Gerontology - Theses, Dissertations, and other Required Graduate Degree Essays

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Double and triple duty caregiving and its effect on personal health and wellbeing: a pilot project and sample funding proposal

Author: 
Date created: 
2018-08-23
Abstract: 

This capstone project examines the effects of double and triple duty caregiving on the personal health and wellbeing of nurses. A mock research grant is proposed for the Canadian Institute of Health Research (CIHR) Project Scheme, based on a critical review of literature and the results of a pilot project. Qualitative interviews were conducted with nine female nurses (aged 45 to 67) living in British Columbia who were providing informal caregiving for a family member. Results from the pilot project indicate that these caregivers experience adverse physical and mental health issues, which in turn compromise their job performance and heightened their family obligations. Caregivers also experience burden differently, depending on their nursing qualifications and support networks. Overall, it is argued that research is needed on this topic to further examine how double and triple duty caregiving places unnecessary strain on both healthcare workers and the health care system.

Document type: 
Graduating extended essay / Research project
Supervisor(s): 
Barbara Mitchell
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Project) M.A.

The aching backbone: perceptions and experiences of care aides in long term residential care

Author: 
Date created: 
2018-06-06
Abstract: 

Purpose: Care aides provide most of the direct care for residents in long-term residential care (LTRC), and thus hold the greatest potential to improve residents’ quality of life. Two-thirds of residents in these facilities are older adults with dementia. The number of care aides working in LTRC needed to support Canada’s aging population is only expected to increase with time. Like residents in LTRC, care aides are a disenfranchised population. There is little understanding of what are the experiences and perceptions of care aides in LTRC. This doctoral thesis adds to the scarce body of knowledge that sheds light on the experience of care aides in LTRC. This study was informed by the literature on person-centered care and personhood theory, as well as critical gerontology and institutional theory. The purpose of this study was to understand the experiences and perceptions held by care aides in LTRC and to identify their perceived barriers and facilitators toward the delivery of care to residents. Method: The overall methodology for this study was a qualitative design, using ethnographic data-generating methods from one complex-care floor located within a campus of care facility in rural and remote Western Canada. Data sources for this study included the following: semi-structured interviews (70 hours) with 31 care aides, naturalistic observation (170 hours), and reflexive journaling (20,000 words). Thematic analysis was used to examine all data sources. Results: Care aides’ experiences entering and working in LTRC are varied; however, there are common overarching themes, including not being adequately trained for the realities of working as care providers and the scope of practice they are expected to fulfill within LTRC, as well as being under supported in their role. Participants report strong feelings of responsibility and affection for their residents, yet they perceive insurmountable barriers in their role that prevent them from delivering the care they would like to give. These barriers include the following: (i) lack of standardized education and training; (ii) lack of proper equipment; (iii) lack of autonomy over their residents; (iv) politics and bullying within the power hierarchy of LTRC; and (v) chronic unaddressed moral distress among care aides. Suggestions for improvement of care delivery in LTRC include the following: (i) standardization of care aide education and training; (ii) incorporation of reporting measures specifically for care aides; and (iii) increased autonomy of care aides over their residents. Implications: The support and empowerment of care aides in LTRC are fundamental in the delivery of good care to residents. Care aides have expressed that their attitudes toward their job are low because they feel unheard and voiceless within their work environment. Efforts to empower care aides’ voices should be developed and implemented to meet the needs of a large segment of Canada’s population living with dementia—residents in LTRC.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Andrew Sixsmith
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) Ph.D.

Stories of resident-to-resident aggression: Fears and experiences in long-term residential care

Date created: 
2018-02-26
Abstract: 

This thesis explores family caregiver concerns and experiences around resident-to-resident aggression (RRA) in long-term residential care (LTRC). Canadian media reports spanning a ten-year period (2007-2017) about RRA (n= 64) were analyzed with a critical discourse lens to examine the representation of family members. Also, family caregivers of residents in LTRC from two British Columbia health regions (n= 8) were interviewed about the influence of RRA media reports on perception of safety for themselves and their relatives in LTRC, and their broader caregiving experiences. Family caregivers viewed media reports on RRA as sensational, contributing to the stigma of dementia, and lacking context, but they did not impact the family caregivers’ sense of safety. Instead, the lack of access to empowerment structures (i.e. informal power, formal power, information, support, and education) and the ambiguous position of family within the hierarchical power structure of LTRC negatively influenced their caregiving experiences. Findings suggest a need for systemic change to increase family empowerment and role clarity with respect to prevention and management of RRA.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Andrew Sixsmith
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) M.A.

