We explored the relationship between neighbourhood and social participation among older adults using a Living Environments and Active Aging Framework. This prospective cohort study used baseline data from the Canadian Longitudinal Study on Aging (CLSA) with a 3-year follow-up. Three aspects of social participation were the outcomes; walkability and greenness at baseline were exposure variables. The sample consisted of 50.0% females (n=16,735, age 72.9± 5.6 years). In males, higher greenness was associated with lower loneliness and less variety in social activities. No significant associations between greenness and social participation were found in females. High walkability was related to a higher variety of social activity and higher loneliness in males but not females, and less desire for more social activity in both sexes. Greenness and walkability impact social participation among older adults. Future research should include sex and gender-based analyses.

We evaluated the feasibility and acceptability of frailty screening using handgrip strength with gait speed measures within four primary care-based memory clinics in Ontario. This mixed methods quality improvement initiative examined the reach, effectiveness, adoption, implementation, and maintenance of frailty screening from the perspective of patients (N = 216), care partners (N = 142), and healthcare providers (N = 9). Frailty screening was well-received by patients and care partners and perceived as quick and easy to administer and integrate into assessment processes by healthcare providers at all four memory clinics. The ease of integrating frailty screening into clinic processes was a key factor facilitating implementation; few challenges or suggestions for improvement were identified. All four clinics plan to continue frailty screening, three using the methods adopted in this study. Integrating frailty screening into memory assessments is feasible and acceptable and, given the interactional relationship between frailty and dementia, provides a significant opportunity to improve health outcomes for older adults.

La maltraitance organisationnelle envers les personnes aînées est présente dans différentes organisations, y compris dans le secteur de la santé et des services sociaux. Elle peut entraîner des conséquences négatives importantes sur la santé mentale et physique, ainsi que la qualité de vie, des personnes aînées qui la subissent. L’objectif de cet article est de présenter les enjeux éthiques liés à la maltraitance organisationnelle perpétrée envers les personnes aînées qui reçoivent des services de soutien à domicile. Une approche d’inspiration phénoménologique utilisée auprès d’ergothérapeutes pour identifier les enjeux éthiques de leur pratique a mené à une analyse des enjeux éthiques spécifiquement liés à des situations de maltraitance organisationnelle. Quinze ergothérapeutes (n=15) œuvrant en soutien à domicile au Québec ont été rencontrés dans le cadre d’entretiens individuels. L’analyse a été effectuée en utilisant une perspective écologique. Les résultats de l’analyse révèlent plusieurs enjeux éthiques complexes de nature micro, méso et macrosystémiques, dont l’abandon administratif des bonnes pratiques, l’accès déficitaire aux services, la chosification de l’aîné, la dépersonnalisation des services et la tolérance des violences.

Despite societal perceptions of older adults as vulnerable, literature on resilience suggests that exposure to adversity and resources gained with life experience contribute to adaptation. One way to explore the nature of resilience is to document assets supporting adaptation. Interviews were conducted with older adults living in Canada at two time points during the COVID-19 pandemic, September 2020–May 2021 (T1) and January–August 2022 (T2). Reflexive thematic analysis was completed to report on what older adults identified as assets and how they understood the value of those assets for resilience. Participants indicated that the potential value of their contributions went largely untapped at the level of the community but supported individual and household adaptation. In line with calls for an all-of-society approach to reduce disaster risk and support resilience, creating a culture of inclusivity that recognizes the potential contributions of older adults should be paired with opportunities for action.

Persons living with dementia are at risk of becoming lost. While return discussions after missing incidents are common with children, these discussions are seldom done with persons living with dementia. Our objective was to describe the use of return discussions with persons living with dementia according to the literature and practice. We conducted a scoping review using 19 databases to locate scholarly and grey literature on return discussions, followed by 20 semi-structured interviews with first responders and service providers in Canada and the United Kingdom (UK). Eleven scholarly and 94 grey sources were included, most from the UK, related to missing children, none included persons with dementia. According to participants, although there was no standardized procedure, there were themes about conditions that facilitate return discussions. This was the first study to examine return discussion practice in dementia, and results can inform development of evidence-based protocols.

The COVID-19 pandemic challenged older adults’ health behaviours, making it even more difficult to engage in healthy diets and physical activity than it had been prepandemic. A resource to promote these could be social support. This study uses data from 136 older adults (Mage = 71.39 years, SD = 5.15, range: 63–87) who reported their daily fruit and vegetable consumption, steps, and health-behaviour-specific support from a close other every evening for up to 10 consecutive days. Findings show that on days when participants reported more emotional support than usual, fruit and vegetable consumption and step counts were higher. Daily instrumental support was positively associated with step counts, only. Participants receiving more overall emotional support across the study period consumed more fruit and vegetables; no parallel person-level association was found for overall steps. There were no significant interactions between dyad type and support links for our outcomes.

