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

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Environmental supports for aging in place at the home and community levels

Author: 
Date created: 
2021-06-09
Abstract: 

Aging in place is a common topic among gerontologists, policy-makers, older adults, and other stakeholders, and is widely recognized as the most desirable option for older adults in Canada. A critical synthesis of the literature related to home-level and community-level environmental supports for older adults to age in place is presented in this capstone project. Two distinct literature reviews were conducted on the following topics: a) home modifications for older adults, and b) age-friendly community-based programs, services, and features for older adults. This research project is guided and informed by selected theories in environmental gerontology, including Lawton and Nahemow’s (1973) seminal ecological theory of aging, or person-environment fit model. The findings and analysis of this project work to bridge existing concepts of aging in place (AIP) and age-friendly communities (AFC), and provides implications for future research and policy development for supporting independence and well-being of community dwelling older adults in Canada.

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

Help-seeking behaviors among older adults and minority ethnic sub-groups: A scoping review

Author: 
Date created: 
2021-07-20
Abstract: 

Background: Although older adults may experience health challenges requiring increased attention and care, they often do not ask for help. This behavior is complex and not completely understood; therefore, further research into help-seeking behaviors of older adults and minority ethnic sub-groups is warranted. Methods: Guided by Arksey and O’Malley’s scoping review framework and the PRISMA-Scoping Review guidelines, a scoping review was conducted. Data were analyzed using a qualitative meta-synthesis framework. Results: Fifty-two studies meeting inclusion criteria were organized into six themes: interactions with formal healthcare providers, identity and independence, appraisal of symptoms and health, turning to social supports, accessibility and awareness, and cultural factors and lay/religious beliefs. A supplementary analysis of younger populations and Asian older adults was conducted to address the low number of minority studies captured by the inclusion criteria and to validate study themes. Discussion: Identifying how factors, such as symptom appraisal and social support, impact older adults’ help-seeking behaviors, may provide insights into how to address such barriers and how cultural dimensions of help-seeking contribute to unique challenges for minority ethnic populations.

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

‘Till long-term care do we part’: Exploring the impacts of separating married couples on couplehood and well-being

Author: 
Date created: 
2021-07-30
Abstract: 

This capstone project explores the impact of separating married couples when one spouse has dementia in long-term care settings. In particular, on couples’ abilities to maintain a sense of couplehood within the socio-physical environment of long-term care and its impacts on each spouse's health and wellbeing. The theoretical perspectives of attachment theory and person-environment exchange are utilized to guide this project, providing a holistic and insightful approach to investigating spousal relationships in long-term care. The goals of this project are two-fold. First, a scoping review of the limited literature will be presented. Second, based on the Canadian Institute of Health Research (CIHR) Project Grant guidelines, a mock grant proposal was developed. The purpose of the grant is to critically examine the institutional practice of separating married couples in LTC settings in British Columbia when one spouse lives with dementia and requires more complex care and support. The proposed study will focus on couples' abilities and challenges in maintaining their relationship within the LTC environment and the effects of separation on their health and wellbeing. Overall, this capstone project will help guide future research, practice, and policy in this important yet understudied topic in gerontology.

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

Exploring health care and personal care decision-making under representation agreements: The lived experience of ‘representatives’ of older adults with dementia

Author: 
Date created: 
2021-04-13
Abstract: 

The representation agreement (RA), a legal planning document in British Columbia, allows an adult to appoint a person—i.e., a representative—to assist them with decisions or make decisions on their behalf for health care and personal care matters. This qualitative study explores the lived experiences of representatives of older adults living with dementia during health and personal care decision-making. Semi-structured interviews were conducted with ten current and past representatives. Interviews were analyzed through conceptualizations of the individual, social, and political bodies, articulated in Scheper-Hughes and Lock’s (1987) three bodies approach. The findings reveal six themes that representatives considered meaningful in their decision-making experiences: (1) motivations behind the creation of the RA, (2) the context in which decisions occurred, (3) the decision-making process, (4) facilitators and (5) barriers to decision-making, (6) and representatives’ reflections on their experiences. Bio-medicalized discourse and knowledge of dementia—dominant in Western societies—informs representatives’ experiences. Furthermore, this study illuminates how a dominant medicalized discourse and knowledge of dementia, rooted in Cartesian Dualism, informs representatives’ decision-making approaches.

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

Ethical issues in the use of surveillance cameras to support ageing in place

Date created: 
2020-11-17
Abstract: 

Background and Objective: Surveillance technology allows family members to monitor older adults’ daily activities and their interaction with the home environment. In particular, video surveillance cameras and surveillance technology’s implementation raises critical ethical concerns due to their invasive and obtrusive nature. Thus, this paper aims to address the ethical issues regarding the use of video surveillance for older adults to age in place. Methods: A literature review is conducted using Springerlink, Sciencedirect, and PubMed Publications related to older adults’ care, ageing in place, and the use of surveillance technologies were included in this project. Results: A total of 19 publications met the inclusion criteria. Nine ethical issues emerged from the data: informed consent, privacy, conflict of interest, stigmatization and obtrusiveness, homogeneity among older adults, and imbalance relationship. These nine themes were further explored in respect to ethical principles, including autonomy, beneficence, non-maleficence, justice and fidelity) Conclusion: Although surveillance cameras can be invasive, well-grounded ethical thinking and proactive response help reduce the risk and ethical challenges associated with it. By examining the ethical issue in video surveillance, it helps to reflect and enhance the current legislation.

