The aim of the study is to identify criteria that frail elderly patients refer to when they appreciate the quality of care of Geriatric assessment units. Twenty-one patients recently released from six Geriatric assessment units in Montreal participated in face-to-face interviews (n = 17) or in a Focus Group (n = 4). Patients reported 56 different criteria grouped into four main dimensions of quality: the environment of care, the attitude and the technical competence of professionals and the results of care. The environment of care consists of physical resources and person related qualities. Comments on the attitude and the technical competence of professionals related mostly to the nurses and physicians. Some quality criteria reported by elderly patients are similar to those reported by patients in various acute care units while others are specific to the frailty of their condition. This study provides health care professionals with rich and useful information on how elderly patients perceive the quality of various components of care in Geriatric assessment units.

The present study examines worry themes and the tendency to worry in older adults. The sample, which is made up of 162 participants, is divided into three groups. The first group includes 47 participants aged from 55 to 64 years old (the youngest subjects). The second group consists of 56 participants aged from 65 to 74 years old. Finally, the third group includes 59 participants who are 75 years old or older (the oldest subjects). Participants completed the Worry and Anxiety Questionnaire, the Worry Domains Questionnaire for Older Adults and the Penn State Worry Questionnaire. For all subjects combined, the most frequently reported worry theme was health, followed by relationships with family and friends. The results show that participants in group 1 (the youngest subjects) worry more about their future, work and finances than those in the other two groups. The results also show that participants in the first two groups have a greater tendency to worry and report a greater number of worries than those in the third group (the oldest subjects). The study's findings are discussed in light of current knowledge of worry among the elderly.

The movement away from institutional care to community living, along with improved nutrition and health care, has led to an increased lifespan for individuals with intellectual disabilities. In Canada, those who were born before 1945 represent the first significant group to grow old. Despite the increasing numbers of these individuals, relatively little is known about them, their life experiences, or their needs. They remain a largely invisible, undervalued, and often overlooked population, and are seldom the focus of new policy or program initiatives. This review of Canadian literature reports on issues related to the prevalence, life expectancy and early aging of individuals with intellectual disabilities, describes the impact of changes in social policy on their life experiences, outlines the needs and expectations of older adults and their families and, finally, suggests future directions for policy development and research in Canada.

The right of the individual to participate in her life-prolonging treatment decisions, either as a decision maker or by having her treatment wishes used as a decision-making criterion, is the result of an evolution in legal guidelines over the last two decades. Although necessary, these legal guidelines are however not sufficient to assure the individual's opportunity to participate. For the chronically ill older adult residing in a health care institution, the opportunity to participate in decisions concerning life-prolonging treatments implicitly depends on the effective communication among three key actors (the individual, her physician, and her proxy). The necessity of this communication has important implications for clinical practice and future empirical research.

Quick Response Programs (QRP) have been instituted to contain hospital costs by reducing unnecessary hospital admissions through the prompt co-ordination of Home Care Services. No formal economic evaluation of the impact of this redirection of services has been conducted. This paper describes a randomized controlled trial designed to compare the costs and effects between comparable emergency department patients (ED) serviced by the QRP versus the usual department services. Patients were assessed at baseline and 10 days following discharge from the ED specifically for their health status, caregiver burden, satisfaction with health care services and expenditures. QRP was an acceptable alternative to ED services for a small percentage of patients and was not more expensive in total care costs although there was a shift in expenditures from hospital to Home Care services. Due to the small sample size the power to detect the clinically important differences in health status was 60 per cent.

The opening of a new Special Care Unit provided the opportunity to study the effect of reduced social density (fewer residents) and spatial density (more area per person) on the behaviour of residents with dementia. Two groups (N = 64) were observed at three periods spaced six months apart. As hypothesized, there was a greater improvement in Disruptive and Nondisruptive behaviour in the experimental group (move from high to low density) compared to the comparison group (constant high density). Findings suggest that unit density is an important determinant of behaviour in elderly residents with dementia.

This study examined the relationship between physical mobility, social integration and well-being in a subsample of 754 unmarried older community dwellers selected from Statistics Canada's 1985 General Social Survey. Also examined was the relationship of mobility; social integration with children, siblings, other relatives, and close friends; and social satisfaction with friend and family relations in predicting well-being. A cross-sectional design was used. Age, gender, marital status and living arrangements were included in the multiple regression analysis. Although no significant interactions were found between mobility and social integration, the results lend support to the importance of mobility and the quality, as opposed to the quantity, of social relationships to well-being. Mobility, satisfaction with friendships, being older and satisfaction with family relations were identified as the variables most strongly related to well-being. Research and practice implications are discussed.