The devastating impacts of the COVID-19 pandemic highlighted the missing voices of families and residents in long-term care (LTC) decision-making and policy processes. Family and resident councils constitute one method of raising these voices, but there is currently a gap in evidence of how to promote the effectiveness of these councils. We conducted five focus groups and two interviews with LTC home leaders, residents, family members, and advocates in British Columbia using a participatory approach integrating knowledge-users throughout the research process. Using a framework analysis, we found modifiable (communication, structure, recruitment/engagement, council leadership, culture/attitudes, and resources/supports) and non-modifiable factors (medical complexity of residents and short lengths of stay) affecting council effectiveness. We discuss strategies implemented by knowledge-users to address modifiable effectiveness factors and construct a preliminary tool (a 35-question survey) that operationalizes and identifies areas that can increase council effectiveness in practice to ensure that their voices are heard in LTC decision making.

The purpose of the current study was to understand the prevalence and patterns of cannabinoid use among LTC residents across Canada. We gathered data on cannabinoid prescriptions among LTC residents for one year before and after recreational cannabis legalization. Multi-level modelling was used to examine the effects of demographic and diagnostic characteristics on rates of cannabinoid prescription over time. All prescriptions were for nabilone. There was a significant increase in the proportion of residents prescribed nabilone following the legalization of recreational cannabis in Canada. Residents with relatively more severe pain (based on the Minimum Data Set pain scale), a diagnosis of depression, or a diagnosis of an anxiety disorder were more likely to have received a nabilone prescription. Our results provide valuable information regarding the increasing use of synthetic cannabinoids in LTC. The implications for clinical practice and policy decision-makers are discussed.

Plusieurs personnes atteintes d’un cancer incurable sont des hommes, âgés de plus de 65 ans. Même si, à notre connaissance, aucune recherche ne porte sur les souffrances de ces hommes, des écrits dévoilent que ces dernières pourraient être considérables. Les réalités du vieillissement au masculin couplées à celles d’être atteint d’une maladie incurable peuvent effectivement engendrer des souffrances particulières. Cette recherche qualitative vise à mieux comprendre les souffrances vécues par les hommes âgés atteints d’un cancer incurable (HACI). Nous explorerons si et comment leurs souffrances se rapportent à des enjeux identitaires de genre et/ou aux transformations de leurs rôles. Dix-sept hommes âgés de 65 ans et plus atteints d’un cancer incurable furent rencontrés en milieu urbain (Montréal) dans le cadre d’entretiens semi-dirigés. L’analyse thématique des résultats a permis de relever des enjeux identitaires et de rôles, la nature des changements affectant l’identité et ses rôles et les enjeux de genre vécus par les HACI.

Cumulative exposure to anticholinergic and sedative medications has been associated with worsening physical function in older adults. We evaluated the feasibility of measuring physical function using wearable devices and explored the impact of reducing the anticholinergic and sedative medication burden in a pilot study of community-dwelling adults aged 60 years and older. Evaluations included the 10-meter walk test (10MWT), the Short Physical Performance Battery (SPPB), and the mini-BESTest. Two participants/month were recruited in one clinic in 2022. The five participants had a median age of 67, a median DBI of 1.7, and four were female. The feasibility analysis showed that the 10MWT and SPPB tests were completed on 12/12, and the mini-BESTest on 11/12. An exploratory analysis showed clinically meaningful improvements in gait speed (mean +0.18 m/s) and SPPB (mean +2.2 points). We showed the feasibility of measuring physical function by wearable devices during deprescribing of anticholinergic and sedative medications.

Despite the negative effects on older adults, resident-to-resident aggression (RRA) remains a complex and understudied problem. Few interventions exist that address this issue by promoting goodwill. Using the intervention mapping approach, the evaluation of the test phase of the pilot Program GIFT in private seniors’ residences (PSRs) (Quebec, Canada) was conducted through qualitative interviews with 25 residents, 21 staff members, and 4 managers. The results indicate that the program achieved its objectives of promoting goodwill, although the strategies to manage RRA and intervention tools were more difficult to integrate into the PSRs’ culture. Obstacles and facilitators were reported. Recommendations were identified to enhance the program’s content, promote it more effectively, and ensure long-term sustainability. This research is the first endeavour to develop, test, and evaluate the test phase of a pilot program co-created with residents, staff members and managers of PSRs, aiming simultaneously at promoting goodwill and countering RRA.

Pandemic-related restrictions in nursing homes have undermined the critical role that family and friend caregivers play in enhancing resident quality of life. We examined how family caregiver access restrictions in nursing homes were implemented and how they impacted the mutual well-being of and relationships between residents and their caregivers over time. Between March 2021 and March 2022, 24 ‘designated caregivers’ in Atlantic Canada were interviewed three times. We identified changes in family relationships and activities over time, constricted support networks, the increasing need for advocacy and monitoring, and the generally negative cumulative impacts of restrictions, especially during residents’ end-of-life. Subsequent adaptations to access restrictions allowed caregivers to contribute to essential monitoring, care relationships, and advocacy roles. We argue that the role of designated caregivers in nursing homes must be maintained during public health emergencies to ensure resident’s supportive family relationships and general well-being.