A reformulation and assessment of the Global AgeWatch Index: Inclusion of a gender-based domain

Date created: 
2018-02-27
Abstract: 

The Global AgeWatch Index (GAWI) is a measure that ranks countries according to the wellbeing of their older adults. The GAWI was constructed using four domains of wellbeing excluding a gender inequality domain. This research aimed to include the domain of gender equality in the GAWI and produce a reformulated index (rGAWI) so that the resulting ranking of countries based on the new indices can be compared with that observed for the original GAWI. This cross-sectional study utilized publicly available data on female labour force participation, total fertility rate and age at first marriage to create a new domain of gender inequality. The new domain was added to the original four GAWI domains to generate the rGAWI. The inclusion of the gender inequality domain into GAWI resulted in changes in the rankings of 87.5% of the countries and countries with lower gender inequality scores had poor reformulated indices of wellbeing.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Andrew Wister
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) M.A.

The Role of the Socio-Physical Environment on Aging in Place for Older Adults in Cohousing and Naturally Occurring Retirement Communities

Date created: 
2017-08-23
Abstract: 

The majority of Canada’s older adults want to “age in place” in their home and community as long as possible, even in the face of declining health and physical functioning. Cohousing and Naturally Occurring Retirement Communities (NORC) have been identified as potential aging in place phenomenon. However, empirical research on both communities in Canada is either scarce or nonexistent. A multiple-case study design was used to gain an understanding of the influence of the physical and social environment of residential settings and neighbourhoods on aging in place processes among older adults in cohousing and NORC. Twenty (20) older adults living in cohousing or NORC in British Columbia, Canada were recruited to conduct photovoices and semi-structured interviews. Data was collected and analyzed following constructivist grounded theory methodology. Findings show that aging in place processes were influenced by interacting factors found at multiple levels. At the individual and psychosocial level, aging in place was influenced by older adults’ health status, functional ability, mobility capacity, agency, resilience, and feeling of safety. At the physical environment level, associations with accessibility, functionality, neighbourhood destinations, and aesthetics were found. At the social environment level, aging in place was linked to community engagement, mutual support, meaningful social connections, and the social fabric of the neighbourhood. In addition, mobility was central to participants’ experience of place. Based on these findings, a conceptual framework on aging in place is proposed to better explain the complex dynamics between older adults and the physical and social environments of the neighbourhood. The integrated analysis of the residential and neighbourhood environments highlighted the relevance of considering “place” in aging as a continuum of various geographical scales in future research. This study documents, for the first time in Canada, the experience of older adults living in NORC and cohousing communities. In which manner these communities may provide an optimal environment for aging in place needs to be further documented.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Habib Chaudhury
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) Ph.D.

Model development and exploration into the driving decisions of older adults

Date created: 
2017-02-23
Abstract: 

With advanced age, declines in physical and/or cognitive abilities make driving more difficult, and challenge the individual to make decisions about their driving. The main aim of this research was to explore how older adults make day-to-day decisions about driving, and how others’ opinions influence them. This thesis addresses major gaps in the published literature on older driver decision processes, and how these processes differ across gender and habit strength for driving. An integrative mixed methods approach was used to study a convenience sample of 37 urban dwelling drivers, age 70 years and older. This exploratory research reveals that decisions about driving are dependent upon at least three main features: 1) interpretation of the driving environment; 2) types of information used and decision processes employed; and 3) influence other’s opinions on driving decisions.Main findings are that older drivers evaluate their driving experience using three distinct components: 1) the driving environment; 2) people who drive; and 3) crashes. In the decision-making process, older drivers are characterized by their dynamic use of information wherein an item may be used to support the decision to drive some instances, but in other instances used in choices not to drive. Three categories of items are identified in a proposed Older Driver Decision Components Framework, and reflect this dynamic process: Motivators, Constraints/Motivators, and Context. Additionally, three groups of older drivers are identified based on their driving choices, and defined by characteristics such as gender, age, and habit for driving. Responses to comments about their driving also help define these groups. Results of the study provide a new direction for research on the older driver, and models are developed that may be used to form a basis for understanding older driver decision-making. Refinement of our knowledge about how elders assess their driving environment, and the subsequent choices they make, should be pursued to better understand how they adjust their transportation needs and desires to age-related changes. In turn, this knowledge may be used to design programs and policies to support the safe driving of our aging population.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Andrew Wister
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) Ph.D.

