The aging population and the epidemic of chronic diseases requires an accompanying finance reform of long-term care that will become increasingly dominant. Many countries have faced this situation and have set up a separate public funding for such care on the basis of a universal insurance covering both home care and institutions. Canada and Quebec must adopt such autonomy insurance and create a separate fund financed partly by a more judicious use of current budgets and tax credits, and also by a significant investment in home care. An autonomy support benefit could be allocated in kind to fund public services and by contract to pay for services delivered by private, voluntary, and social economy agencies. This benefit would be established following a standardized assessment of functional autonomy achieved by the case manager who will manage the services and control their quality.

In this study we examined the longitudinal relationships between five dimensions of social support and psychological distress to determine whether (1) social support was related to subsequent psychological distress levels; or (2) if distress levels were related to subsequent social support levels; or (3) if distress and support had a reciprocal (bi-directional) relationship across time. Using bivariate autoregressive cross-lagged models, we analysed data from 2,564 older adults. We found support for the reciprocal relationship between affectionate support and distress. Higher psychological distress was related to subsequently higher levels of positive social interaction, and significantly related to subsequently higher emotional/informational support. No significant relationship was found between tangible and structural support and psychological distress. This study demonstrates that different types of support are associated in correspondingly different ways with psychological distress, and that psychological distress may be important in predicting levels of social support two years later.

Although some studies have confirmed positive associations between social engagement and well-being in later life, this study aimed to understand why some seniors cannot be engaged. The authors analyzed the lived experiences of 89 seniors in three rural communities in Canada, from semi-structured interviews and using the constant comparison method. Five factors make choices for social engagement in later life unequal among older adults who differ by gender, class, age, and health status. Profound engagement in care work, compulsory altruism, personal resources, objectively perceived and subjectively available engagement opportunities, and ageist barriers around paid work constrain choices for seniors who lack privilege in the context of a market economy, particularly for low-income older women. To avoid stigmatizing vulnerable older persons, societal barriers to meaningful activities must be addressed – for example, through provision of income security or by reversing inter- and intragenerational ageism in access to the labor market.

HIV/AIDS and aging is an important emerging topic with relevance to gerontology. Currently, little is known about the housing experiences of older adults within the context of HIV/AIDS. This article explores the issue and examines interview data concerning the housing experiences of 11 older adults (52 to 67 years old) living with HIV/AIDS in Ottawa, Ontario. Participants’ stories revealed concerns relating to three major themes: acceptance into retirement homes and long-term care communities, barriers to accessing subsidized housing services, and homelessness. Participants reported feeling that they lacked recognition and experienced confusion about their future housing prospects. These data suggest that a shift may be occurring in the housing needs of people aging with HIV/AIDS. This emerging population presents challenges to mainstream ideas of aging. We conclude that increased attention is needed in research, policy, and practice to address housing issues among this age group of people living with HIV/AIDS.

We analysed a prospective cohort study to determine (1) if self-rated health (SRH) predicts mortality in older adults with and without depressive symptoms, and (2) to determine if there is an interaction between SRH and depressive symptoms on mortality. We followed 1,751 community-dwelling adults aged 65 and older over five years. Measurements included age, gender, education, the Center for Epidemiological Studies-Depression (CES-D), SRH, the Modified Mini-Mental State Examination (3MS), and the Older Americans Resource Survey (OARS). Our outcome measure was time to death. Analyses were conducted in those with, and those without, depressive symptoms. We constructed Cox regression models with an interaction term for the CES-D and SRH. The hazard ratio (HR) for mortality was 1.63 for those with depressive symptoms; it was 1.68 for those without. No significant interaction was found between depressive symptoms and SRH for mortality.

Social inclusion is an important factor in promoting optimum health and wellness for older adults. Community-engaged arts (CEA) have been promoted as a means to support social inclusion for this population, but little empirical evidence has been reported. The objective of this study was to explore the role of a CEA program in the social inclusion of older, community-dwelling adults. Sixteen hours of participant observation, nine interviews, and document analyses were conducted with 20 older adults participating in the Arts, Health and Seniors (AHS) Program in Vancouver. Results indicated that the program supported seniors’ capacity to connect to community in new ways by helping them forge connections beyond the seniors centre. Participants also developed a stronger sense of community through collaboration as a group, working together on the arts project towards a final demonstration to the larger community. The results suggest that CEA programs contribute to social inclusion for older people.

Families of adults with an intellectual disability (ID) face post-parent transition when they can no longer assume their son’s or daughter’s care. This exploratory study aims to assess the perceptions of 12 mothers (Mage = 65.1; years, SD: 11) sharing a household with an adult with an ID (Mage = 36.9; SD: 11.4)): benefits and constraints of cohabitation, residence transition planning, perceptions and emotions about the future. The results of a questionnaire completed in an interview indicate that several mothers can envision siblings becoming potential caregivers for the future and that the transition generates emotions relating to their son’s or daughter’s welfare. However, participants’ planning of the transition is not advanced in most cases.

Time is a phenomenon that is often taken for granted. In gerontology, time is often equated with chronological or linear time, which thereby causes time to be defined as chronological age. With this paper, my purpose is to illuminate further understandings of time and how the passage of time is experienced in old age, particularly in the context of a move to a long-term care institution. Towards that end, I describe a case study of a gentleman coming to live in a long-term care facility. In this case study, time was perceived as an element outside day-to-day experience that structured daily life. Specific dimensions of temporality are evident, including biographical time, embodied time, and embedded time (including institutional time). These dimensions of time provide further understanding of the experiences of age and institutionalization.

In 2010, approximately 500,000 Canadians suffered from a dementia-related illness. The number of sufferers is estimated to double in about 25 years. Due to this growing demographic, dementia (most frequently caused by Alzheimer’s disease) will increasingly have a significant impact on our aging community and their caregivers. Dementia is associated with challenging behaviours such as agitation, wandering, and aggression. Care providers must find innovative strategies that facilitate the quality of life for this population; moreover, such strategies must value the individual person. Social commitment robots – designed specifically with communication and therapeutic purposes – provide one means towards attaining this goal. This paper describes a study in which Paro (a robotic baby harp seal) was used as part of a summer training program for students. Preliminary conclusions suggest that the integration of social commitment robots may be clinically valuable for older, agitated persons living with dementia in long-term care settings.