Fries predicted in 1980 a continuing rectangularization of the survival curve, and trends toward delayed age of onset of chronic disease and toward compression of morbidity in late life. Others have presented evidence that challenges the first two predictions. However, direct evidence regarding the last one has been lacking.

The study reported here analyzed death certificate data on the longest interval between the onset of any condition listed as causing or contributing to the death and the occurrence of the death, from a representative sample of 500 Ontario death certificates in 1975 versus 1985, to deceased individuals aged 65 +. There was a statistically significant decrease between 1975 and 1985 in the frequency of the shortest intervals (under a month) and a not statistically significant increase in the frequency of the longest intervals (5+ years or “years”). Adjustments regarding not-stated intervals and attempts to control for a confounding factor did not change the picture. This study did not yield any statistically significant evidence of a compression of morbidity in late life, and did yield statistically significant findings that were inconsistent with that hypothesis.

A survey of the first two years of a psychiatric clinic within a geriatric medical day hospital was undertaken to determine the role of such a clinic. Forty per cent of all day hospital attenders were referred for psychiatric evaluation: at least 80 per cent of these had major psychiatric diagnoses and 20 per cent had other conditions needing psychosocial intervention. Depression and dementia accounted for 62 per cent of all psychiatric referrals. Those who were referred to the psychiatric clinic were quite comparable to the unreferred group in age, sex, marital status, pre-retirement employment and source of referral to the day hospital. The outcomes of intervention at three, six and 12 months were similar in both groups but referred patients stayed longer in the program. It is concluded that such a clinic provides a necessary mental health service where it is needed.

Commentaire

Lorsqu'un auteur aborde le thème de la scientificité d'un domaine de la connaissance, il rend explicite une démarche à la fois réflexive et appréciative d'une discipline sur elle-même. Dans le domaine de la gérontologie sociale, cet exercice soulève aisément des débats houleux. Ne craignant pas la polémique, F. Béland dresse son propre bilan de la recherche québécoise dans ce domaine en traitant de questions méthodologiques, de problèmes relatifs à la théorisation, ainsi que du développement institutionnel de la gérontologie. Ce bilan se veut utile, en ce qu'il doit permettre d'identifier les éléments qui favorisent ou qui entravent le développement de la recherche en gérontologie sociale.

For this study, we adapted the Montgomery Borgatta Caregiver Burden Scale, used widely in the United States, to the Saudi Arabian context. To produce an Arabic, culturally sensitive version of the scale, we conducted semi-structured interviews with 20 Saudi family caregivers. The Arabic version of the scale was tested, and participants were asked to comment on the appropriateness of items for the construct of “caregiver burden” using the repertory grid technique and laddering procedure – two constructivist methods derived from personal construct theory. From interview findings, we examined the content of the items and the caregiver burden construct itself. Our findings suggest that the use of constructivist methods to refine constructs and quantitative instruments is highly informative. This strategy is feasible even when little is known about the investigated constructs in the target culture and further elucidates our understanding of cross-cultural variations or invariance of different versions of the scale.

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.

In contrast to the negative images which attend old women in many social and statistical reports, literary gerontology provides a framework which allows us to see old women as complex and integrated figures. Canadian literature offers numerous examples of powerful old women who defy reductive stereotypes. Literary grandmothers, particularly when they appear in pairs, force a recognition of the integrating and mediating powers of old women. This paper discusses four Canadian novels in which pairs of grandmothers can be seen to supply a structural matrix which orders and supports the growth and development of future generations. Through the old women in these novels we may recognize the tradition of the mythic Great Mother in whose image we recognize the full power of our witches, wise women and ordinary old grandmothers.

Following 14 months of operation, all 142 patients assessed by the Day Hospital program at Seven Oaks General Hospital in Winnipeg were reviewed. Needs identified through referrals from physicians were compared with those assessed by the Day Hospital team. Findings showed that medical, nursing and learning needs were most frequently not identified and more than half the referrals identifying a single need were assessed as having multiple needs. However, the ranking of needs by referrers and assessors were identical.

The review confirmed that this Day Hospital met the objective of assessing the multiple factors affecting the well-being of the elderly.

