Service providers have a unique understanding of older homeless adults’ challenges and service needs. However, research on the experiences of health care providers (HCPs) who work with this population is limited. We aimed to gain a better understanding of the experiences (roles, challenges, and rewards) of HCPs who work with older homeless adults (age 50 and over) in outreach settings. We conducted individual semi-structured interviews with 10 HCPs who worked in these roles. Four themes emerged: (a) the client–provider relationship as an essential building block to HCPs’ work; (b) progression of care that acknowledges the “whole person”; (c) collaboration as integral to providers’ work; and (d) the importance of system navigation. Providers found their work personally and professionally fulfilling but were frustrated by system-level challenges. Findings can be used to identify strategies on how to further support providers in their roles and enhance service provision for older homeless individuals.

In Canada, foreign-born older adults (FBOAs) have a higher prevalence of chronic conditions and poorer self-reported physical and mental health than their Canadian-born peers. However, very little research has explored FBOAs’ experiences of health care after immigration. This review aims to understand the patient experiences of older immigrants within the Canadian health care system. Employing Arksey and O’Malley’s framework for scoping reviews, we searched six databases and identified 12 articles that discussed the patient experience of this population. Although we sought to understand patient experience, the studies largely focused on barriers to care, including: communication difficulties, lack of cultural integration, systematic barriers in health care, financial barriers, and intersecting barriers related to culture and gender.

This review provides insight into new areas of research and advocates for strengthened policy and/or programming. Our review also highlights that there is a paucity of literature for an ever-growing segment of the Canadian population.

The use of communities of practice (CoP) to support the application of knowledge in improved geriatric care practice is not widely understood. This case study’s aim was to gain a deeper understanding of the knowledge-to-action (KTA) processes of a CoP focused on environmental design, to improve how persons with dementia find their way around in long-term care (LTC) homes. Qualitative data were collected (key informant interviews, observations, and document review), and analysed using emergent coding. CoP members contributed extensive knowledge to the KTA process characterized by the following themes: team dynamics, employing a structured process, technology use, varied forms of knowledge, and a clear initiative. The study’s CoP effectively synthesized and translated knowledge into practical tools to inform changes in practice, programs, and policy on dementia care. More research is needed on how to involve patients and caregivers in the KTA processes, and to ensure that practical application of knowledge has financial and policy support

COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.

La pandémie de la COVID-19 et l’état d’urgence publique qui en a découlé ont eu des répercussions significatives sur les personnes âgées au Canada et à travers le monde. Il est impératif que le domaine de la gérontologie réponde efficacement à cette situation. Dans la présente déclaration, les membres du conseil d’administration de l’Association canadienne de gérontologie/Canadian Association on Gerontology (ACG/CAG) et ceux du comité de rédaction de La Revue canadienne du vieillissement/Canadian Journal on Aging (RCV/CJA) reconnaissent la contribution des membres de l’ACG/CAG et des lecteurs de la RCV/CJA. Les auteurs exposent les voies complexes par lesquelles la COVID-19 affecte les personnes âgées, allant du niveau individuel au niveau populationnel. Ils préconisent une approche impliquant des équipes collaboratives pluridisciplinaires, regroupant divers champs de compétences, et différentes perspectives et méthodes d’évaluation de l’impact de la COVID-19.

We present the development of a regional dementia strategy in Southwestern Ontario, Canada. We worked with stakeholders in a regional health authority to develop a dementia strategy. We conducted interviews with persons with dementia and their care partners (n = 26) and health care administrators and policy makers (n = 33); and administered a priority-setting survey (n = 64). Both participant groups identified provider compassion, professionalism, and care in the early stages of dementia as system strengths. Both groups also highlighted a need for more integration and coordination, a need for more person-centred care, support for care partners, and more flexibility in the provision and receipt of services. The highest-ranked priorities were improving care partner support, improving access to care, and improving system-wide quality. We integrate these strengths, needs, and priorities in a strategic framework, “Whole Person, Whole Journey”. Organizations developing a dementia strategy may use this framework as a springboard for their own work.

