Caroline L Duquette, Melissa K Andrew, George A Kuchel, Jo-Anne Clarke, Robert Ohle, Chris P Verschoor
{"title":"Emergency Department Boarding Time Is Associated with Functional Decline in Older Adults Six Months Post Discharge.","authors":"Caroline L Duquette, Melissa K Andrew, George A Kuchel, Jo-Anne Clarke, Robert Ohle, Chris P Verschoor","doi":"10.1017/S0714980824000199","DOIUrl":"10.1017/S0714980824000199","url":null,"abstract":"<p><p>Functional decline following hospitalization remains an important problem in health care, especially for frail older adults. Modifiable factors related to reduction in harms of hospitalization are not well described. One particularly pervasive factor is emergency department (ED) boarding time; time waiting from decision to admit, until transfer to an in-patient medical unit. We sought to investigate how the functional status of frail older adults correlated with the length of time spent boarded in the ED. We found that patients who waited for 24 hours or more exhibited functional decline in both the Barthel Index and Hierarchical Assessment of Balance and Mobility and an increase in the Clinical Frailty Scale from discharge to 6 months post discharge. In conclusion, there is a need for additional investigation into ED focused interventions to reduce ED boarding time for this population or to improve access to specialized geriatric services within the ED.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"571-579"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Association between Residential Environment and Self-Rated Mental Health among Older Canadians: The Moderating Effects of Education and Gender.","authors":"Ethan Siu Leung Cheung","doi":"10.1017/S0714980824000230","DOIUrl":"10.1017/S0714980824000230","url":null,"abstract":"<p><p>This study examined the associations between residential environment and self-rated mental health (SRMH) among Canadians aged 65 or older (<i>n</i> = 16,304) and whether education and gender moderated the associations. Data came from the 2018 Canadian Housing Survey. Hierarchical multiple regressions were conducted to test the associations. Analyses revealed that increased dwelling size was associated with better SRMH among older women with high school education. Older adults with higher satisfaction with their dwelling design were more likely to report better SRMH, except for women with some college education. Feeling safer in the community was uniquely associated with better SRMH for men with high school education and women with a university degree. Results confirmed significant associations between specific home and residential environment features and SRMH for each gender-by-education group. Environmental programs designed to improve SRMH for older adult populations should consider within- and between-group diversity.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"611-620"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irmina Klicnik, Andrew Putman, David Rudoler, Michael J Widener, Shilpa Dogra
{"title":"Neighbourhood Walkability and Greenness Exhibit Different Associations with Social Participation in Older Males and Females: An Analysis of the CLSA.","authors":"Irmina Klicnik, Andrew Putman, David Rudoler, Michael J Widener, Shilpa Dogra","doi":"10.1017/S0714980824000369","DOIUrl":"https://doi.org/10.1017/S0714980824000369","url":null,"abstract":"<p><p>We explored the relationship between neighbourhood and social participation among older adults using a Living Environments and Active Aging Framework. This prospective cohort study used baseline data from the Canadian Longitudinal Study on Aging (CLSA) with a 3-year follow-up. Three aspects of social participation were the outcomes; walkability and greenness at baseline were exposure variables. The sample consisted of 50.0% females (n=16,735, age 72.9± 5.6 years). In males, higher greenness was associated with lower loneliness and less variety in social activities. No significant associations between greenness and social participation were found in females. High walkability was related to a higher variety of social activity and higher loneliness in males but not females, and less desire for more social activity in both sexes. Greenness and walkability impact social participation among older adults. Future research should include sex and gender-based analyses.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linda Lee, Tejal Patel, Loretta M Hillier, Carrie McAiney, Kara Skimson, Emma Conway, Caitlin Agla, Jane McKinnon Wilson, Susie Gregg