The present study examines the relationships between health status, medication usage and depression in a community sample of elderly francophones. The results reveal that the use of non-psychotherapeutic medication is significantly greater by subjects who are physically impaired and those who are depressed. In addition, physically impaired subjects use significantly more psychotherapeutic medication than those in good health, whereas there is no difference between depressed and non-depressed subjects. The results also show that women use more psychotherapeutic medication than men. Thus, health status and depression both account for the increased use of non-psychotherapeutic medication in the elderly. In addition, the greater use of psychotherapeutic medication by the physically impaired and the lack of difference in the use of psychotherapeutic medication between depressed and non-depressed may point to possible over prescription for the elderly.

This case study examines the exposure risk of Quebec drivers aged 68 and over in five different difficult driving situations. 307 cases were identified based on driving performance (three or more accidents or traffic violations over a 3-year period) and paired on a 2:1 basis according to age, sex and area (urban/rural) with a random-selected control group (clean driving record). The response rate to this mail survey was 60 per cent. Assumptions were validated using the logistic regression method. Results show that as drivers get older, they gradually give up driving in risky situations; regardless of age, the number of drivers who stop driving in difficult conditions is proportionally higher in the control group. On the other hand, vulnerability would seem to increase with the exposure level. The analysis also shows that rural drivers are more vulnerable than urban drivers, regardless of exposure factors. Finally, the perception of health would seem to have little impact on the elderly drivers' performance.

An assumed fixed maximum life span was involved in a much publicized prediction of a compression of morbidity in late life. The maximum life span has major weaknesses as a measure. The “usual life span“, or age to which 1.0% of a birth cohort survives, is suggested as a more useful measure.

Statistics were derived from recent United States and Canadian censuses on the age above which 1.0% of the population is contained, from recent United States and Canadian mortality data on the age above which 1.0% of the deaths were reported, and from recent Canadian life tables on the age to which 1.0% of a cohort would survive. These statistics suggest that the usual life span increased at least 2 years in the 1960–1980 period in North America.

The purpose of this research was to study the influence of spousal support in the pursuit of retirement goals on retirement satisfaction and marital satisfaction. The 100 retirees had to evaluate the support they received from their spouse for the realization of their personal projects. Regression analyses demonstrated that availability of spousal support, capacity to realize one's projects and spousal support to these projects accounted for 36% of the variance of retirement satisfaction and for 71% of the variance of marital satisfaction. Spousal support in the realization of retirement projects is an important element to consider in the evaluation of retirement and marital satisfaction.

Caregivers play a determining role in choosing treatments for persons with Alzheimer's disease. The objective of this study was to examine caregivers' willingness to have persons with Alzheimer's disease continue taking cholinesterase inhibitors in the event that any 1 of 11 adverse effects was to occur. Data were gathered via postal questionnaire from 375 caregivers in Montreal. Sixty-four per cent of caregivers responded (n = 201), and most (≥59%) were willing to continue treatment if persons with Alzheimer's disease suffered from weight loss or loss of appetite. However, most (≥53%) were not willing to continue treatment in the event of headache, dizziness, nausea, diarrhea, vomiting, drop in blood pressure, insomnia, muscle cramps, or stomach bleeding. The use of cholinesterase inhibitors by persons with Alzheimer's disease was positively associated with caregivers' willingness to accept greater numbers of adverse effects (adjusted relative risk = 1.97; 95% CI = 1.11 to 3.61). Caregivers appear to make a risk–benefit assessment when they decide whether or not care-recipients should continue pharmacotherapy in the event of adverse effects.

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.

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.

Towards developing more effective interventions for fall-related injuries, this study analysed a novel database from six retirement home facilities over a 4-year period comprising 1,877 fallers and 12,445 falls. Falls were characterized based on location, activity, injury site, and type, and the database was stratified across four levels of care: Independent Living, Retirement Care, Assisted Care, and Memory care. Falls most occurred within the bedroom (62.8%), and during unknown (38.1%), walking (20.2%), and transfer tasks (14.6%). Approximately one in three (37%) of all falls resulted in an injury, most commonly involving the upper limb (31.8%), head (26.3%), and lower limb (22.2%), resulting in skin tears (35.3%), aches/pains (29.1%), or bruises (28.0%). While fall location, activity, and injury site were different across levels of care, injury type was not. The data from this study can assist in targeting fall-related injury prevention strategies across levels of care within retirement facilities.