This article examines the living situations and access to social support for community-dwelling people between the ages of 50 and 65, and who have lived with significant physical impairment for more than 15 years. Data were gathered through in-depth, semi-structured interviews with eight men and women. Findings suggest that coping with long-term impairment may be a lonely experience when the individual lacks a strong network of family and/or friends to offer emotional support. Participants felt their experiences of aging with significant long-term impairment were improved when they shared thoughts, feelings, and problems with others. Findings also show the significance of gender regarding access to social support and point towards the importance of using subjective understanding when ascertaining the level of social support available to individuals. More generally, findings underscore the broader point that individuals aging with impairments are immersed in and wish to maintain reciprocal relationships.

Background: Use of benzodiazepines, common among older people, may lead to substance dependence. DSM-IV-TR criteria for this iatrogenic problem may apply poorly to older persons following a physician-prescribed regimen. This study, first of its kind, aimed to determine the prevalence rate of benzodiazepine dependence in older persons according to DSM-IV-TR and other atypical criteria.

Methods: Descriptive study based on face-to-face interviews conducted in the homes of 2,785 persons aged 65 years or older who were randomly selected from across the province of Quebec, Canada.

Results: Use of benzodiazepines was reported by 25.4% of respondents. Among them, 9.5% met DSM-IV-TR criteria for substance dependence. However, 43% of users reported being dependent, and one third agreed that it would be a good thing to stop taking benzodiazepines.

Interpretation: Benzodiazepine substance dependence is established at one tenth of community-dwelling older persons taking these medications, although a much larger proportion self-labels as dependent.

Western societies are experiencing a dramatic growth in the population aged 75 and older. Changes in family composition raise questions about who will care for those who need assistance. We compared population projections to the year 2030 of those families aged 75 and older in Canada and France. Over the next 25 years, the pool of potential family carers, (i.e., spouses and children), will broaden from the effect of the baby boom and increased proportion of women with spouses. The populations most dependent on formal care, with no potential support from a child or a spouse, will increase more sharply in Canada (123%) than in France (34%) but at a slower rate than the total population. Policy and programs in both countries will need to prepare for a greater number of elderly spouses providing care and in Canada, at least, a significant increase in the number that will need to rely on formal services.

This article examines, on the basis of longitudinal data from the Canadian Survey of Labour and Income Dynamics, the effects of health and employer-provided pensions on retirement decisions, which have not been studied simultaneously in the Canadian context. The results indicate that employer-provided pensions have substantial and significant incentive effects on retirement behaviour. Having poor health substantially increases the likelihood of entering retirement, by up to 25 percentage points. The results corroborate previous evidence regarding the relative importance of attenuation and justification bias in self-reported health measures. Further, the results confirm U.S. and European evidence that employer-provided pensions and health are significant determinants of retirement.

In filial caregiving, women typically provide more care than men. The numerical predominance of female caregivers has been explained such that diversity among male caregivers has been overlooked. That is, “internalist” explanations, which emphasize the differing socialization experience of females and males, tend to homogenize each gender’s caregiving experience. “Externalist” explanations, which emphasize various factors that push or pull women and men into caregiving, reduce the actors involved to passive agents whose subjective understanding of caregiving over time is ignored. Both explanations divert attention from the diversity in male caregiving. This article presents qualitative data derived from interviews with 48 caregiving sons to provide evidence of that diversity. Some themes are common to both married and never-married male caregivers, yet there are also systematic differences between the two groups of caregivers. For example, caregiving for married sons was more limited; caregiving for never-married sons was a more central element in their lives.

This study used van Dijk’s critical-discourse approach to explore the current societal discourse on hope and to explore the hope of older terminally ill cancer patients, their significant others and primary nurse. Forty-three newspaper articles dealing with hope and cancer were collected and analyzed to explore how hope is socially constructed by print media. Individual face-to-face, qualitative, open-ended interviews were conducted with three triads, each consisting of an older palliative cancer patient, a significant other, and a primary nurse. The predominant discourse of hope and cancer in the newspaper articles was considered ageist, conveying the message that only one legitimate hope existed for persons with cancer: hope for a cure. The study findings suggested that this message caused confusion and distress for the patients, significant others, and their primary nurses because their own discourses of hope were focused on comfort, peace, and maintaining relationships at the end of life.

Among the older population in Canada, the majority of whom are women, incurable cancer is rampant. Having incurable cancer often implies suffering. Studies reveal that communication with one’s circle is therefore often arduous, leading us to believe that it can cause suffering. To our knowledge, there has been no research that specifically explores the suffering related to communication among older women with incurable cancer: this will be the objective of our article.

