This article examines the struggle to win lifetime eligibility for selected home care benefits provided through the Veterans Independence Program (VIP) for veterans' widows in recognition of their years of unpaid caregiving – a policy change eventually implemented between 2003 and 2004. It explores how arguments on their behalf shifted from discourses of dependency, cost-saving, and compassion to ones of entitlement and commemoration between 1981 and 2004 as the large cohort of Second World War veterans and their wives moved towards the end of their lives. This policy victory for veterans' widows marked a historic shift in mandate for Veterans Affairs Canada and an important recognition by the state of unpaid caregiving as a form of national service. If Canadians are to learn from this example, however, it must be through seeing all caregiving labour – not just that of veterans' wives – as equally heroic and worthy of compensation.

Psychological treatment of depression in the elderly has recently benefited from the development of the cognitive approach. In particular, cognitive psychotherapy seems well adapted to and accepted by older people. In this article, we attempt to show the course of this type of psychotherapy in the case of a 79 year-old depressive woman in our Cognitive Therapy Unit for Elderly. We emphasize the therapeutical setting and the content of the sessions, the techniques used, the changes that occurred, and finally, the therapeutic alliance is described. Although some negative views about psychotherapy with older people are not totally abandoned, this vignette is a good illustration of the benefits for the patient and the highly enriching work for the therapist.

In this article we analyse the rates at which those admitted to hospital with acute myocardial infarction (AMI) receive aggressive treatment, assess how those rates have changed over time, and ask whether there is evidence of age discrepancies. Estimates made on the basis of data from an administrative database that includes discharges from all acute care hospitals in Ontario for selected years, from 1995 to 2005, indicate that there are strong and persistent age patterns in the application of medical technology. Results showed that to be true even after controlling for the higher rates of co-morbidities among older patients and variations across hospitals in practice patterns.

The aim of this research was to study the relationship between aging and decision-making. Specifically, it deals with managers' views on the hypothetical effects of age and experience on decision behaviour. Do the numerous beliefs and stereotypes related to the supposed effects of aging (i.e. agism) affect the decision-making process and its results? Are younger managers more creative, quicker or more audacious than older managers? Are the experienced managers more skilled, cautious or pragmatic than the less experienced ones? Given the fact that mean age of managers in many contemporary public organizations is rising, further information is needed on how this trend will affect the behaviour and state of mind of public managers who make daily decisions bearing important economic and social consequences. To investigate these questions, interviews were conducted with managers employed by Quebec's public service. These interviews were aimed at collecting data about the way managers themselves perceive the effects of aging on decision behaviour. Results indicated that managers do not readily link age and decision behaviour. However, the relationship between experience and decision behaviour is perceived as comparatively strong. The relevancy of further research on the effects of experience on decision behaviour and, more generally, on the effects of experience on working abilities is discussed.

This is a descriptive retrospective study of geriatric medical consultation to a psychogeriatric unit in a general teaching hospital over a two-year period. Ninety-eight discharges were studied to assess patient demographics, medications and discharge status. 39.8 per cent of patients on the unit were seen in consultation by geriatric medicine. Males were more likely to require consultation. Length of stay was longer for those seen in consultation. Primary affective disorder was the most common psychiatric diagnosis in the patients studied. Management of pre-existing neurologic and cardiac disease were the predominant reasons for consultation. The supportive environment of this medical liaison model on a psychogeriatric unit provides an excellent teaching environment for both geriatric medical and psychiatric trainees.

Online delivery is new to the field of music therapy (MT). This research investigated older adults’ perceived quality of MT online by certified music therapists. In this feasibility study, applying both process and outcome assessments, nine older adults volunteered to participate. Zoom was used, and a virtual music therapy (VMT) kit was developed as a resource. Surveys and observed technical difficulties revealed that perceived quality varied slightly by level of technical difficulty experienced; however, overall mean perceived quality was 7.2 out of 9. Post-study interviews revealed three main themes: (a) individual experiences with VMT, (b) individuals’ suggestions for further development of VMT sessions, and (c) individuals’ personal outcomes from VMT sessions. Participants reported overall positive experiences with VMT. Despite a slight decline in perceived quality when more technical difficulties were present, each participant reported a desire for more sessions, and they would recommend it to others.

