Canadians expect the same access to health care whether they are rich or poor, and wherever they live, often without direct charge at the point of service. However, we find that the private cost of long-term care differs greatly across the country, and within provinces, we find substantial variation, depending on income level, marital status, and, in Quebec alone, on assets owned. A non-married person with average income would pay more than twice as much in the Atlantic provinces as in Quebec, while a couple with one in care would pay almost four times as much in Newfoundland as in Alberta.

In this article we analyse the rates at which those admitted to hospital with acute myocardial infarction (AMI) receive aggressive treatment, assess how those rates have changed over time, and ask whether there is evidence of age discrepancies. Estimates made on the basis of data from an administrative database that includes discharges from all acute care hospitals in Ontario for selected years, from 1995 to 2005, indicate that there are strong and persistent age patterns in the application of medical technology. Results showed that to be true even after controlling for the higher rates of co-morbidities among older patients and variations across hospitals in practice patterns.

Preparing for the future housing needs of older adults is imperative in countries with an aging population, but little is known about these issues among vulnerable older adults. This study used a qualitative approach to identify key housing concerns in this group. A total of 84 vulnerable older adults including Aboriginal elders, those with various disabilities, and ethnic minorities participated in 10 focus groups. The Canadian Mortgage and Housing Corporation’s (CMHC’s) standards of core housing need provided a framework for data analysis, along with the identification of additional key housing themes across and within groups of vulnerable older adults. The results provide insight into preferred housing characteristics, regardless of housing form. Additionally, the results provide insight into how to support vulnerable older adults who choose to remain in their homes and communities and how to help ensure that appropriate housing is developed that meets the needs of this diverse population.

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.

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.

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.

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.

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.

This study examined how serious leisure, individual differences, social context, and location contribute to older adults’ experiences of flow – an intense psychological state – in their daily lives. The Experience Sampling Method was used with 19 older adults in a Midwestern city in the United States. Experience of flow was the outcome measure, and the data were analyzed using hierarchical linear modeling. Results indicated that location and employment status influenced the subjects’ flow experience. Furthermore, the findings revealed that retirement was negatively related to experiencing flow, and there was a significant association between home and the flow experience. The results of this study enhance the understanding of flow experiences in the everyday lives of older adults.

The move to a long-term care facility can be particularly traumatic for new residents. Staff can make this transition easier in a number of ways. However, the staff’s perceptions of the transition process and residents’ experiences will play a significant part in determining the type of support that is given residents during the transition. The purpose of this research was to examine the staff’s perceptions of a person’s coming to live in a long-term care environment. Using in-depth interviews with staff from one long-term care facility, three main themes emerged that encompassed descriptions of residents’ lives. Essentially, the staff described how residents learned to live a life involving various factors in three main categories—life around losses, life around the institution, and life around the body.

This article presents the results of a study on the barriers and facilitators to bus use for people aged 60 or older. Two complementary methodologies, nominal group technique and focussed ethnography, were used to identify barriers and facilitators and rank their importance. Two sample sites from Queensland, Australia, were selected, with 227 people participating in the nominal group technique and 40 people participating in the focussed ethnography component. Seven priorities for age-friendly bus systems emerged from the data: vehicle entrance/exit; bus driver friendliness and helpfulness; timetables and scheduling of buses; bus stop locations; pedestrian infrastructure; information and training for older people; and bus routes and destinations. These findings will assist researchers, policy makers, and transport providers to set evidence-based strategic directions for creating age-friendly bus systems. Both methods provide complementary perspectives on bus usability, which could not be gained from either method alone.

Using the 2002 Aging and Social Support Survey (GSS16), multinomial logit regression, and cohort-component projection techniques, this study explored how social support networks, health, and economic characteristics have shaped the residential choices of older Canadians, and predicts how they are likely to do so in the future. It focused on the distribution of 55-to-75-year-olds across three private-dwelling types: general community living, age-restricted housing, and age-restricted housing with nursing care. The analysis shows that social support characteristics are the strongest predictors of dwelling type, meaning that individuals appear to choose their dwellings largely on the basis of their social needs and wants, rather than on their economic or health characteristics. The analysis also indicates an increased age-specific demand for all dwelling types in the future, but with a reduction of over 2 million older Canadians living in dwellings in the general community between 2002 and 2022.