This exploratory qualitative research is in humanistic psychology. It is based on a phenomenological analysis of the conceptual categories that emerged from 19 semi-structured interviews among 10 women aged 65 years and over with incurable cancer.

The results reveal both the dynamic of silence, desired in order to prevent increased suffering, and sometimes imposed and a source of further suffering. They also reveal that the absence of listening, the imposition of silence, and the minimization of what these women say, also cause suffering. The consequences of disclosing one’s illness and its suffering are also explored.

Time-of-day effects have been identified as a possible confound in research on age-related differences in cognitive performance. Circadian rhythms have been related to time-of-day variations in sensory measures; however, more is known about the effect of circadian rhythms on vision than on hearing, and virtually nothing is known about whether time-of-day effects are potential confounds in studies of auditory aging. The purpose of the current study was to determine whether age-related differences in performance on auditory tasks are affected by time of day. A set of four auditory experiments was repeated three times over the course of one day with a group of Evening-type younger adults and a group of Morning-type older adults. The results replicated previous findings of age-related differences, but time of day did not affect the basic results. Thus, time of day does not confound the results observed in typical laboratory experiments investigating auditory aging.

Drawing on the intergenerational stake hypothesis (Bengtson and Kuypers, 1971), this article explores intergenerational congruence and incongruence on filial obligation, and implications for social support, between older nisei (second generation) parents and adult sansei (third generation) children in Japanese Canadian families. Using data from semi-structured interviews with 100 parent–child dyads in British Columbia, congruence on close-ended responses to value statements (degree congruence) and the content congruence of open-ended responses are examined. The findings show the majority of parent-child dyads indicate overall (both degree and content) congruence in filial obligation, especially when a parent is female, widowed, and/or has poor/fair health status. We conclude that despite markedly different historical life course experiences and acculturation processes, both generations continue to regard filial obligation as important. These findings are discussed with respect to implications for social support exchanges given a continued valuation of filial obligation in Asian post-immigrant (North American-born) and immigrant families.

The study’s purpose was to evaluate the psychometric properties of the short form of the Daily Spiritual Experience Scale (DSES) in an elderly French population. Two studies were conducted to examine the psychometric properties of the DSES. Results of factor analysis (studies 1-2) and confirmatory factor analysis (Study 2) indicated that the DSES can be conceptualized on a single general factor. The reliability of the DSES appeared to be satisfactory with good internal consistency (studies 1-2) and good temporal stability (Study 2). As expected, higher scores were correlated with good life satisfaction and good self-evaluation of health, but no correlation was found with depression. Study results provided preliminary evidence of the psychometric properties of the French translation of the DSES short version. This short version indicates the potential benefit of encouraging the spiritual aspects of life and could be used in a variety of health-related research.

In this multiple-case study, we engaged directors of care of Ontario long-term care (LTC) homes in semi-structured interviews designed to increase our understanding of the influence exerted by organizational and extra-organizational factors on two key aspects of organizational performance: operational efficiency and quality of care. We also examined the influence of these factors on the relationship between efficiency and quality. Through a review of the health services and organization and management literatures, four broad factors identified a priori as influential for one or both performance outcomes were used to guide our data collection: staff characteristics, facility characteristics, extra-organizational influences, and the function of volunteers. Our findings suggest that while both high efficiency and high quality of care are achievable, there are aspects of a home’s operations and realities associated with the LTC sector in Ontario that can make achieving both, simultaneously, exceedingly challenging.

The Aboriginal population in Canada, much younger than the general population, has experienced a trend towards aging over the past decade. Using data from the 2001 Aboriginal Peoples Survey (APS) and the 2000/2001 Canadian Community Health Survey (CCHS), this article examines differences in health status and the determinants of health and health care use between the 55-and-older Aboriginal population and non-Aboriginal population. The results show that the older Aboriginal population is unhealthier than the non-Aboriginal population across all age groups; differences in health status, however, appear to converge as age increases. Among those aged 55 to 64, 7 per cent of the Aboriginal population report three or more chronic conditions compared with 2 per cent of the non-Aboriginal population. Yet, among those aged 75 and older, 51 per cent of the Aboriginal population report three or more chronic conditions in comparison with 23 per cent of the non-Aboriginal population.

The purpose of this study was to better understand adjustment and life satisfaction in later life. In particular, it examined the contribution of leisure participation and motivation toward leisure in older people’s adjustment to their nursing homes and their satisfaction with life.. Study results underlined the contribution of participation in leisure activities both to the adaptation of an elderly person to his residence and to life satisfaction. In terms of adaptation to the residence, participation in recreational activities exhibited this mediational sequence: leisure participation → self-determined motivation for leisure → adjustment to nursing homes. This suggests that leisure participation has an indirect effect on older people’s adaptability. Various practical implications of this research emerge for the development of future recreational programs in nursing homes to promote seniors’ adaptation.