{"title":"Frailty Screening in Primary Care-Based Memory Clinics: Feasibility, Acceptability, and Preliminary Findings.","authors":"Linda Lee, Tejal Patel, Loretta M Hillier, Carrie McAiney, Kara Skimson, Emma Conway, Caitlin Agla, Jane McKinnon Wilson, Susie Gregg","doi":"10.1017/S0714980824000394","DOIUrl":"https://doi.org/10.1017/S0714980824000394","url":null,"abstract":"<p><p>We evaluated the feasibility and acceptability of frailty screening using handgrip strength with gait speed measures within four primary care-based memory clinics in Ontario. This mixed methods quality improvement initiative examined the reach, effectiveness, adoption, implementation, and maintenance of frailty screening from the perspective of patients (<i>N</i> = 216), care partners (<i>N</i> = 142), and healthcare providers (<i>N</i> = 9). Frailty screening was well-received by patients and care partners and perceived as quick and easy to administer and integrate into assessment processes by healthcare providers at all four memory clinics. The ease of integrating frailty screening into clinic processes was a key factor facilitating implementation; few challenges or suggestions for improvement were identified. All four clinics plan to continue frailty screening, three using the methods adopted in this study. Integrating frailty screening into memory assessments is feasible and acceptable and, given the interactional relationship between frailty and dementia, provides a significant opportunity to improve health outcomes for older adults.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ann MacLeod, Justine Levesque, Catherine Ward-Griffin
{"title":"Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research.","authors":"Ann MacLeod, Justine Levesque, Catherine Ward-Griffin","doi":"10.1017/S071498082300048X","DOIUrl":"10.1017/S071498082300048X","url":null,"abstract":"<p><p>This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"230-243"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Staff's Attitudes towards the Use of Mobile Telepresence Robots in Long-Term Care Homes in Canada.","authors":"Mineko Wada, Joey Wong, Evangeline Tsevis, Jim Mann, Hideaki Hanaoka, Lillian Hung","doi":"10.1017/S0714980823000697","DOIUrl":"10.1017/S0714980823000697","url":null,"abstract":"<p><p>This cross-sectional study investigated staff's attitudes towards the use of mobile telepresence robots in long-term care (LTC) homes in western Canada. We drew on a Health Technology Assessment Core Model 3.0 to design a survey examining attitudes towards nine domains of mobile telepresence robots. Staff, including nurses, care staff, and managers, from two LTC homes were invited to participate. Statistical analysis of survey data from 181 participants revealed that overall, participants showed positive attitudes towards features and characteristics, self-efficacy on technology use, organizational aspects, clinical effectiveness, and residents and social aspects; neutral attitudes towards residents' ability to use technology, and costs; and negative attitudes towards safety and privacy. Participants who disclosed their demographic backgrounds tended to exhibit more positive attitudes than participants who did not. Content analysis of textual data identified specific concerns and benefits of using the robots. We discuss options for implementing mobile telepresence robots in LTC.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"319-339"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Les effets de la méditation de pleine conscience sur les symptômes cognitivo- émotionnels dans le trouble cognitif léger et la maladie d'Alzheimer : une revue de littérature narrative].","authors":"Sandrine Kalenzaga, David Clarys","doi":"10.1017/S0714980823000612","DOIUrl":"10.1017/S0714980823000612","url":null,"abstract":"<p><p>La maladie d'Alzheimer se manifeste par des troubles de la mémoire et un déclin cognitif plus général, le plus souvent associés à des troubles de l'humeur et du comportement. Les traitements médicamenteux ayant une efficacité assez modeste, il apparaît nécessaire de leur associer une prise en charge non pharmacologique. La méditation de pleine conscience, qui a des effets bénéfiques sur le fonctionnement cognitif et sur l'état émotionnel, semble être une piste intéressante. Cette revue de littérature narrative se propose de recenser les études ayant testé l'efficacité d'une intervention basée sur la pleine conscience auprès de personnes souffrant de la maladie d'Alzheimer ou à risque de développer cette maladie. Il apparaît que ces interventions présentent un intérêt pour réduire les symptômes cognitifs (troubles attentionnels et mnésiques notamment) et émotionnels (affects dépressifs et anxiété en particulier). Cependant, elles nécessitent un certain nombre de modifications pour être adaptées à ce public.