The Influence of Group Music Therapy on Residents with Dementia in a Special Care Unit

Date created: 
2016-12-05
Abstract: 

Empirical evidence on the influence of music therapy on persons with dementia in residential care homes is fairly limited. Residents often experience a low quality of life due to the prevalent medical model of care that focuses on health-related outcomes, rather than a person-centered approach to support and care for the whole person. This qualitative study explored the influence of group music therapy on quality of life in residents with dementia living in a special care unit. Data were generated through focused, ethnographic observations, interviews, document analysis and a focus group. The data provide a rich and in-depth understanding on the process and outcomes related to group music therapy’s influence on residents’ care home experience. The findings provide substantive insights on the role of music therapy in improving the quality of life for residents with dementia and have practice implications for music therapy programming in residential care facilities.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Habib Chaudhury
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) M.A.

Person-Centered Care Practices and Organizational Issues in Long-Term Care Facilities: A review and synthesis of the literature

Author: 
Abstract: 

Care practices in long-term care facilities have typically been guided by the biomedical approach to care. In the past two decades, there has been a growing movement in transforming care for residents from a medical model to a person-centered model in long-term care. This capstone project reviews and synthesizes current literature on person-centered care, with a focus on care practices and organizational issues. An extensive literature review was conducted using databases such as Ageline, PsychINFO, Medline, Google Scholar, CINAHL and the Simon Fraser University library catalogue. A total of 69 articles that addressed the research questions were identified and incorporated in this review. Empirical evidence indicates that implementing person-centered care practices that honor the dignity and choice of residents, strengthen resident and care staff relationships and utilize nonpharmacological care to preserve the personhood of residents can improve the caring experience. In addition, there is evidence that person-centered care can improve the well-being and quality of life of residents and improve job satisfaction for care providers. This paper also examines the organizational facilitators such as culture change, staff training and management’s role, and environmental design as well as the organizational barriers in implementing person-centered care.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Dr. Habib Chaudhury
Dr. Deb O'Connor
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Project) M.A.

A Process Evaluation Framework for a Long-Term Care Garden Program

Date created: 
2016-11-23
Abstract: 

The purpose of this project is to develop a logic model and process evaluation framework for a therapeutic garden program at Banfield Pavilion, a residential long term care facility located in Vancouver, B.C. A six-step process evaluation design developed by Saunders, Evans, and Joshi (2005) is used to develop the evaluation framework. Steps of the framework include (1) describing the program, (2) describing complete and acceptable delivery of the program, (3) developing the potential list of questions, (4) determining methods, (5) considering the program’s resources, context, and characteristics, and (6) the final process evaluation plan. The logic model connects program elements to concepts drawn from Ulrich’s (1984) stress reduction theory (SRT) and theory of supportive garden design (1999). A central consideration of the evaluation is whether the program should focus more on spontaneous or structured activities and garden interactions. Both the logic model and evaluation framework can be used for the Banfield program and/or other therapeutic garden programs.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Andrew Wister
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Project) M.A.

The psychosocial aspects of older adults’ decision making process in the adoption of home modifications: Development of a research proposal for grant funding

Date created: 
2016-07-27
Abstract: 

This project presents a research grant proposal based on the Canadian Institutes of Health Research (CIHR) Project Scheme: 2016 1st Live Pilot guidelines. The proposed study aims to have a comprehensive understanding of the objective and subjective factors impacting older adults’ decision making process to implement home modifications (HMs). The study will utilize a mixed methods research approach. Community-dwelling older adults from urban and rural British Columbia will take part in surveys and home environment assessments using the Housing Enabler (North American version) tool. A sub-set of participants will receive HM recommendations and take part in semi-structured interviews about their decision to adopt and implement HMs. The study findings will provide conceptual and substantive insights into the various factors that influence the decision making process. Additionally, the findings will inform professionals in occupational therapy and housing policy on the influencing factors and multidimensional characteristics of older adults’ decision making process.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Habib Chaudhury
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Project) M.A.