Little comparative research exists on health experiences and conditions of minority groups in Canada and the United States, despite both countries having a racially diverse population with a significant proportion of immigrants. This article explores race and immigrant disparities in health and health care access across the two countries. The study focus was on middle and old age given the change and increasing diversity in health and health care policy, such as Medicare. Logistic regression analysis of data from the 2002–2003 Joint Canada/United States Survey of Health shows that the joint effect of race and nativity on health outcomes – health differences between native and foreign-born Whites and non-Whites – is largely insignificant in Canada but considerable in the U.S. Non-White native and foreign-born Americans within both 45-to-64 and 65-and-over age groups experience significant disadvantage in health status and access to care, irrespective of health insurance coverage, demographic, socio-economic, and lifestyle factors.

This study provided an exploratory analysis of key social determinants of health for older Canadian women, with a focus on differences between rural and urban residency, given that socio-economic status (SES) and social capital have been shown to differ by rural–urban residence. Secondary analysis was conducted using the 2000/2001 Canadian Community Health Survey. A comparative logistic regression analysis revealed, unexpectedly, that SES and social capital variables were more strongly associated with the health status of urban older women than for the health status of their rural counterparts. Associations between health status measures and household income, food insecurity, and community belonging were largely not supported among rural women, but were for their urban counterparts. Findings are discussed concerning applications of the social-determinants-of-health model for explaining health patterns among older urban and rural women. Cost of living, access to health services, and dimensions of rural culture are discussed as potential explanations.

An estimated 36,000 home support workers assist older Canadians annually with daily activities, such as bathing, dressing, grooming, and light housework, yet home support workers’ day-to-day experiences are not well understood. Mahmood and Martin-Matthews (2008) have developed a model that locates the home support worker, elderly client, and family member at the intersection of the public and private spheres framed by their social, spatial, temporal, and organizational features. This study, funded by the Canadian Institutes of Health Research, examines and refines that model through an analysis of in-depth interviews with home support workers in British Columbia. Home support workers identify key issues in service delivery and discuss a range of creative solutions to complete their daily tasks efficiently, effectively, and respectfully. The study’s findings inform our understanding of home support workers’ job experiences; they also highlight those qualities that characterize exceptional workers in navigating the various domains of home support.

Despite the fact that Meals-on-Wheels have both nutritional and social aspects, research on the social objectives of the service is lacking. This study set out to develop an understanding of the social objectives of Meals-on-Wheels and to explore the extent to which they are met by Ireland’s Meals-on-Wheels services. A literature review suggested that Meals-on-Wheels services can potentially meet three social objectives: (a) providing meals recipients with social contact, (b) helping to restimulate an interest in meals and regularising mealtimes, and (c) helping to develop acceptance of the service. Interviews were conducted with 66 meals recipients to explore these themes and augment them as necessary. Study results show that meals recipients derive limited social contact from the service; regularising mealtimes was not important to most recipients; and many were reluctant to accept the service. The three objectives are therefore minimally met within the Irish system at present.

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.

Immigrant care workers play an increasingly important role in home and long-term care in Canada, yet the full extent of their relations with older persons in those settings is relatively unknown. This article examines the role of immigrant care workers in both home and long-term care sectors, with a focus on relations with older clients and implications for quality of care. The data are derived from interviews with workers, employers, and older clients conducted in various home and long-term care services for older adults across three Canadian provinces: Ontario, British Columbia, and Quebec. Factors stemming from immigrant care workers’ ethnic/racial background, language barriers, and contextual factors such as staff shortage in different care settings for older adults complicate the relationship between immigrant care workers and their clients. In some cases, these factors diminish the quality of care. We point to some policy alternatives that our findings suggest should be considered.

This repeated measures study examined undergraduate students’ beliefs about aging and Alzheimer’s disease (AD) in the cognitive, social, and physical domains. Students rated typical 25-year-olds (young target), typical 75-year-olds (old target), and typical institutionalized persons with AD (AD target) on 46 statements about cognitive, physical, and social abilities. Beliefs about aging were found to be generally negative in the cognitive and physical domains but positive in the social domain, consistent with the age-stereotyping literature. Interestingly, by comparing ratings of old and AD targets, beliefs were found to be generally negative in the cognitive and social domains but positive in the physical domain. AD is perceived to be a disease primarily of the mind, but in comparison to differences expected with aging, physical prowess is enhanced. Documenting beliefs, a first step toward modifying stereotyped behaviour, could have significant effects on the health and well-being of older adults and persons with AD.