The COVID-19 pandemic and subsequent state of public emergency have significantly affected older adults in Canada and worldwide. It is imperative that the gerontological response be efficient and effective. In this statement, the board members of the Canadian Association on Gerontology/L’Association canadienne de gérontologie (CAG/ACG) and the Canadian Journal on Aging/La revue canadienne du vieillissement (CJA/RCV) acknowledge the contributions of CAG/ACG members and CJA/RCV readers. We also profile the complex ways that COVID-19 is affecting older adults, from individual to population levels, and advocate for the adoption of multidisciplinary collaborative teams to bring together different perspectives, areas of expertise, and methods of evaluation in the COVID-19 response.

This study investigated the complex mechanisms underlying team-based delivery of person- and family-centred care (PFCC) in geriatric home care. Using a realist synthesis approach, an evaluative framework was developed and populated with 159 references from scoping the literature, consulting Canadian experts in PFCC, purposive searching in PubMed/MEDLINE® and Cumulative Index to Nursing and Allied Health Literature (CINAHL), and reviewing grey literature within Canada. References were selected using a two-person review and/or consensus approach and quality appraisal. Data were extracted and synthesized using context, mechanism, and outcome configurations into a theoretical framework of team-based PFCC in geriatric home care. The framework details the predominant discipline-specific contributions of nurses, occupational therapists, and physiotherapists, their collective contributions through communication in the context of a virtual team, and the system-level support required for comprehensive team-based PFCC delivery. Findings from this study could inform improvements to PFCC education, best practice guidelines, and more integrated delivery of PFCC in geriatric home care and other team-based care environments.

Our pilot study evaluated the feasibility, effectiveness, and implementation of a group-based lifestyle-integrated functional exercise (Mi-LiFE) program for older adults in an interprofessional primary care practice. A physical therapist taught participants how to integrate strength and balance activities into daily routines during one individual and four group sessions, and two follow-up phone calls. Feasibility outcomes were recruitment, adherence, and retention over 6 months. Physical activity (PA) (accelerometer, International Physical Activity Questionnaire [IPAQ]), Short Physical Performance Battery (SPPB), and health-related quality of life (EuroQol Five-Dimensional Questionnaire with 3 Levels [EQ5D-3L]) were evaluated at baseline and 6 months. Of the 123 eligible individuals, 39 per cent participated and 61 per cent were not interested or unreachable. Forty-eight participants (mean ± standard deviation [SD] age = 81 ± 5 years; body mass index [BMI] = 28 ± 5 kg/m2; 60% women; moderate-to-vigorous PA = 49 ± 87 minutes/week) enrolled. Four participants withdrew prior to intervention. Thirty-two participants (67%) were retained at follow-up. Daily diary-documented adherence was 50 per cent at 6 months, and 77 per cent attended more than four sessions. No statistically significant changes in moderate-to-vigorous PA and SPPB outcomes were observed; yet self-reported strength and balance PA and quality of life significantly improved at follow-up. The Mi-LiFE program is feasible with acceptable recruitment and attendance rates alongside modifications to address retention and adherence challenges. These findings inform the feasibility of future pragmatic exercise programs in primary care for older adults.

Quality of life (QoL) of long-term care (LTC) facility residents is an important outcome of care. This cross-sectional, descriptive study examined the self-reported QoL of LTC facility residents in Canada using the interRAI Self-Report Nursing Home Quality of Life Survey instrument. A secondary purpose was to test the instrument’s psychometric properties. Psychometric testing of the instrument supported its reliability and its convergent and content validity for assessing the residents’ QoL. Findings showed that residents rated positively several aspects of their life, such as having privacy during visits (76.9%) and staff’s being honest with them (73.6%). Residents gave lower ratings to other aspects such as autonomy, staff-resident bonding, and personal relationships. The findings point to gaps between facility philosophies of care and their translation into a care environment where care is truly resident-directed. Moreover, the findings have potential implications for resident care planning, facility programming, social policy development, and future research.