Commentaire

Lorsqu'un auteur aborde le thème de la scientificité d'un domaine de la connaissance, il rend explicite une démarche à la fois réflexive et appréciative d'une discipline sur elle-même. Dans le domaine de la gérontologie sociale, cet exercice soulève aisément des débats houleux. Ne craignant pas la polémique, F. Béland dresse son propre bilan de la recherche québécoise dans ce domaine en traitant de questions méthodologiques, de problèmes relatifs à la théorisation, ainsi que du développement institutionnel de la gérontologie. Ce bilan se veut utile, en ce qu'il doit permettre d'identifier les éléments qui favorisent ou qui entravent le développement de la recherche en gérontologie sociale.

Fries predicted in 1980 a continuing rectangularization of the survival curve, and trends toward delayed age of onset of chronic disease and toward compression of morbidity in late life. Others have presented evidence that challenges the first two predictions. However, direct evidence regarding the last one has been lacking.

The study reported here analyzed death certificate data on the longest interval between the onset of any condition listed as causing or contributing to the death and the occurrence of the death, from a representative sample of 500 Ontario death certificates in 1975 versus 1985, to deceased individuals aged 65 +. There was a statistically significant decrease between 1975 and 1985 in the frequency of the shortest intervals (under a month) and a not statistically significant increase in the frequency of the longest intervals (5+ years or “years”). Adjustments regarding not-stated intervals and attempts to control for a confounding factor did not change the picture. This study did not yield any statistically significant evidence of a compression of morbidity in late life, and did yield statistically significant findings that were inconsistent with that hypothesis.

This study reports on a population of Anglophone Canadian seasonal migrants to Florida. Surveys were mailed to 4,500 subscribers to Canada News, a Florida-based weekly paper, and were completed by 61% of the respondents. The descriptive profile reveals younger-old, healthy, married, home owners of moderate income who stay in Fionda for six months, but communicate regularly with their Canadian family. They utilize no social services in Florida, are satisfied with life and with their Florida health care experiences, but take various precautionary health care measures prior to leaving Canada. Their Florida visits will continue, moderated more by the exchange rate than health concerns. These data will be discussed relative to policy issues for Florida and Canada.

The results of examining all hospitalizations of the elderly consequent to injury in one Canadian province indicate that 66.3% were for accidental falls and 21.3% were for “other accidents” and for adverse effects of therapeutic regimens. Nursing home residents were significantly more likely to be hospitalized for falls than community dwellers but very elderly institutionalized females, who comprise 40% of the nursing home population, used significantly fewer days than their community peers.

In view of the growing numbers of physically and developmentally handicapped older persons in Canada, this study attempts to determine the effects of basic client characteristics on the delivery of services to these groups. Using data from the 1984 Disability Information System of Calgary, a series of models are estimated which focus on the characteristics of age, gender, geographical location, and level of physical and cognitive functioning as determinants of the receipt or non-receipt of residential, professional, support and day program services. The results indicate that there is a weak relationship between age, gender and level of cognitive functioning and the overall receipt of services. However, when each service is analyzed separately, only day programs are adequately explained. As was anticipated, it appears the needs of the elderly handicapped are not being met within the rehabilitation service system.

Commentary

When an author comments on the scientific value of a particular discipline, he leads the way to an insightful period of introspection. In the field of Social Gerontology, such an undertaking could stir up quite a stormy debate. F. Béland, undaunted by controversy, prepared his own review of the research conducted in Quebec in this field, addressing methodological issues, problems related to theorization, as well as the institutional development of Gerontology. The document is useful in that it highlights the elements which benefit or hinder the advancement of research in Social Gerontology.

The purpose of this study was to measure the impact of a leisure education/ counseling workshop on the leisure motivation, participation and satisfaction of a group of 27 senior citizens. The content of the workshop was based largely on the value clarification technique. The data, analysed using the t-test, indicate the workshop's limited impact on the dependent variables measured.

François Béland in his appraisal identifies certain peculiarities characteristic of research in Social Sciences in Gerontology in Quebec; however, he seems somewhat unfamiliar with the material in question. Béland does not retrace the history of Gerontology in Quebec, nor does he situate it in its social, political, economical and cultural context; this would have been quite beneficial when trying to determine the future course of research. The present commentary attempts to lay the groundwork for such an undertaking and suggests that the growing strength of the Welfare-State and of Quebec nationalism accounts for the major characteristics found in the material compiled by Béland.

Ce livre nous offre un exposé sommaire des énoncés théoriques présentement avaricés au niveau de l'abus et du manque de soins envers les gens âgés. L'auteur soutient que nous devons élargir notre présente définition de l'abus et du manque de soins pour y incorporer la notion de soins inadéquate. Cette nouvelle proposition nous permettrait de nous éloigner d'une notion de blâme et punition pour effectivement réorienter nos travaux de recherches et nos stratégies d'intervention vers le développement de nouvelles stratégies qui offriraient des soins adéquats basés sur les besoins et les désirs particuliers des personnes âgées à l'inteneur de leur propre contexte de soins.

Les auteurs décrivent un outil d'évaluation connu sous le nom d'Elder Assessment Instrument et son préconisent emplois aux équipes d'abus aux vieillards qui sont établies dans les hôpitaux. Les auteurs soutiennent que ces équipes sont en mesure d'aider à développer et à mettre aupoint les services nécéssaires requis par les personnes âgées qui reçoivent présentement ou risçuent de recevoirdes soins inadéquats. La critique favorise une telle démarche puisqu'elle nous permettrait de redéfinir nos stratégies pour ensuite aborder les questions d'abus, de manque de soins et de soins inadéquate envers les gens âgés d'une façon plus constructive.

Ce livre s'adresse à tous les professionals au domaine de la santé qui ont une certaine expérience en psychiatrie, en gériatrie, en gérontologie et dans les domaines qui se rattachent à ces disciplines. Effectivement, cet ouvrage est complet, peu coûteux, pratique et pertinent. Six auteurs qui ont travaillé en psychiatrie, en sciences sociales, et au secteur des soins infirmiers, contribuent aux chapitres qui traitent du vieillissement normal, du chagrin causé par laperte d'un être cher et la période d'adaptation qui s'ensuit, de la psychodynamique de vieillissement et des syndromes cliniques, évaluation et administration. Dans la section finale les auteurs brossent un tableau des ressources familiales et communautaires.

Les critiques de Thomas et Stryckman sont de plusieurs ordres, mais deux sont particulièrement dommageables pour l'économie de mon texte si elles s'avéraient exactes. La première veut que les chercheurs dans le domaine de la gérontologie sociale n'ont pas proposé de si nombreuses réflexions sur leur champ de pratique et la deuxième affirme que je réduis à la formalisation mathématique la logique de la démarche scientifique