This article aims to evaluate and assess the health issues of Calgarians over the age of 50 who are experiencing chronic homelessness, determine their unmet service needs, and assess whether there are predictors of chronic homelessness (such as childhood trauma) that could be addressed with changes to policy or service delivery. Three hundred participants were recruited from emergency shelters, as well as a from a small group of rough sleepers in Calgary, Canada in the winter of 2016. Excel and SPSS were used for analysis beginning with descriptive statistics for the samples of respondents who are 50 and older (n = 142) and under the age of 50 (n = 158). More than half of participants had been homeless continually for more than 10 years. Older adults reported complex health issues and significant barriers to accessing health care including finances, wait lists, and asking for help but not receiving it. Older adults reported lower rates of childhood trauma than their younger counterparts, yet the average was two and half times that of the general population. Recognition of the intersecting and cumulative effects of long-term homelessness and age could inform changes to policy to reduce siloes around public systems. Given that older adults are at higher risk for an early death, they should be prioritized for housing programs. Culturally appropriate and trauma-informed interventions are necessary to address the diverse and complex needs of this vulnerable group.

Uganda's population is ageing, which comes with increased and varied burdens of disease and health-care needs. At the same time, gerontological care in Uganda remains neglected. This paper examines the factors that cause older Ugandans to delay health-care access. We conduct a thematic analysis of data drawn from nine focus groups held with rural Ugandans aged 60-plus. Our analysis highlights the factors that delay older persons’ access to health care and how these align with the Three-Delay Model, which was originally developed to assess and improve obstetric care in low-resource settings. Our participants report delays in deciding to seek care related to mobility and financial limitations, disease aetiology, severity and stigma (Delay I); reaching care because of poor roads and limited transportation options (Delay II); and receiving appropriate care because of ageism among health-care workers, and poorly staffed and under-supplied facilities (Delay III). We find these delays to care are interrelated and impacted by factors at the individual, community and health-system levels. We conclude by arguing for multi-pronged interventions that will address these delays, improve access to care and ultimately enhance older Ugandans’ health and wellbeing.

The Seniors Support Services for South Asian Community (S4AC) project was developed in response to the underutilization of available recreation and seniors’ facilities by South Asian seniors who were especially numerous in a suburban neighbourhood in British Columbia. Addressing the problem required the collaboration of the municipality and a registered non-profit agency offering a wide range of services and programs to immigrant and refugee communities. Through creative outreach and accommodation, the project has engaged more than 100 Punjabi-speaking seniors annually in diverse exercise activities. Case study research methods with staff and current and former senior participants of S4AC include participant observation, individual interviews, and focus groups. Viewed through the critical interpretive lens of the “candidacy framework”, findings reveal the myriad ways in which access to health promotion and physical activity for immigrant older adults is a complex iterative process of negotiation at multiple levels.

Access to long-term nursing homes by French-speaking seniors in minority situations is a very real problem. However, few studies have been conducted on this subject. We wanted to better understand this issue in New Brunswick while taking into account the language aspect. In this article, we will present the problem based on different issues encountered by Francophones in minority situations and by giving an overview of the studies conducted on French-speaking seniors in minority situations. We will then address the issue related to the rights of French-speaking senior to receive services in French in nursing homes by analyzing briefly the province’s legal requirements. Furthermore, we will present the regulatory framework of nursing homes in New Brunswick. Finally, we will provide a geographic analysis of existing New Brunswick nursing homes while taking into account the language aspect, the levels of service and the distribution of French-speaking seniors within the territory.

Background: Western policy initiatives prioritize early diagnosis of dementia, but minority ethnic (ME) people currently present later to dementia specialist care than their indigenous counterparts. In order to allow the development of rational interventions, we completed this first study to explore the link between attitudes to help-seeking for dementia and the help-seeking pathway in the ME and indigenous population.

Methods: We purposively recruited a maximum variation sample comprising 18 family carers of people with dementia from the major UK ethnic groups. We used semi-structured interviews to determine the barriers to and facilitators of help-seeking, and the pathways to diagnosis. Two researchers independently coded interviews and recruitment continued until theoretical saturation was reached.

Results: ME carers, in contrast to the indigenous population, tended to delay help-seeking until they could no longer cope or until others commented on the problems. They often thought that families should look after their own elders and a diagnosis alone was purposeless. This appeared to relate to beliefs about the etiology of cognitive impairment, negative beliefs about psychiatry and their sense of familial responsibility.

Conclusions: ME carer beliefs were an important barrier to early diagnosis. Further work should explore whether an intervention can modify these attitudes, so that families understand that a diagnosis may allow planning and avoidance of crises; rather than signifying a failure in duty, disloyalty, or relinquishing of the caring role. Further research should focus on developing interventions to tackle barriers to help-seeking in ethnic minorities so that healthcare access can be equitable for all.

The ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

We report the findings of a survey of 104 Asian older people in Bradford. For a high proportion, their condition was characterised by poverty, limited entitlements, inadequate housing, low levels of knowledge of health and social services, and problems of access to welfare benefits, health and social care. The situation of women was of particular concern. The study also highlights the problems of divided families, caused by restrictive immigration rules, resulting in many elderly people having no family support in this country.