In long-term care (LTC) homes, the management of frail older residents’ pharmacotherapy may be challenging for health care teams. A new pharmaceutical care model highlighting the recently expanded scope of pharmacists’ practice in Quebec, Canada, was implemented in two LTC homes. This study aimed to evaluate health care providers’ experience and satisfaction with this new practice model. Twenty-three semi-structured interviews were performed and analyzed thematically. Positive results of the model have been identified, such as increased timeliness of interventions. Barriers were encountered, such as lack of clarity regarding roles, and suboptimal communication. The increased involvement of pharmacists was perceived as useful in the context of scarce medical resources. Although requiring time and adjustments from health care teams, the new model seems to contribute to the health care providers’ work satisfaction and to positively influence the timeliness and quality of care offered to LTC residents.

As demographics and gender norms shift, more older men will be providing care for their wives living with dementia than ever before. Research on husbands as caregivers is limited and offers an incomplete picture of their role development and how they experience caregiving. This study examined husbands whose wives have dementia and how they provide care and construct their sense of self. Semi-structured interviews with 11 men aged 61–88 were conducted in Ontario, Canada. Data were analyzed using constant comparison analysis and a constructivist grounded theory (CGT) approach. Two categories were developed: Adapting to the Role of Caregiver and Staying a Husband. Caregiving as a husband for a wife living with dementia required revision of the role of husband to include that of caregiver by reimaging intimacy, being a protector in new ways, and finding new meanings to being a provider and the value of wealth.

Dementia is a growing concern in Canada, affecting peoples’ health and raising the cost of care. Between June and October 2019, we conducted an environmental scan to identify primary care models, strategies, and resources for dementia care from 11 pre-selected countries and assess their impact on quality-of-life measures. Search strategies included a rapid scoping review, grey literature search, and discussions with stakeholders. Eighteen primary care-based models of dementia care were identified. Common factors include team-based care, centralized care/case coordination, individual treatment plans, a stepped-care approach, and support for care partners. Five provinces had released a dementia strategy. Evidence of positive outcomes supported primary care-based models for dementia care, although only one model demonstrated evidence of impact on quality of life. Although these findings are encouraging, further research is needed to identify primary care-based models of dementia care that demonstrably improve quality of life for people living with dementia and their care partners.

The objectives of this feasibility study were to measure the prevalence of nutrition risk in community-dwelling older adults (CDOA, ages ≥ 65 years) and explore the perspectives of CDOA of the acceptability, value, and effectiveness of nutrition risk screening in primary care and community settings. Using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN)© eight-item tool (n = 276), results indicated that moderate and high nutrition risks affected 50 per cent and 8 per cent, respectively, of those screened. Interviewees (n = 16) agreed that screening is acceptable, important, and valuable (Theme One). Effectiveness was unclear, as only 3 of 16 respondents recalled being told their nutrition risk status. When articulating nutrition-related issues, a food security theme, expressed in the third person, was prominent (Theme Two). Screening for nutrition risk and receiving nutrition information in community-based settings are acceptable to CDOA and medically necessary, as evidenced by the high proportion of CDOA at moderate-high nutrition risk.

Different care settings in Quebec use levels of medical intervention forms, also called levels of care (LOC), to determine the code status of patients and to improve end-of-life care planning. It is not currently possible to know whether the levels of care in hospitals benefit patients and staff in facilitating the decision making process of treatment options and resuscitation measures. No study, to the best of the authors’ knowledge, has been published about LOC, particularly in Quebec and Canada. This literature review was undertaken on levels of care in order to clarify this topic. Relevant articles are discussed under different themes that are pertinent to LOC. The themes addressed in this article include care at the end of life, do-not-resuscitate orders, treatment withdrawal, and decision making at end of life.

Community support services are an integral enabler of aging in place. In social housing, older adult tenants struggle to access these services because of the siloed nature of housing and health services. This study examined the provision of government-funded community support services to 83 seniors’ social housing buildings in Toronto, Ontario. Although there were 56 different agencies operating within the buildings, only about one third of older tenants were actually receiving services. There was a subset of services that were available in more than 80 per cent of the buildings, and the most widely accessed services were food supports, crisis intervention, transportation, caregiver support, and hearing/vision care. There were also many cases in which multiple agencies offered duplicative services within the same building, suggesting that there are opportunities for improving service coordination. Practice recommendations for increasing access to community support services among low-income older adults in social housing are provided.