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 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 article highlights the incidence of poverty amongst older persons in Canada by documenting the poverty rates among women and men from seven different ethnic groups representing both White ethnic and visible minority populations (Chinese, Aboriginal, Ukrainian, Jewish, Black, Greek and Italian ethnic ancestry). Special attention is placed on the incidence of poverty amongst older women and reasons for differential poverty rates among ethnic older women will be addressed. An attempt is made to link these issues with an agenda for gerontological research, policy and practice including addressing the need for improved services for this population.

The aim of this study was to investigate the age differences in the rates and costs of broad categories of medical procedures (diagnostic, therapeutic and surgical) during the last year of life as well as hospitalization among the adult population of Quebec. The study is population-based and took into account 90 per cent of deaths occurring among the Quebec population (15 years and older) in 1991. The data were collected from the physician claim files of the Health Insurance Board. Costs were defined as physician payments for the procedures performed. The results showed that the rates of these procedures increase with age to reach a maximum in middle life and then decrease among the elderly. A similar trend was observed in the average cost of surgery and diagnostic procedures but the average cost of therapeutic procedures followed a constant decline with age. These data suggest that the oldest old do not seem to get more aggressive care at the end of life than younger decedents.

In June 1993, the newly elected Progressive Conservative government of Alberta headed by Ralph Klein initiated a three-year deficit-elimination plan focussing exclusively on expenditure reductions. Despite the rapid implementation of this plan over the next three years, most Albertans did not find subsequent changes in government services and the shift of costs to the consumer to be consequential.Senior citizens, however, differ in a number of significant ways from the general population. Direct reductions in benefits, as well as cost-of-living increases and increases in other costs, combined to create a larger impact for seniors. A case study of one middle-income senior couple illustrates this point. This paper indicates that a more in-depth appraisal of the potential impact of social policy changes on vulnerable groups should be undertaken in other jurisdictions prior to the adoption of such fiscal-reform plans.

Developmentally grounded research on norms for social exchange in adult relationships is equivocal, and rife with theoretical and methodological inconsistencies. We examined the applicability of three theoretical perspectives to specific relationships differing in self-perceived closeness in three groups of adults. Participants were first year (n = 37, MAge = 19.1 years) and fourth year (n = 42, MAge = 22.1 years) undergraduates, and retired teachers (n = 42, MAge = 66.8 years). We find considerable similarity among the three age groups on exchange norms and reciprocity expectations, despite considerable differences in sources of supportive relationships. Results indicate greatest support for exchange based upon need over either equity or social exchange perspectives, with this being especially true for very close relationships. Older adults report relationships operating to a greater extent on expectations for long-term over short-term reciprocity than young adults. Findings highlight the importance of considering intra-individual variation in exchange norms and expectations for reciprocity.

Do men and women age differently? This is the question the authors attempt to answer. By borrowing from biological, psychobehavioural and sociohistoric fields of study, the authors address - from a differential angle - man/woman relationships, life expectancy, causes of morbidity and mortality, health status perception, psychological aging, life cycle events, and family relationships. This is an excellent, well-documented review of writings that elicit reflection on current and future aging at the dawn of the 21st century.