There is limited research addressing both resident and staff perceptions regarding the autonomy of institutionalized elderly residents, particularly in relation to their daily activities. This study determined residents' and their caregivers' perceptions of residents' latitude of choice regarding daily living activities. The study was conducted in two intermediate care facilities within Vancouver B.C. Study questionnaires were provided to 45 intermediate care residents and 45 nurses. Through three non-parametric statistical techniques, significant differences were found to exist between residents' and staff's perceptions. The study findings indicated that residents' extent of choice over daily activities of importance to them may not be realized to a greater extent if the staff do not attach a similar degree of importance to a particular activity. This study also indicates that, with some activities, staff do not perceive residents associating little or no choice with activities of particular importance to them.

Les cliniques « Brown Bag » permettent aux pharmaciens participants de rencontrer les personnes âgées afin d'examiner les médicaments en leur possession et de corriger les situations qui pourraient mener à des réactions toxiques (DRAPEs — drug-related adverse patient events). Cent vingt-trois patients ont été en contact avec 30 pharmaciens lors des cliniques pilotes tenues dans sept communautés de la Colombie-Britannique. En moyenne, chaque patient a apporté plus de neuf médicaments (prescrits ou non-prescrits) et les cliniciens ont identifié 482 problèmes potentiels de médication (les médecins traitants de 39 patients ont été immédiatement contactés). Plus de 80 pour cent des patients ont considéré les cliniques « Brown Bag » comme étant utiles et ont manifesté le désir de participer à nouveau lors de futures cliniques. Les pharmaciens cliniciens, bien qu'en faveur des cliniques, sont cependant réticents à ré-offrir leur services de façon bénévole. Lors des cliniques de rappel conduites de six à 11 mois plus tard, les patients avaient oublié une bonne partie de l'information obtenue lors des premières sessions.

This paper addresses the question of whether or not today's adults, by dramatically reducing their fertility, are jeopardizing the very source of support they will need in their old age. Part of the answer may be found in examining how present-day elderly with a demographic profile similar to that of a great many future old, cope with the prospect of isolation. Using Canadian data, the authors test the hypothesis that when there are few children to look after their aging parents, a transfer does exist from offspring support to that of collaterals, and that isolation in old age is not necessarily linked to previous fertility.

Using data from a Canadian national sample, participation in three activities - going to public places, travel, and going on outings - in a sample of 4,258 respondents aged 55 and over is examined. OLS regression results indicate that the childless go to public places and travel as frequently as parents and go on outings more frequently than parents. Significant differences are also found for gender, marital status, health, and education. Logistic regression results indicate that the childless are more likely to seek companionship with friends and other relatives than are parents. However, gender and marital status are more often significant predictors of source of companionship than is parent status. We conclude that the childless negotiate unique social participation networks which ensure social participation outside the home.

The free radical theory of aging is critically discussed. This review deals with the biological effects of free radicals during the aging process, the relationship between aging and diseases and how they both may be affected by free radicals, and the effects of free radicals on the human lifespan. The paper emphasizes aspects which require additional investigation.

This study evaluates a local health promotion project that may be widely adaptable to assist frail elderly persons to live longer at home. Subjects, enrolled in New Westminster, B.C., were men and women aged 65 and over living in their own homes but assessed and newly admitted to “personal care at home” by the Long Term Care (LTC) program of the B.C. Ministry of Health. About 90 per cent of eligible clients consented to participate. Randomized to Treatment or Control, they were followed for three years. Controls (n = 86) received standard LTC services, which included screening and pre-admission assessment, arrangement/purchase of needed services and review at three months and at least yearly thereafter. The Treatment group (n = 81) received standard LTC services plus visits from the project nurse who helped each subject to devise a personal health plan based on his or her needs in the areas of health care, substance use, exercise, nutrition, stress management, emotional functioning, social support and participation, housing, finances and transportation. The visits concentrated on setting goals and developing personal health skills, with referral to appropriate community services. An additional group of LTC clients (n = 81) from the adjacent community of Coquitlam was also followed. Success or “survival” was defined as “alive and still assessed for care at home”. After three years the “survival rate” for the Treatment group was 75.3 per cent, compared with 59.3 per cent for the Control group and 58.0 per cent for the Coquitlam group. Standard Kaplan-Meier “survival” graphs show that Treatment subjects were more likely to be alive and living at home at every time point during the three years. Differences between the Treatment and Control groups were statistically significant (p ≤ 0.05) both for simple cross-tabulations of care status at 24 and 36 months and in tests comparing “survival” curves. The results are especially striking because Control subjects received LTC services in a geographic area that offers universal access to health care and community resources and because the Control data were concurrent, not historical.

