'aidant et l'aidé. L'article présente les résultats d'une recherche conduite auprès d'un échantillon représentatif des aidants québécois de personnes âgées en perte d'autonomie (n = 294). Selon cette analyse, le degré d'assistance fournie, l'aide pour les activités de la vie quotidienne et l'interaction avec les professionnels du réseau de soins formel sont associés au fardeau ressenti. De plus, le degré d'autonomie et l'état de santé de la personne aidée, de même que l'âge de l'aidant influencent le fardeau. Les variables interactionnelles influençant le fardeau sont: la proximité du lien de parenté entre l'aidant et l'aidé, le degré de responsabilité assumée par l'aidant, la cohabitation, ainsi que l'assistance fournie par les autres membres du réseau personnel. Ces résultats appuient plusieurs conclusions des travaux antérieurs, suggérant ainsi que les principaux facteurs associés au fardeau pourraient être similaires, peu importe le pattern ou le contexte de la situation aidant/aidé au plan de la culture (l'échantillon est québécois), du statut de l'aidant (principal ou secondaire) et du degré ou du type d'incapacité de l'aidé. Les résultats de cette recherche sont finalement discutés dans la perspective des tendances sociales à venir et des implications concrètes qu'ils soulèvent pour la planification des services sociaux et de santé.

Employing a participatory arts-based research approach, we examined an innovative program from rural Ontario, Canada, designed to address social isolation among older people. Older socially isolated adults were matched to trained volunteers, where in dyads, the eight pairs created expressive art in their home setting over the course of 10 home visits. With thematic and narrative inquiry, we analysed the experiences and perceptions of the program leader, older participants, and older volunteers via their artistic creations, weekly logs, evaluations, and field notes. The findings reveal a successful intervention that positively influenced the well-being of older adult participants and older volunteers, especially in regards to relationships, personal development, and creating meaning as well as extending the intervention’s impact beyond the program’s duration. We also discuss opportunities for similar programs to inform policy and enable positive community-based health and social service responses to rural social isolation.

Elderly people from ethnic minority groups often experience different barriers in accessing health services. Studies have typically focused on combined groups of elderly immigrants or on large ethno-cultural minorities such as the Chinese in Canada, or African-Americans and Hispanics in the U.S. This study aimed to examine the types and factor structure of barriers to using health services experienced by aging South Asian immigrants in Calgary, Alberta, Canada. A telephone survey was used to collect data from a random sample of South Asian immigrants aged 55 years and older. Principal component analysis revealed four major types of barriers: cultural incompatibility, personal attitudes, administrative problems in delivery, and circumstantial challenges.

Des niveaux moins élevés de participation sociale et d’épisodes de marche représentent deux facteurs pouvant contribuer à la dépression chez les personnes âgées, mais les recherches antérieures ne sont pas concluantes à ce sujet. L’objectif de cette étude transversale est de quantifier les associations entre la dépression et l’effet combiné de la participation sociale et de la marche dans un échantillon de personnes âgées vivant au Canada (n = 549). Des analyses de régressions linéaires et logistiques ont été effectuées pour examiner si la participation sociale et la marche prédisent la dépression indépendamment des caractéristiques individuelles. Dans les modèles finaux, les résultats suggèrent que les individus qui ne prennent pas de marches présentent davantage de symptômes dépressifs ou une possible dépression (l’association entre la participation sociale et la dépression devient non significative dans les modèles ajustés). La présente étude souligne le rôle central des habitudes de vie telle la marche pour la santé mentale des aînés.

Over the past three decades, there has been a notable increase in studies of practice change interventions in long-term care (LTC) settings. This review, based on a modified realist approach, addresses the following questions: What practice change intervention characteristics work? And, in what circumstances do they work and why? A modified realist approach was applied to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases and published literature for empirical studies of practice change interventions that (a) were conducted in LTC settings, (b) involved formal care staff members, and (c) reported a formal evaluation. Ninety-four articles met the inclusion criteria. Interventions that included only predisposing factors were least likely to be effective. Interventions that included reinforcing factors were most likely to produce sustained outcomes. We concluded that interventions aimed at practice change in LTC settings should include feasible and effective enabling and reinforcing factors.

In this study we examine the impact of parent status and marital status on (1) the foundations of social support networks and (2) who one turns to if help is required with activities of daily living. Data are taken from structured interviews with 678 community-dwelling persons aged 55 and over in London, Canada. This sample overrepresents the childless, single (never married), and divorced, thus ensuring adequate numbers in each category for data analysis. Our findings indicate that marital status is more influential than parent status regarding differences in the foundations of social support. However, for more specific forms of assistance, the divorced and single are more likely than the married, and the childless are more likely than parents to rely on formal support and paid help and less likely to rely on family. As well, for both marital and parent status, there are significant interactions with gender.

This study examined the six-month prevalence, risk factors, and costs of falls in older people using home support services who are at risk of falling. Of the 109 participants, 70.6 per cent reported ≥ one fall in the previous six months, and 27.5 per cent experienced multiple falls. Although there was no statistically significant difference in any fall-related risk factor between fallers (1+ falls) and non-fallers (0 falls), fallers had clinically important trends towards lower levels of physical, social, and psychological functioning. There was no statistically significant difference between fallers and non-fallers in the total per-person costs of use of health services in the previous six months; however, there were significant differences between groups in specific types of health services. The multivariate analysis revealed the presence of five risk factors for falls: neurological disorder (e.g., cognitive impairment, Parkinson’s disease), age ≥ 85 years, environmental hazards, previous slip or trip, and visual impairment.

