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This qualitative study aimed to explore the dining experience of residents with dementia in long-term care facilities, with a focus on the psychosocial aspect of their experiences. Data were collected by multiple methods, including participant observation and conversational interviews with residents with dementia, focus groups with staff, and examination of documents at two urban facilities in British Columbia, Canada. Data analysis revealed eight themes: (1) Outpacing/ Relaxed pace, (2) Withholding/ Holding, (3) Stimulation, (4) Disrespect/ Respect, (5) Invalidation/ Validation, (6) Distancing/ Connecting, (7) Disempowerment/ Empowerment, and (8) Ignoring/ Inclusion. These themes provide a clear set of factors that affect the quality of residents' experiences and offer insights into the processes of how multiple factors influence the residents' experiences in complex ways. The results suggest that although staff approaches significantly impact residents' experiences, the physical environment and organizational milieu are also responsible for hindering and facilitating staff to provide care.
This thesis examined the role of health literacy in accessing Internet health knowledge and predictors of an adequate level of health literacy among older Canadians. Eighty-eight percent of older Canadians have been estimated to posses an inadequate level of health literacy. Internet use is also growing fastest among the same group. We hypothesized that seniors with an adequate level of health literacy would be more likely to search for health information online. We further hypothesized that predisposing, enabling, and need factors would differentially predict an adequate level of health literacy. Cross-sectional data from the IALSS (2003) were used. Seniors with an adequate level of literacy were nearly three times more likely to search for health information online. Unexpectedly, Internet access emerged as the only predictor of an adequate level of health literacy. Suggestions regarding the policy, practice, and research implications of our findings were put forth.
Mixed-methods research explored change in the meaning of home for nine mainly Sikh, South Asian Indian (SAI) late-life immigrant women, living in the Vancouver area. One translated, three-hour, face-to-face semi-structured post-immigration interview was conducted with each participant. The meaning of home was also explored in a non-random survey of 40 SAI seniors. A conceptual model was developed to guide the interviews, analysis and findings. Findings include that reductions and changes in the meaning of home occurs after immigration and that core relationship and sociocultural meanings are established resulting in participants feeling at home. SAI ethnic enclaves promote congruence with the old home and competence in the new one. Strong place attachment to the Indian home prompted regular return trips, which sustained the participant’s "place" in their original neighbourhood networks, an important source of self identity that is not easily reproduced in Canada.
The process of aging can bring forth health-related challenges, specifically an increased risk of cardiovascular disease. This thesis examines the effect of self-efficacy on changes in nutrition behaviour in an intervention aimed at reducing cardiovascular risk in mid-life persons (aged 45-64). The construct of self-efficacy refers to beliefs in our capabilities to undertake the actions necessary to produce a given goal. This psychological construct has shown to be a mediator between various determinants of health and subsequent health behaviour. Social Cognitive Theory lays the groundwork for examining self-efficacy. Undertaking a secondary data analysis of the Cardiovascular Health Best Practice Project, this study examines self-efficacy in both a general health and nutrition health context. Results show that nutrition self-efficacy, income, mutual aid, and family physician visits play a role in changing nutrition behaviour over time, contributing to the understanding and development of research and nutrition health promotion programs for this population.
This case study explores environmental influences on the physical activity of older adults (age 60 and over) in two neighbourhoods. The concept of social capital – the resources available through one’s social networks – is used to explore social factors that affect physical activity in later life. A conceptual framework was developed to map relationships among key study concepts. Research methods included neighbourhood environmental audits, focus groups, and activity diaries. Findings confirmed neighbourhood differences in physical features hypothesized to impact physical activity. Neighbourhood physical and social factors identified as supports and barriers by participants themselves also differed. Moreover, one neighbourhood was found to be more supportive of walking for transport while the other was more supportive of recreational forms of physical activity. Individual participants differed in access to social capital from neighbourhood and personal networks. Relevant planning issues are discussed as they relate to physical activity promotion in later life.
Research has demonstrated that impulsivity is strongly associated with suicide-related ideation and behaviour among young adults. To date, however, the potential importance of impulsivity as a predictor of suicide-related ideation in later life has yet to be determined. The current study set out to examine impulsivity, hopelessness, depressive symptomatology and socio-demographic factors vis-à-vis suicide-related ideation among a sample of older adults using both hierarchical regression and canonical correlation. A national sample was recruited from multiple sources for this study over a 1-year period (N = 117). Canonical correlation analysis showed that the impulse to self-harm may be more pronounced among older adults less likely to present as typically depressed. The findings of this study further suggest that impulsivity is more broadly associated with suicide-related ideation than hopelessness, and that screening for impulsivity as well as hopelessness may increase clinicians’ ability to identify older adults at greatest risk for self-harm.
This thesis examines the influence and interrelations of socio-economic, regional and social factors on elderly women's health from a life course perspective, integrating the concept of "social capital." A sample of 8,684 women aged 65+ is drawn from the master files of the 2001 Canadian Community Health Survey. Using logistic regression, analyses indicate elderly rural women are more likely to report having any chronic condition, hypertension, diabetes and heart disease, compared to elderly urban women, after controlling for socio-economic status, social capital and lifestyle. However, while community integration (a form of social capital associated with better health) is often stronger in rural communities, no rural advantage for subjective health is observed. Separate analyses of rural and urban sub-samples of elderly women also reveal a number of striking differences in the factors associated with subjective and objective health outcomes. Findings are discussed with regard to implications for policy and future research.
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