Cet article traite des problèmes vécus par les families dont un proche parent réside dans un hôpital de soins aigus et se trouvent en attente de placement dans un établissement de soins prolongés. Les données ont été recueillies dans un grand hôpital universitaire de Toronto. On a demandé à 84 aidants, membres de la famille et des proches du patient, de décrire les problèmes qu'ils ont vécus à la suite de son hospitalisation. Les problèmes énumérés étaient d'ordre personnel, familial et se trouvaient directement reliés à la situation du patient, à l'hôpital. Les problèmes ont été analysés en fonction du statut des aidants: conjoint(e), enfant ou simplement parent. Plus encore que les autres catégories d'aidants, les conjoint(e)s ont eu tendance à faire état de problèmes financiers ou encore du sentiment de ne pas se sentir écouté(e) par l'équipe de soin. Quant aux enfants ou aux autres parents, ils ont été portés, plus que les conjoint(e)s, à signaler des problèmes reliés à la famille élargie et aux situations conflictuelles nées de leurs multiples rôles et responsabilités.

Survivorship of patients placed into long-term care facilities within the Regional Municipality of Hamilton-Wentworth was studied over a seven-year period from 1980 to 1987. All patients had been assessed prior to placement by the Placement and Coordination Service and their computer files served as the data base for this study. Over the seven years, 25 per cent of patients died in each of nursing homes, homes for the aged and lodging homes and over 50 per cent of patients died after being placed in chronic care hospitals. Approximately 10 per cent of the deaths occurred in the first year after placement in the lodging homes, homes for the aged and nursing homes, whereas 25 per cent died in this time in chronic care beds. Survivorship rates of all patients combined differed significantly for males compared with females, but were not significantly different for variables such as age at time of placement, marital status, ambulation, living arrangement, previous location of community versus institutions, and agreement between recommended and final placement. Client's memory at time of placement was associated with survivorship in a nursing home: males with “no recall” and females with “marked confusion” and “no recall” survived longer than those with “normal” memory.

Using data from the Ontario Longitudinal Study of Aging (LSA) and data for aluminum and fluoride water concentration in areas where the LSA subjects resided, a preliminary analysis suggests that persons who show no indications of impaired mental functioning are more likely to have resided in areas where the aluminum concentrations (in drinking water) are relatively low and where fluoride concentrations (in drinking water) are relatively high. The difficulties in analyses of this type include the likelihood that many persons who are affected by impaired mental functioning do not respond to surveys, the identification of impaired mental functioning, and obtaining good exposure estimates of fluoride and aluminum drinking water concentrations.

Cet article se consacre essentiellement aux couples mariés et aux individus âgés mariés résident dans des foyers pour personnes âgées et dans des centres d'accueil en Ontario. Les données ont été recueillies à partir de réponses d'administrateurs à des questionnaires envoyés par la poste (331 administrateurs d'établissement en 1988 et 395 en 1989). Les résultats montraient que 12 pour cent des lits, dans ces deux sortes d'établissements, sont occupés par des personnes mariées. En outre, il a également été démontré qu'il y a plus de couples âgés dans les foyers de personnes âgées que dans les centres d'accueil, qu'ils habitent ou non dans la même chambre. Enfin, les résultats ont laissé entendre qu'il y aurait, dans les centres d'accueil, davantage d'individus mariés vivant seuls (leur époux vivant ailleurs) que dans les foyers de personnes âgées. De nouvelles perspectives de recherche sont envisagées.

Both theoretical and anecdotal evidence suggest that urinary incontinence brings with it psychological effects and that these play an important role in patient response to treatment. Nevertheless, previous research has not systematically examined the physical and the psychosocial aspects of urinary incontinence from the perspectives of the patients as well as their physicians. The medical staff and 39 continence clinic patients answered questionnaires measuring the following aspects of the patients' experience of incontinence: (a) physical, (b) psychological, (c) social, and (d) knowledge about their incontinence and its treatment. Results showed (1) the medical staff perceived greater improvement than the patients did, (2) the patients placed greater emphasis on the psychological and social aspects than did the staff, and (3) patient satisfaction is more strongly associated with improvements in disease severity.

While the majority of seniors live outside of institutions, many live in seniors apartment buildings rather than in single family dwellings. MacPherson (1983) suggested that not maintaining an independent living style may have some negative consequences for seniors. The question asked was whether differences in lifestyle arising from the nature of the residence were associated with measures of psychomotor performance. Some 36 seniors, average age approximately 68 yrs., all in good health, completed 800 responses on a discrete pursuit tracking task which emphasized response speed and accuracy. Significant differences in performance were noted for both RT and speed of movement. Overall, seniors living independently, either in urban or rural areas, responded faster than seniors living in seniors apartment buildings. The data do not imply a causal relationship, however, they do suggest that psychomotor variables are relevant factors to consider in regard to differing living styles.

Ce livre, qui traite des origines, de l'évaluation et du traitement des problèmes émotionnels de la personne âgée, se présente comme un livre pratique de référence à l'usage des cliniciens. En plus de sujets habituellement couverts dans des ouvrages de ce genre, comme la dépression et les problèmes associés aux maladies physiques, cet ouvrage aborde les problèmes de communication et de collaboration avec la personne âgée et sa famille, ainsi que les interventions susceptibles de favoriser l'épanouissement psychologique et physique à l'âge adulte avancé. Clairement organisé et rédigé, cet ouvrage se caractérise par la concision. Comme tel, il satisfera mieux le clinicien désireux de trouver rapidement une information pratique que le chercheur soucieux d'approfondir une question. Cet ouvrage constitue néanmoins un choix intéressant de manuel pour un cours avancé de premier cycle dans les disciplines qui s'occupent de santé mentale.

