In the context of demographic aging, preventing autonomy loss is a major issue. Adapting care systems to help keep seniors at home is a daily challenge. “La Mutualité Française”, a national mutual insurance company, has implemented in one of its healthcare services an innovative program to strengthen well-being: “The Well-Being Autonomy Pole.” This program comprises five Prevention and Support Care components and hypothesizes that strengthening the well-being of elderly people already suffering from physical limitations would prevent their autonomy decline. The originality of this program is its focus on elderly people who have rarely been studied in terms of preventing autonomy loss, given their existing functional limitations. A first evaluation was carried out over three months to verify the methodological feasibility of an impact assessment and to provide preliminary results on the effectiveness of the program. Key findings suggest improved levels of self-esteem, physical well-being, psychological autonomy and decreased anxiety. Methodological limitations of this first feasibility assessment and perspectives for future research are discussed.

This research examined transportation problems of non-institutionalized elders with ambulatory difficulties. The purpose was to explore their responses to their needs, and their satisfaction levels. The sample is composed of 67 elderly persons divided into three levels of mobility (low, medium and severely-reduced), and three types of localities (large, rural and semi-rural). In general, transportation is supplied by family and friends. The need which receives the highest level of satisfaction is meals. For elders with medium and severe ambulatory difficulties recreational activities are absent and their satisfaction is low. Urban elders, as opposed to rural elders, are the most unsatisfied. Their insecurity and fear of going outside is one explanation for these results.

In response to the contradictions appearing between, on the one hand, government promotion of family caregiving for elderly parents and, on the other, the rise of autonomist values (as documented in the literature), we surveyed a number of elderly people living with disabilities about the kind of assistance they would like to receive. The present qualitative, thematic analysis is based on the accounts given by 19 elderly people who receive assistance. The findings show that the position of elderly people with respect to their desire to receive (or not receive) substantial assistance from their family rests on a set of values, wishes, and/or fears – including, particularly, adherence to the value of autonomy, the desire to respect freedom (one's own as well as that of others), adherence to norms of familial duty, attachment to one's home, the value placed on solitude and privacy, and the degree of emotional closeness between the elderly and their children. Access to quality formal services also stands out as a factor enabling elderly people to actualize the desire for care which they elicited within the framework of this analysis.

Little is known as yet about the impact of telesurveillance services on social participation. To document the interaction between telesurveillance services and social participation of the elderly living at home, a study was conducted in the context of a government call center employing nurses. A focus group study was realized with elders (n=4), caregivers (n=6), healthcare system practitioners and industry employees (n=7). A qualitative analysis was performed using the Disability Creation Process model and generally accepted criteria for evaluating telehealth interventions. The results showed, on the one hand, factors that facilitate the use of telesurveillance services (user's intellectual capabilities, acceptance of clinical settings, relevance of recommendations, cost of service, and accessibility) and, on the other, factors that reinforce such use (user behaviors; level of satisfaction; impact on informal caregiver; system's level of performance; technical features; and life-habit aspects such as personal transportation, sleep, housekeeping, personal care, interpersonal relationships, and recreational activities).

This study consists of a secondary analysis of data collected during the SIPA demonstration project. Its purpose is to identify the proportion of Adult Day Care (ADC) users as well as the determinants of use in this group of persons 65 years old and over receiving home care services in Montreal. Results show that 18.8% of the sample have at least one ADC presence during a 6 months study period. The following factors increase the probability of ADC use: being younger; not having a university degree; being born outside of Canada or for persons born in Canada, living with a caregiver; receiving help from the CLSC for daily life activities more than once a week; being in the catchment population of an ADC which fees are lower; and for men only, having had a stroke or presenting more functional incapacities.