This study examined the discriminant validity of the Multi-focus Assessment Scale (MAS). The MAS was administered to three groups of older adults varying in ability to live independently: Extended Care in-patients; Assessment Clinic out-patients; and independently functioning elderly. Analysis of variance showed strong group differences on all of the scales. Discriminant function analysis indicated that the MAS variables predicted group membership with a high degree of accuracy. Replications using random samples indicated the accuracy rates were stable. It was argued that cases of misclassification were largely due to overlap between subgroups of Extended Care and Assessment Clinic patients in terms of their capacity to engage in independent functioning. Also addressed in this study was the identification of variables on the MAS critical to independent functioning. The results indicated that there was a general lowering of functioning rather than specific patterns of preserved strengths or deficits. This was consistent with the presence of a general factor. The need for additional normative data for the MAS was discussed.

This paper identifies some factors associated with changes in face-to-face contact between grandmothers and grandchildren following a child's marriage breakdown. A qualitative analysis showed that geographic mobility, the appeal of a grandmother's home, employment status of the adult child, and the absence of the child-in-law were related to increases in visiting. Unresolved conflict and difficulties re-negotiating post-breakdown relationships were related to decreases in visiting. These findings as well as implications for service delivery are discussed.

Three Canadian research studies which used similar sampling strategies are examined. Data on their survey experiences are presented so as to assist those planning research to do so more efficiently. The response and completion rates of the three studies were quite similar, suggesting that some predictions might be made for similarly-designed future studies. The findings may give heart to those wondering whether their response and refusal rates are adequate or embarassing. Detailed reporting of survey research sampling experiences and adoption of a uniform terminology is called for.

This paper explores lay health care beliefs and practices. More specifically, the research tests the hypothesis that traditional “popular” health beliefs and self care practices are most likely to be found among older persons. Data were obtained through personal interviews with a randomly selected cross-sectional sample of 524 residents of Winnipeg, Canada. Statistical analysis was intended to assess the relationship between age and lay health care beliefs and practices, and to evaluate the relative explanatory power of age compared to other sociodemographic factors; self-reported health status; and medical care contact. The results suggest that the relationship between age and lay conceptions of health and self-care responses to illness is a rather complex one. Furthermore, respondents' age alone explained little of the variance in any of the dependent measures. Finally, this study revealed that although lay self-care beliefs and behaviour exist, they are not limited to older persons.

This paper presents a novel conceptualization of emotional support in intergenerational families. In a stratified random sample of 458 adults in Hamilton, Ontario, over half the respondents said that there was currently, or had been in the past, a person in their family to whom other family members turned for emotional support and personal advice. In the paper, this person is referred to as the “comforter.” Many people also identified the person who provided emotional support prior to the present comforter. On the basis of the data, a “position” of family comforter is inferred. The paper investigates the social correlates of the position, the type of activities associated with being the family comforter, and the pattern of succession as different generations in the family move in and out of the position. The paper demonstrates the family provision of emotional support at the level of the extended family. It is shown that occupancy, activities and succession of the comforter position are patterned by gender. Further, the data suggest that people seek emotional support from a generational peer.

This paper presents an analysis of access to social and health services of elderly people at three community and social service centres (CLSCs) in Montreal. Workers at the CLSCs were interviewed about service accessibility for elderly people in their neighbourhood. The elderly clientele of one CLSC, located in the centre of Montreal, primarily consists of French-Canadians and English-Canadians; the second CLSC is in a neighbourhood with many elderly Portuguese and the third CLSC is in a neighbourhood where a large concentration of elderly Chinese people live. No problems of access to services were perceived for elderly French-Canadian, English-Canadian or Portuguese people while serious problems of access were perceived for elderly Chinese people. Services provided for elderly people of the dominant cultures and elderly Portuguese are limited or unavailable to elderly Chinese people of Montreal. This suggests institutional racism against elderly Chinese people.

Programmes for publicly assisted housing for senior citizens are making it increasingly possible for the elderly to reside in towns and villages. A study of senior citizen apartment projects in nine small Ontario Towns appraises the quality of housing being produced. Many shortfalls in design and construction are revealed along with out-of-the-way locations for projects. Deficiencies are not easily rectified and responsibility impossible to assign.

Aging and Health Care: A Social Perspective gives the reader a straightforward presentation of information. Users of Aging and Health Care can feel confident that they are receiving accurate information, presented with readable style and clarity. The purpose of the book (as outlined in the Preface) is to integrate social elements of aging, with a discussion of health and the health care system, in the light of an aging society. Overall, the book seems to succeed in achieving its fundamental objectives. Any critique I would have of the book is based largely on what is not said. Many readers are likely to feel that Aging and Health Care is a “no frills” text. A broad range of topics are presented, but many could be afforded extra space for expanded emphasis. The prospective audience for Aging and Health Care should therefore be evaluated carefully. Instructors can use it as a basic reading for courses in social gerontology, but should also be prepared to supplement the chapters during class sessions. However, for the reader who desires an easy-to-follow introduction to gerontology, with the objective of identifying some areas of personal interest for subsequent in-depth follow-up, Aging and Health Care should be very appropriate and helpful.

The majority of long term care facilities for the elderly have the characteristics of total institutions. Care is based on the medical model which emphazises the physical needs of the residents. Current gerontological research and literature concludes that a biopsychosocial approach offers the highest quality of care to the elderly in institutions. This paper discusses political, economic, institutional and professional barriers to the implementation of the holistic approach to care. It recognizes that accommodation to the constraints identified is required. It then comments on the potential for an active alliance between two important actors in traditional long term care service delivery, the professional social worker and the nurse, to move the institution towards biopsychosocial care.

The first half of this book reviews what aging is like for most people including their health status and the help they receive from family and friends. The second half focuses on the formal health care system and the adequacy of it. The book is well-written and has a number of strengths, the outstanding one being the numerous references to Canadian research. The book also has weaknesses. It compares and contrasts the health care systems of Canada, the United States and the United Kingdom, but does this so briefly that the significant differences within each of these systems are lost. The book criticizes the Canadian health care system for being “over medicalized” to the detriment of the care of older people. This point is emphasized to the extent that it comes across as strong anti-physician bias. The authors emphasize the need for a range of community services to offset the need or both acute and long-term institutional care. They provide helpful descriptions of many such services, for example, adult day care and respite care, but fail to deal with the problem of lack of articulation among the various levels of care. For individuals new to the field of aging, the book provides an excellent introduction to key concepts and research findings. For the more experienced practitioners and academics, it provides useful references and discussion of recent studies.

This book is the first in a series on perspectives on individual and population aging. Emphasis is placed on the social patterns and institutions, and policy issues which arise from demographic aging in the Canadian context. A variety of topics are covered in the text. The general theme that emerges from the selected review of the available evidence presented in this volume is that scare imagery or siege mentality have no role in the discussions of this topic and may well create further problems rather than solutions. The book is written in a style that does not require any particular expertise.

The book discusses the socio-cultural background of the Euro-American elderly; focuses on social institutions such as family, the ethnic neighbourhood and the church; addresses programs and services; identifies program models and describes some intervention strategies. The issues discussed appear to apply to the ethnic elderly from a range of ethnic groups in addition to the ones analyzed. Besides practitioners, this book should prove of interest to researchers, policy makers and gerontology students.