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.

Reminiscence is the process of thinking or telling about past experiences. The goal of this study was to investigate which functions young adults attribute to their own reminiscences, and to the reminiscences of older persons. The views of young adults on the reminiscences of older adults were also compared with the self-reports of older persons on their reminiscences. We used the Reminiscence Functions Scale (Webster, 1993,1997), which measures eight functions: Boredom Reduction, Death Preparation, Identity, Problem-Solving, Conversation, Intimacy Maintenance, Bitterness Revival, and Teach/Inform. Seventy-six undergraduate students reported on their own uses of reminiscences. A few weeks later, they gave their views regarding the functions for older persons on the same scale. Eighty-three adults over the age of 65 completed the scale regarding their own uses. Age-appropriate higher uses of the functions of Boredom Reduction, Identity and Problem-Solving characterized the young adults. Older adults most characteristically used reminiscence for Teach/ Inform, i.e. for transmission of life experiences. Compared to themselves, young adults believed that older adults reminisced more for practically all functions, which reflects the stereotypical view. When these beliefs were checked against the reports of older adults, it became clear that young adults overestimated almost all uses, especially Boredom Reduction, Death Preparation, and Teach/Inform. These findings reflect the prevalence of ageist assumptions regarding the uses of reminiscence by older persons.

The goal of this study is to develop and validate a tool for measuring perceptions of caregivers of the quality of care and services in Geriatric Assessment Units. It has been designed so as to reproduce the notion of quality for caregivers. The validation of the tool is based on analyses of responses provided by caregivers (n = 274) to questions of perceived quality and to a certain number of questions necessary for the evaluation of its metric qualities. The measurement scale developed includes 25 items and it demonstrates good internal consistency. The Alpha Cronbach coefficients are 0.95 for the global index and they range from 0.88 to 0.91 on the sub-scales. The various analyses support a three-dimensional structure of the notion of quality for caregivers, explaining 66 per cent of the total variance. These dimensions are: “exchanges with professionals on the relative's condition,” “care given to a loved one,” and “planning the discharge”. It is hoped that this tool will promote the inclusion of the points of view of caregivers in the process of the improvement and assessment of quality.

Vers 2031, les personnes les plus âgées (85 ans et plus) pourraient composer 4 pourcent de la population totale du Canada. Ce document relève les changements constates dans le domaine de l'utilisation des soins de longue durée, des activités de la vie quotidienne (AVQ) et des activités instrumentales de la vie quotidienne (ATVQ) chez les participants les plus âgés du Aging in Manitoba Longitudinal Study, d'après trois éléments répartis sur 13 ans. Parmi les participants, 38,4 pour cent n'avaient pas eu recours aux soins de longue durée pendant la période examinée; entre 75 et 88 pour cent des participants pouvaient continuer à manger, à se déplacer dans leur maison et à se mettre au lit et à en sortir sans aide. En ce qui a trait aux activités instrumentales de la vie quotidienne, la proportion des gens qui n'avait pas besoin d'aide allait de 3 pour cent (réparations dans la maison) à 58 pour cent (se préparer une tasse de thé ou de café). Les résultats de ces analyses signalent l'hétérogénéité des aptitudes fonctionnelles des personnes très âgées et viennent enrichir la documentation portant sur cette tranche de la 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.

Voici un livre efficace, honnête et bien documenté sur le traitement des maladies terminates et les facteurs de stress inhérents aux soins à domicile. L'auteur présente une analyse solide et avisée des exigences et des récompenses des soins non structurés dans un langage accessible à un vaste auditoire. La prise de décision proactive y est présentée dans le cadre des incertitudes et des difficultés qui s'y rattachent. Dans l'ensemble, le livre offre une analyse complète, équilibrée et sensible. Je le recommande sans réserve aux soignants et aux professionnels de la santé qui accompagnent des families dont un membre meurt à la maison.

This paper presents a selective review of sociological gerontology in Canada, examining where it has been, where it is, and where it could go in the future in four general areas: inequality, population aging and the social construction of crisis; family relations and caregiving; work, retirement and income security; and health, health care systems, and health policy. This review suggests that the sociology of aging has not differentiated itself by the topic studied or by its applied and empirical focus, but rather in its unique perspective that reveals the importance of social structures for the personal and private experience of aging. In doing so, sociological gerontology rejects deterministic assumptions ofinevitability. The importance of relating the personal to the public and of continuing a critical examination of existing trends will continue into the future. An additional challenge will be the generation ofnew knowledge on how to transform institutions so that they better enhance the quality oflife ofseniors, including the identification of support of family structures and community environments, as well as more appropriate health and income security policies. This also includes research on effective and appropriate means of introducing new structures and implementing new policies and programs within the context of current social institutions.