Michèle Charpentier's book explores the idea of government's sharing, with private and community resources, the responsibility for services for the frail elderly. Charpentier addresses the issue of the emergence of private residences, within the context of the evolution of the Quebec government. This book traces the history of Quebec policies on support of the frail elderly, discusses the social, ethical, and legal stakes involved in the development of private residences, and presents the points of view of different stakeholders affected by this dilemma. Charpentier's book proves to be both a rich and nuanced reflection on the legitimacy of the government's intervention, as well as on the opportunities for development available to the government, in the housing sector in particular, and on a broader scale, in the general area of services for the fragile elderly.

Cet ouvrage nous aide à mieux comprendre les relations complexes entre la santé physique et la dépression au sein de la population âgée. Les parties les plus intéressantes du livre s'attachent à discuter de l'influence de variables potentiellement responsables de la médiation des liens bidirectionnels entre la santé physique et la dépression chez les aîné(e)s, et des implications de ces découvertes pour une meilleure identification et des traitements plus adéquats de la dépression parmi les patient(e)s médicaux(ales) âgé(e)s. Malgré une organisation des chapitres qui laisse à désirer une perspective nettement médicale sur le sujet, cet ouvrage représente une contribution importante à notre compréhension de la dépression à l'âge adulte avancé.

Il est grand temps, essentiel en fait, que nous accordions toute l'importance qu'il mérite au témoignage des personnes atteintes de démence. Cet ouvrage, s'appuyant sur le point de vue des personnes qui vivent avec la maladie, vient enrichir la masse croissante de connaissances sur la démence. Pour répondre à la question « Comment vit-on chaque jour avec une maladie mentale comme la maladie d'Alzheimer (MA)? », l'auteure choisit de donner la parole à des personnes atteintes de démence. L'ouvrage reconnaît la contribution de ces personnes au corpus de connaissances sur la démence, il relate leur expérience et dénonce les stigmates associés à la maladie: à savoir que ces personnes sont des coquilles vides qui représentent un fardeau pour la société. Au contraire, nous dit l'auteure, ce sont elles les « vrais experts », et nous devons les écouter. Cet ouvrage est un outil indispensable pour tous les fournisseurs de services de santé et ceux qui s'occupent de personnes atteintes de démence, mais aussi pour les enseignants, les chercheurs, les décideurs et le personnel des sociétés d'Alzheimer. Ceux qui vivent avec la démence auront le sentiment d'être compris en lisant le récit d'autres personnes dans leur situation. L'ouvrage apporte une contribution précieuse à la recherche sur la démence, il nous fait mieux comprendre la maladie du point de vue des « experts » – ceux qui vivent avec la démence.

This paper focuses on the role of religion and ethnicity in providing social support for elderly Dutch Canadian Catholic and Calvinist parents and in establishing ethno-religious retirement and long-term care facilities. The data come from a 1995 survey of elderly Dutch Canadian immigrants (N = 79) and their adult children (N = 364) examining intraethnic differences in ethnic persistence and parent care. Continuity theory provides the theoretical framework for this study. In the last few decades, second generation Dutch Calvinist immigrants have been busy establishing retirement and long-term care facilities to look after the needs of the older Calvinist generation. Dutch Catholic immigrants have established very few retirement and nursing homes for their elderly members. Ethnic and religious differences influence the kind of support available to elderly Dutch Canadians.

This paper tests assumptions often made by policy makers and practitioners that networks of family, friends, and neighbours are able to provide sustained care to frail elderly Canadians. Using national survey data, we examined characteristics of the care networks of 1,104 seniors living with a long-term health problem. Care networks were found to vary considerably in size, relationship composition, gender composition, age composition, and proximity, and these network characteristics were found to help explain variations in the types and amounts of care received. As a result, network characteristics that might place seniors at risk of receiving inadequate care (including small size and higher proportions of non-kin, male, and geographically distant members) were identified. These risk factors appear to be poorly reflected in most existing policy.

For the past 10 years, in long-term care systems, we have witnessed the accelerated deployment of casemix management systems. A casemix is formed by clusters, defined by individual characteristics that explain similar resource use. However, certain questions regarding the development of these systems must be raised. Moreover, none of these systems was developed in the context of an integrated care organization that can track the progress of a dependent elderly person through every kind of care arrangement available—from own home, through intermediate facility, to long-term care institution. This article emphasizes the necessity of being well informed about the features of existing systems, in order to choose or develop the system that best answers the goals of a particular health care system. Finally, it underlines important elements that should be considered in each step of the development of a casemix system in this context.

While the benefits of participating in care or medical decision making are widely reported, research on decision-making participation preferences usually reveals some portion of individuals who do not want to be involved. Data collected through structured, in-person interviews with 100 residents of six long-term care (LTC) facilities in Victoria, British Columbia, were used to examine participation preferences with respect to four types of care decisions (bedtimes, medication choice, room transfer, and advance directives), as well as predictors of these preferences. Residents with higher levels of formal education, a greater number of chronic conditions, and greater confidence about the worth of their input tend to prefer more active involvement in decision making. This research also suggests that predictors of preference for independent control over decision making (active involvement) differ from predictors of preference for joint or shared decision making. Implications for the empowerment of LTC facility residents and the meaning of decision-making involvement in these environments are discussed.

This study investigates the participation of family caregivers when an elderly relative is going to a nursing home. Twenty-two primary caregivers, whose relative, aged 60 years or older, had recently been admitted to a public nursing home, were interviewed. The content analysis reveals that caregivers worry about and do what is needed to ensure the physical, psychological, and social well-being of their elderly relative and take care of her/his belongings. Doing things for her/him gradually gives way to managing things. Caregivers carry out the duty of protecting their family members, stimulating them, and keeping a close watch on the work of the staff of the institution.

There are numerous ways to better integrate the elderly into communities, many of which are contingent upon whether they will remain in their pre-retirement homes or make a move. Using a life course perspective, this paper establishes that residential history, social and family relations, socio-economic status, and health trajectories measured at mid-life can be associated with moves in later life, either directly, or indirectly through their effect on the mid-life residential trajectory. These relationships are examined with multivariate Cox proportional hazards and Poisson regression models, using data from the Ontario Longitudinal Study of Aging. These findings suggest directions for future research, to aid the development of public policy for the large baby-boom cohorts that are just entering mid-life.