Using a case scenario involving a marginally competent elderly woman living alone at risk, we assessed the care decisions made by older adults (n = 82) and health care professionals (HCPs, n = 87), and identified differences in the values underlying the care decisions. Overall, participants did not place a high value on independence when they appraised the risk to the client as high and safety as low. Under these conditions, elderly respondents tended to be more paternalistic in their decisions about care, while HCPs tended to be more beneficent. If the values of HCPs differ from those of elderly people, how likely is it that the care provided to marginally competent elderly people will be congruent with their wishes? The care provided by HCPs might be improved by incorporating knowledge of the values and perspectives of other older adults.

This study focused on issues of concern to and service needs of older parents caring for an adult son or daughter with an acquired brain injury (ABI) in Ontario. Three issues were identified as particularly challenging: diagnosis of the brain injury, parents’ feelings about the cause of the brain injury, and planning for long-term accommodation for their family member with a brain injury. The most frequently cited services needed for the person with ABI were social and/or recreational activities, day programs, and residential placement. The most frequently cited services needed by parents were parent education and support groups. The information gathered provides a base for further research in other sectors. Implications of these initial findings for clinical practice and policy and program development are discussed.

We conducted a survey to document the rehabilitation services available to clients aged 65 years and older who had suffered a stroke. In all, respondents – gleaned from 295 resources located in three health regions in the province of Québec – completed a postal questionnaire describing the services that they offer, in terms of type of intervention (related to nine capabilities and seven areas of social participation) and type of services (evaluation, rehabilitation, and support). The results show that most rehabilitation services offered to older people with stroke address motor skills and mobility. Somewhat unexpectedly, for four capability-related interventions and two social-participation-related interventions, there appear to be more active rehabilitation services offered in regions with rural areas than in metropolitan regions.

Background: Use of benzodiazepines, common among older people, may lead to substance dependence. DSM-IV-TR criteria for this iatrogenic problem may apply poorly to older persons following a physician-prescribed regimen. This study, first of its kind, aimed to determine the prevalence rate of benzodiazepine dependence in older persons according to DSM-IV-TR and other atypical criteria.

Methods: Descriptive study based on face-to-face interviews conducted in the homes of 2,785 persons aged 65 years or older who were randomly selected from across the province of Quebec, Canada.

Results: Use of benzodiazepines was reported by 25.4% of respondents. Among them, 9.5% met DSM-IV-TR criteria for substance dependence. However, 43% of users reported being dependent, and one third agreed that it would be a good thing to stop taking benzodiazepines.

Interpretation: Benzodiazepine substance dependence is established at one tenth of community-dwelling older persons taking these medications, although a much larger proportion self-labels as dependent.

Time-of-day effects have been identified as a possible confound in research on age-related differences in cognitive performance. Circadian rhythms have been related to time-of-day variations in sensory measures; however, more is known about the effect of circadian rhythms on vision than on hearing, and virtually nothing is known about whether time-of-day effects are potential confounds in studies of auditory aging. The purpose of the current study was to determine whether age-related differences in performance on auditory tasks are affected by time of day. A set of four auditory experiments was repeated three times over the course of one day with a group of Evening-type younger adults and a group of Morning-type older adults. The results replicated previous findings of age-related differences, but time of day did not affect the basic results. Thus, time of day does not confound the results observed in typical laboratory experiments investigating auditory aging.

The study’s purpose was to evaluate the psychometric properties of the short form of the Daily Spiritual Experience Scale (DSES) in an elderly French population. Two studies were conducted to examine the psychometric properties of the DSES. Results of factor analysis (studies 1-2) and confirmatory factor analysis (Study 2) indicated that the DSES can be conceptualized on a single general factor. The reliability of the DSES appeared to be satisfactory with good internal consistency (studies 1-2) and good temporal stability (Study 2). As expected, higher scores were correlated with good life satisfaction and good self-evaluation of health, but no correlation was found with depression. Study results provided preliminary evidence of the psychometric properties of the French translation of the DSES short version. This short version indicates the potential benefit of encouraging the spiritual aspects of life and could be used in a variety of health-related research.

This study provided an exploratory analysis of key social determinants of health for older Canadian women, with a focus on differences between rural and urban residency, given that socio-economic status (SES) and social capital have been shown to differ by rural–urban residence. Secondary analysis was conducted using the 2000/2001 Canadian Community Health Survey. A comparative logistic regression analysis revealed, unexpectedly, that SES and social capital variables were more strongly associated with the health status of urban older women than for the health status of their rural counterparts. Associations between health status measures and household income, food insecurity, and community belonging were largely not supported among rural women, but were for their urban counterparts. Findings are discussed concerning applications of the social-determinants-of-health model for explaining health patterns among older urban and rural women. Cost of living, access to health services, and dimensions of rural culture are discussed as potential explanations.

Elderly people from ethnic minority groups often experience different barriers in accessing health services. Studies have typically focused on combined groups of elderly immigrants or on large ethno-cultural minorities such as the Chinese in Canada, or African-Americans and Hispanics in the U.S. This study aimed to examine the types and factor structure of barriers to using health services experienced by aging South Asian immigrants in Calgary, Alberta, Canada. A telephone survey was used to collect data from a random sample of South Asian immigrants aged 55 years and older. Principal component analysis revealed four major types of barriers: cultural incompatibility, personal attitudes, administrative problems in delivery, and circumstantial challenges.

The measurement of psychological constructs depends upon clear definitions and demonstrated relationships among items, scales, and relevant theories. In this study, we examined these relationships for the measurement of affect as reflected in the popular Bradburn Affect Balance Scale (ABS). Results of confirmatory analyses of data from 187 older Canadian adults (Mean age, 69.7 years) showed that a two-dimensional structure fitted the item data much better than the unidimensional, bipolar model suggested by the original scoring key. The two dimensions showed parallel patterns of correlations with two measures of morale and with a measure of social desirability, but these patterns differed from that of the conventional unidimensional ABS score. Results suggested that the ABS should be used with caution and with scoring for two distinguishable dimensions.

Services for elders with severe mental illness (SMI) have major deficiencies, among them a lack of adequate psychosocial services. Some analysts have attributed this situation to “double stigmatization” targeting both ageing and mental illness in our societies. Using qualitative methods (23 semi-directed interviews, theme-based content analysis), our exploratory research aims to understand better the perceptions of psychosocial practitioners working in community and institutional settings about the elderly with SMI and their living situations. Our informants evoke living situations marked by a lack of support (isolation), of resources (financial precariousness/poverty) and of power (learned passivity), traits that are related not only to mental illness per se, but also to long term psychiatric institutionalization. For them, the current situation of elders with SMI is the end product of biographies in which life-course, illness-course and life in services and/or institutions join and, sometimes, become indistinguishable. Implications for psychosocial practices are discussed.