Many patients, particularly older patients, interact with multiple providers while accessing health care services in a variety of different settings over extended periods of time. Understanding older patients’ experiences of their journeys through the health system is critical to improving service integration and quality of care. In this study, we have summarized the experiences of four patients living with chronic obstructive pulmonary disease as they interacted with the health care system over a three-month period following hospital discharge. Guided by case study methodology, we gathered data through semi-structured interviews and patient logs. Three overarching themes – social support, system navigation, and access – emerged from the data. Attending to provider-patient and provider-provider communication, and to patient social support and self-care needs, could improve integration and care outcomes. Achieving what patients perceive as an integrated and effective system will require time and commitment.

An aging population is best served by social, personal, and health support focused on maintaining and maximizing personal independence. The Internet affords numerous opportunities for individuals of all ages to communicate, access information, and engage in recreational activities. A community-based sample of 122 adults over 60 years of age completed a questionnaire which assessed three clusters of characteristics: (a) frequency and patterns of Internet use, (b) well-being (loneliness, life satisfaction, self-efficacy, social support, and depression), and (c) demographics (age, income, education). Significant correlations emerged between the three clusters of measured variables. Controlling for demographic differences, Internet use and self-efficacy remained significantly related. Among the sample of older adults, individuals who used the Internet more had higher perceptions of self-efficacy than those who used the Internet rarely or not at all.

Attitudes toward elder abuse differ with age, ethnicity, profession, and training. This article introduces a threshold model in order to reconcile findings on attitudinal differences within a unifying theoretical framework. The model assumes that individuals rate the abusiveness using consistent standards but different thresholds. Predictions from the model include consistency among individuals in their ratings of different behaviours (i.e., high relative consistency), but variation in the levels of rating (i.e., systematic departures from absolute consistency).

Samples of 339 seniors and 233 professionals rated 112 items representing a wide range of abuse severity. The findings suggested high relative consistency but systematic deviations from absolute consistency, with higher ratings (i.e., lower thresholds) by professionals than seniors, and by residents of smaller (rural) rather than larger (urban) communities. The implications of the threshold model include prevention through elder-abuse education and reporting practices.

Visual requirements for a simple walking task were evaluated for young and elderly persons to determine if, with normal aging, elderly subjects require more visual information. Ten young adults and 10 elderly people were asked to complete a simple walking task within predetermined pathway boundaries under two conditions of visual restriction. In the reactive condition, subjects automatically received a 200 ms flash of visual information at the halfway point of the walkway. For the predictive condition, subjects did not receive any visual information during the walking trial, but were equipped with an emergency button that would provide 200 ms of visual information whenever they needed it. For both experimental conditions, subjects received additional flashes of visual information if they stepped out of the walkway boundaries. Results showed that older persons stepped out of bounds more often in the reactive condition and gave themselves more visual cues than the younger subjects in the predictive condition. The relative importance of vision during locomotion seems to be higher in the elderly population when compared to young adults.