Specialized geriatric services care for older adults (≥ 65 years of age) with dementia and other progressive neurological disorders, frailty, and mental health conditions were provided both virtually and in person during the pandemic. The objective of this study was to implement a software-enabled standardized self-report instrument – the interRAI Check-Up Self-Report – to remotely assess patients. A convergent, mixed-methods research design was employed. Staff found the instrument easy to use and the program-level metrics helpful for planning. Most patients urgently needed a geriatrician assessment (72%) and had moderate to severe cognitive (34%) and functional impairments (34%), depressive symptoms (53%), loneliness (57%), daily pain (32%), and distressed caregivers (46%). Implementation considerations include providing ongoing support and facilitating intersectoral collaboration. The Check Up enhanced the geriatric assessment process by creating a system to track all needs for immediate and future care at both the patient and program level.

The purpose of this study was to identify the self-report physical activity (PA) tool best suited for assessment of PA in community-dwelling older adults with multiple chronic conditions (MCC). PA can positively influence physical and psychological health in this population. Although self-report PA tools exist, little is known about the psychometric properties and feasibility of using these tools in older adults with MCC. A systematic literature review from 2000 to 2018 was conducted of studies reporting on the psychometric properties and feasibility of 18 self-report PA tools for community-dwelling older adults (≥ 65 years) to determine the suitability of these tools for use in older adults with MCC. Based on an assessment of the available evidence for the psychometric properties and feasibility of 18 different self-report PA tools, the Physical Activity Assessment Scale for the Elderly (PASE) is recommended as the best-suited self-report PA tool for older adults with MCC.

Intersectionality analysis is the study of overlapping or intersecting social identities. Intersecting social identities may have an impact on the perception of burden by family caregivers of older persons with multiple chronic conditions (MCC). The purpose of this study was to explore the interaction of social factors on the burden of caring for older adults with MCC. A total of 194 caregivers of older adults with MCC were recruited from Alberta and Ontario. Survey data were collected at two time points, six months apart. Additive and multiplicative models were analysed using a generalised linear model to determine the level of caregiver burden. Medium-high social interference (impact on social life) was associated with higher burden when adjusted for age, gender, education, and employment status. The overall results of the five-way interaction suggest that males in general had lower burden scores than females. Irrespective of their education and employment status, females had generally higher burden scores. These results add to the current body of literature, suggesting areas for further research to fill knowledge gaps, and promoting ideas for evidence-guided public health interventions that focus on caregivers.

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne’s interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

The literature on patient-physician interactions has largely ignored the perspectives of older adults with multiple morbidities. Featuring in-depth interview data from 16 men and 19 women with an average of six chronic conditions, this study focused on how participants perceived and experienced the care provided by their primary care physicians. Participants suggested that physicians caring for patients with multiple chronic conditions should be thorough, amenable to gate keeping, trustworthy, and open to different decision-making styles. However, many study participants perceived that they received inadequate care due to the personal failings of their physicians, constraints of medical consultations, and societal ageism. Consequently, many of the participants, especially the women, employed various strategies to maximize the care they received and manage their physicians’ impressions of them as worthy patients. Our findings suggest that elderly patients with multiple morbidities perceive that their health needs are not being adequately met.