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"217-229"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Age-Friendly Communities: Are they also \"Friendly\" for Death, Dying, Grief, and Bereavement?","authors":"Julia Brassolotto, Albert Banerjee","doi":"10.1017/S0714980823000624","DOIUrl":"10.1017/S0714980823000624","url":null,"abstract":"<p><p>The age-friendly movement aims to ensure that people can live healthy and meaningful lives as they age. It is committed to activity and inclusion, with policies, services, and structures that enable older adults to remain engaged in activities that they value. We suggest that there is further opportunity for communities to increase inclusion and reduce ageism by improving their \"death-friendliness\". A death-friendly approach could lay the groundwork for a community in which people do not fear getting old or alienate those who have. To this end, we consider the merits of the compassionate communities framework which has emerged out of palliative care and critical public health. Compassionate communities focus on end-of-life planning, bereavement support, and improved understandings about aging, dying, death, loss, and care. The age-friendly and compassionate communities initiatives are complementary in their objectives but have not yet converged in practice. We suggest that they should.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"311-318"},"PeriodicalIF":1.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine A P Zagrodney, Emily C King, Deborah Simon, Kathryn A Nichol, Sandra M McKay
{"title":"A Good Investment: Expanding Capacity to Care for Older Adults in the Home and Community Care Sector Through Increased Personal Support Worker Wages.","authors":"Katherine A P Zagrodney, Emily C King, Deborah Simon, Kathryn A Nichol, Sandra M McKay","doi":"10.1017/S0714980823000557","DOIUrl":"10.1017/S0714980823000557","url":null,"abstract":"<p><p>Most older adults prefer to age in place, which for many will require home and community care (HCC) support. Unfortunately, HCC capacity is insufficient to meet demand due in part to low wages, particularly for personal support workers (PSWs) who provide the majority of paid care. Using Ontario as a case study, this paper estimates the cost and capacity impacts of implementing wage parity between PSWs employed in HCC and institutional long-term care (ILTC). Specifically, we consider the cost of increased HCC PSW wages versus expected savings from avoiding unnecessary ILTC placement for those accommodated by HCC capacity growth. The expected increase in HCC PSW retention would create HCC capacity for approximately 160,000 people, reduce annual health system costs by approximately $7 billion, and provide an 88 per cent return on investment. Updating wage structures to reduce turnover and enable HCC capacity growth is a cost-efficient option for expanding health system capacity.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"197-202"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10340101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Avantika Vashisht, Gloria Gutman, Dawn Mackey, Brian de Vries, Taranjot Kaur, Helen Kwan
{"title":"Primary Care Physicians' and Hospitalists' Experience with Advance Care Planning with South Asian Canadian Older Adults before and during COVID-19.","authors":"Avantika Vashisht, Gloria Gutman, Dawn Mackey, Brian de Vries, Taranjot Kaur, Helen Kwan","doi":"10.1017/S0714980823000739","DOIUrl":"10.1017/S0714980823000739","url":null,"abstract":"<p><p>Few older adults discuss their end-of-life care wishes with their physician, and even fewer minorities do this. We explored physicians' experience with advance care planning (ACP) including the barriers/facilitating factors encountered when initiating/conducting ACP discussions with South Asians (SA), one of Canada's largest minorities. Eleven primary care physicians (PC) and 11 hospitalists with ≥ 15 per cent SA patients ≥ 55 years of age were interviewed: 10 in 2020, 12 in 2021. Thematic analysis of transcripts indicated that cultural and communication barriers, physician's specialization, SA older adults' lack of ACP awareness, and decision-making deference to family and physicians were barriers to ACP discussions. Although the COVID-19 pandemic impacted physicians' practices, contrary to our hypothesis most reported no change in frequency of ACP discussions. Although ACP discussions were viewed as best conducted by PC physicians, only 55 per cent had ACP training and only 64 per cent had used ACP tools. Training in ACP facilitation, concerning ACP tool usage, and training in patient-physician communication are recommended.</p>","PeriodicalId":47613,"journal":{"name":"Canadian Journal on Aging-Revue Canadienne Du Vieillissement","volume":" ","pages":"340-349"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}