Égalité is an Acadian journal which specializes in political analysis. The theme of this particular issue is “Vieillir au Nouveau-Brunswick”. The publication contains seven research articles and a commentary on issues relating to aging. The authors touch on a variety of important topics such as demography, pensions, health, utilization of drugs, political behaviour, status of women, etc. All those interested in demographic aging and its impact on Canadian society would benefit greatly from reading this issue. Indeed, the facts compiled for these articles can, for the most part, be transposed to other provincial or regional contexts.

Contractile, histochemical and biochemical properties of the triceps surae were compared in 13 aerobically trained male subjects aged 63 to 76 years. Electrical stimulation of the triceps surae was used to determine muscle twitch, tetanic, and fatigue parameters. From these tests, twitch tension (Pt), time to peak tension (TPT), half relaxation time (RT), tetanic tensions at 10(Po10), 20(Po20), and 50(Po50) Hz and a fatigue index (FI) were calculated. Muscle samples from the belly of the lateral head of the gastrocnemius were obtained using the needle biopsy technique. A portion of each sample was tested histochemically for myosin ATPase (pH 4.30, 4.58 and 10.00) and NADH-tetrazolium reductase in order to classify fibre types (ST, FTa, FTb) and to determine fibre areas. The remainder of each sample was analysed for succinic dehydrogenase (SDH) and phosphofructokinase (PFK) enzyme activities. Significant correlations were found between fibre areas (both ST and FT) and Po10/Po50 and FI. No significant relationships were noted between Pt, 1/2RT and MVC and any histochemical parameter. SDH and PFK activities did not correlate significantly with any histochemical or physiological parameter. Regular endurance exercise apparently does not retard the decline in contractile properties seen with the aging process. Substrate related regulatory enzyme activities (PFK) and marker enzyme activities (SDH) from skeletal muscle of the elderly are much lower than activities found in younger subjects, despite regular aerobic exercise.

This study descriptively compares two older Canadian seasonal migrant populations in Florida: anglophones and francophones. It is based on two surveys, an anglophone survey conducted in 1986 and a non-probability survey of francophones in 1988. This exploratory study suggests that there may be little variation in the demographic profiles, migration experience and behaviour, living arrangements and social networks between the two types of seasonal migrants. The differences that do emerge, however, are interesting. There were strikingly different settlement patterns in Florida, and the francophones were more youthful and had larger families, contributing to larger social support networks.

Cette collection de 31 articles réunit les contributions des participants à un colloque organisé par l'IRAT en 1989. Elle donne accàs aux résultats de recherche et aux réflexions d'un groupe d'experts intemationaux sur l'impact du vieillissement de la main-d'oeuvre dans plusieurs pays industrialisés. Adoptant une prespective micro-sociale, plusieurs articles analysent les conséquences des conditions de travail sur les capacités fonctionnelles des travailleurs et sur les circonstances de la prise de retraite. D'autres articles adoptent une perspective macro-sociale oú la retraite est conçue comme un outil de gestion de la main-d'oeuvre. Cette façon de concevoir la retraite a eu comme résultat l'expansion de la pratique de la retraite anticipeée et, dans plusieurs industries et régions, une pénurie de certaines catégories professionnelles. Plusieurs auteurs concluent que cette politique ne peut pas continuer et réfléchissent sur différents moyens d'encourager les travailleurs vieillissants à rester au travail plus longtemps. Ce volume permet de comparer les politiques que plusieurs pays industrialisés ont adoptées face au vieillissement de leur main-d'oeuvre, et incite tant les gouvernements que les employeurs et les syndicats à être attentifs aux problèmes que peut entraîner le phénomène de la retraite dans l'avenir.

C.G. Gifford, a retired professor of social work at Dalhousie University, publishes here the results of his last research. Basing this research on 90 indepth interviews of persons prominent in the organization of seniors' asssociations in Canada, the United States and Europe, Gifford traces the history of these organizations and provides us with a critical analysis of their political involvement. This is an indispensable work.

Law and Legal Services for an Aging Population is a report in three parts. The first part deals with substantive law in areas such as access to legal services, discrimination on the basis of age, and protection of the elderly person. That first part contains a good review of some legal aspects of protection against elder abuse. Other aspects which are becoming very important such as powers of attorney in medical decisions are only touched in passing, while others such as housing accommodations and the rights of elderly persons in nursing homes are simply ignored. The second part presents the results of a survey carried in Greater Vancouver purporting to assess existing and future demands for legal services and obstacles thereto. The results are interesting mainly because so little research has been undertaken in this area. There is no conclusion and no specific recommendations result from this survey. The Third part presents a good annotated bibliography of legal cases and scholarship on selective law issues affecting elderly persons.