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

I belong to Canada: The role of Neighbourhood House for the mental health of older visible minority immigrants

Author: 
Date created: 
2020-12-10
Abstract: 

Considering Canadian immigration trends, the current aging of the country’s population, and access issues related to services that promote the mental health needs of older visible minority immigrants, more attention is required to understand the role of organizations that offer programs and services to this population group. Using qualitative inquiry and the PRECEDE-PROCEED model, this study aims to determine to what extent programs and services available in the Neighbourhood House sector contribute to the mental health of older visible minority immigrants as understood in the VicHealth Framework.

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

A critical analysis of continuing care systems, integrated care strategies, and policies: Assessing the success of Canada, Denmark, and Australia

Author: 
Date created: 
2020-08-18
Abstract: 

In recent years there has been a call for the development of integrated continuing care systems in Canada. Such systems would provide older adults and informal caregivers with a comprehensive continuum of integrated supports, linking formal and informal health and social care to improve efficiencies. The purpose of this study was to examine how an integrated continuing care system can be developed in BC to address limitations and gaps in service. The study was informed by a critical public policy and a systems approach. A multi-pronged longitudinal methodological strategy was utilized and entailed: 1) Analysis of BC’s home and community care system; 2) Document analysis; and 3) Comparative analysis of systems and reforms in other jurisdictions (Ontario, Québec, Nova Scotia, Australia, and Denmark). Data were collected through a) interviews in 2014/15 and 2019/20 with stakeholders in BC and a small number of key informants for each comparison jurisdiction; b) analysis of government policy documents; and c) review of literature and other information sources. Key deficits identified in BC included: lack of a clear vision for home and community care; gaps and fragmentation in the care continuum; lack of investment in home and community care; and lack of supports for informal caregivers. Similar deficits were experienced in many of the comparison jurisdictions, but there also were areas of policy divergence. One of the identified points of tension for integrated care approaches was the fine line between the substitution of services and downloading of responsibilities. A key recommendation for BC is that the lens through which policy is being developed needs to be adjusted and moved away from simply viewing home and community care as substitutes for acute and residential care. Furthermore, the ambiguous position of continuing care in Canada is contributing to the marginalization, medicalization, and underfunding of continuing care systems. It is concluded that a funding model for continuing care needs to be developed at the national level, which has become particularly apparent during the COVID-19 pandemic. Additional recommendations include improving supports for informal caregivers, providing a broader range of community-based supports, shifting care paradigms, and strengthening the integration of services.

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

Understanding transitions from hospital to shelter/housing: Perspectives of people with lived experience of homelessness

Author: 
Date created: 
2020-08-26
Abstract: 

People with lived experience of homelessness (PWLEs) have poorer health and higher rates of hospital admissions than stably housed persons. However, PWLEs are often discharged from hospital to unsupportive settings that do not meet their complex health needs, resulting in ongoing and worsening health conditions and prolonged recoveries. To expand on current understandings of hospital-to-shelter/housing transitions and to investigate the differences between younger and older PWLEs, this study conducts a secondary data analysis of 20 in-depth interviews with 11 younger (<45 years) and older (>45 years) PWLEs. Findings are organized into three categories: 1) Self-rated health and healthcare use; 2) Discharge planning; and 3) Recovery and follow-up care. Differences between older and younger PWLEs are highlighted. Identifying challenges of hospital-to-shelter/housing transitions and supports needed provides an avenue for healthcare and shelter/housing providers to improve service delivery.

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

Intergenerational perceptions of family care: Examining non-dyadic baby boomers and adult children of boomers

Author: 
Date created: 
2020-09-18
Abstract: 

The aging of the baby boomer (BB) generation (1946-1965) presents unique challenges for those planning future care contexts. Limited research has examined anticipated care perspectives of both BBs and adult children (AC). Drawing upon a critical life course perspective, this study aims to: (1) examine family care perceptions of BBs as future care recipients and non-dyadic AC of BBs as potential caregivers; and (2) explore perceived societal supports for family caregivers. Two focus groups of BBs (n=10) and two of AC (n=9) were conducted between January and March 2020. Thematic analyses revealed congruent and non-congruent generational viewpoints within four overarching themes: individual outlooks, social locations, and proximity; family preservation/care norms; perceived aging realities and plans; and negotiating contemporary care. Analyses also identified perceived systemic gaps and opportunities in community supports for aging families. Findings are discussed in relation to supporting those giving and receiving care across generations.

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

relational practice in long term care

Author: 
Date created: 
2020-08-17
Abstract: 

This critical ethnography explores the concept of relationality from the perspective of nurses working in long term care. The existing literature on this concept, in this context, has mostly focussed on allied health professionals. Data was collected through field observations, solicited diaries, and semi-structured interviews conducted with seven nurses working in long term care. A theory of relational work was used to inform a reading of, and thinking through the research process, data collection and analysis. The findings from this study indicate that nurses privilege the relational in their work, seek out opportunities to cultivate family-like relationships with residents, and see hands-on care as an opportunity to strengthen feelings of connection with the people they care for and with. These findings have potential implications when considering appropriate skill-mix in long term care and for re-evaluating the meaning of nursing work to nurses who work in these settings.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Sharon Koehn
Barbara Mitchell
Department: 
Arts & Social Sciences: Department of Gerontology
Thesis type: 
(Thesis) M.A.