This study investigated the relationships among gender role and self-reported health functioning in a sample of community dwelling older adults. One hundred and two (55 female, 47 male) participants were recruited through seniors’ associations in Windsor, Ontario. Analyses of variance were conducted separately by gender to compare the self-rated physical health functioning, wellness, and life satisfaction of participants differing on classification of their gender role. For older women classified as androgynous, gender role exhibited significant effects on general wellness and life satisfaction, but not on self-reported physical health functioning. In support of Bem’s androgyny model of optimal adjustment, post-hoc analyses revealed that women who rated themselves as androgynous reported better overall wellness levels than their peers. Older men’s self-reported physical health functioning and general wellness did not differ significantly by gender role. Limitations and implications are discussed.

Innovations in information and communication technologies are changing society, but only 1 in 15 Canadian seniors used a computer at the turn of the millennium (Statistics Canada, 2000). Furthermore, about 1 in 5 Canadian seniors has difficulty hearing, seeing, or communicating. The primary goal of the study was to investigate the relationship between hearing impairment and the use of information and communication technologies by older adults. A questionnaire about use of technologies was administered to 135 older adults and hearing was measured using audiometry. Hearing was found to be related to the extent of use of communication technologies, especially newer and more specialized technologies. Those with hearing loss who did not use a hearing aid did not use other technologies as much as peers with good hearing or hearing-aid users. Overall, the extent of and ability to use information and communication technologies was greater for the study sample than in previous findings for a national sample; however, the patterns of usage of various technologies and the factors influencing use were similar in the two samples. Recommendations are made for future research, health education programs, and universal design.

Volunteering has become increasingly recognized as governments try to shrink the public purse, yet it is an area where little knowledge has been established. Using the National Survey on Volunteer Activity (1987) conducted in Canada, this paper examines types of and reasons for volunteering among Canadian seniors, compares these with types of and reasons given by younger adults, and examines the predictors of different types of reasons. The data reveal that seniors are less likely to volunteer out of self-interest but are more likely to volunteer for reasons of obligation and social value than is true of younger adults. Reason for volunteering, furthermore, is related to the type of volunteer activity in which individuals engage. Those volunteering out of obligation and for social value rather than self-interest (that is, seniors) are more likely to be involved in service provision. The reason for volunteering is also related to satisfaction with the experience.

A review of gerontological literature on elder abuse and feminist literature on wife assault points to the conceptual and practice divisions that have separated attention to age and gender and, thus, obscured older women's experiences of abuse by their male partners. The first person account of a woman who left her abusive husband in her 70s and the supporting observations of a group of concerned service providers are introduced to bridge these conceptual divisions and to call attention to the social processes that hide and perpetuate wife assault in old age. With a view to developing methodologies and practices that make visible and challenge the conditions that sustain abuse of older women, directions for future approaches to research and service are considered.

Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as “the need for personalization of service”. Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

In this article, we raise the question as to whether retirement is lost as we currently know and understand it in Canada. With a selected review, we examine retirement research according to the scope of retirement and the new retirement, possible theoretical developments, the timing of transitions into retirement, and life as a retiree including the quality or lack of pensions. Accordingly, we propose that retirement is undergoing modifications on the basis of several trends that commenced before the 2008 economic downturn. The data would appear to lean towards the emergence of a different type of retirement, insofar as the collective Canadian vision of retirement is lost, notwithstanding the economic meltdown in global markets.

Although previous research has examined the various correlates of self-rated health, little attention has been paid to how position in the social structure influences this important measure of health. Drawing upon the social structure and personality perspective, I examine whether the relationship between socio-economic status (income adequacy and education) and self-rated health is mediated by financial stress, self-esteem, mastery, social support, smoking, alcohol consumption and physical activity, using data from the 1994 National Population Health Survey. Results show that almost one-third of the relationship can be explained by the mediating effect of these variables. Income adequacy and education, however, remain significantly related to self-rated health net of these variables. Further research with a broader array of variables related to social position is required to specify the mechanisms connecting socio-economic status and perceived health.

Recent discourses on aging emphasize the value of older people’s social participation. How participation is defined in policy, however, may not correspond with seniors’ realities. This article reports on the results of a critical discourse analysis conducted on aging policy in Quebec between 2005 and 2011. Results indicate that participation definitions can be problematic recommendations, standards, and expectations. Over time, participation increasingly came to be defined as productivity. The participation context also changed from collective responsibility to community adjustment and personal choice. Finally, policy texts reflected a polarization between activity and a loss of autonomy that linked participation with health status. Results suggest that, although innovative in the Canadian context, articulation of participation in Quebec’s recent policies on aging lacks the politics from which to discuss difference, otherness, and access to participative opportunities. The case of older people’s aging with disabilities illustrates the challenges of the new participatory agenda.

Community-dwelling seniors increasingly require physical assistance to perform the activities of daily living (ADL). To examine the possible association of this need with psychological distress, we conducted a prospective cohort study of community-dwelling people age 75 and older in Montreal, Canada. We report the results for women only (n = 530). Multivariable linear regression was used to examine the association between met and unmet need in instrumental ADL (IADL) and personal ADL (PADL) with concomitant psychological distress. Unmet IADL need was associated with elevated psychological distress [β = 0.42 (95% CI: 0.26, 0.60)], as was met IADL need [β = 0.19 (95% CI: 0.06, 0.33)], but not met and unmet PADL need. The full model explained 32.8 per cent of the total variance in psychological distress. Receiving assistance to meet IADL needs is associated with elevated psychological distress. Not receiving assistance, however, is associated with even greater distress.