Resource Utilization Groups III (RUG-III) is a case-mix system developed in the United States for categorization of nursing home residents and the financing of residential care services. In Hong Kong, RUG-III is based on several board groups of residents. The aim of this study was to examine the reliability and validity of the RUG-III in Hong Kong nursing homes. A cross-sectional survey was conducted in seven residential facilities operated by one agency. Residents (N=1,127) were assessed by the Minimum Data Set (MDS) and nursing as well as auxiliary staff care times were recorded within 2 weeks before or after the completion of MDS assessment. Forty-five out 1,127 residents were re-interviewed by an independent assessor to assess the inter-rater reliability. The inter-rater reliability of MDS assessment was excellent (κ=0.76) and the original RUG-III accounted for about 30 per cent of nursing staff time. Results provide preliminary evidence to support that RUG-III is a reliable and valid case-mix system for Hong Kong nursing homes, but future studies must be explored to reduce the variance of resource use explained by this case-mix system.

In response to the contradictions appearing between, on the one hand, government promotion of family caregiving for elderly parents and, on the other, the rise of autonomist values (as documented in the literature), we surveyed a number of elderly people living with disabilities about the kind of assistance they would like to receive. The present qualitative, thematic analysis is based on the accounts given by 19 elderly people who receive assistance. The findings show that the position of elderly people with respect to their desire to receive (or not receive) substantial assistance from their family rests on a set of values, wishes, and/or fears – including, particularly, adherence to the value of autonomy, the desire to respect freedom (one's own as well as that of others), adherence to norms of familial duty, attachment to one's home, the value placed on solitude and privacy, and the degree of emotional closeness between the elderly and their children. Access to quality formal services also stands out as a factor enabling elderly people to actualize the desire for care which they elicited within the framework of this analysis.

Sign comprehension is critical for effective driving, responses to warnings, and way-finding. Signs that are poorly comprehended by older people increase accident risk and may compromise independence. This study sought to determine whether iconic sign comprehension suffers in healthy aging and in the presence of cognitive impairment. Additionally, we examined whether the addition of text to iconic signage would increase comprehension in older adults. In Experiment 1, young adults, healthy older adults, and older adults with varying levels of cognitive impairment were asked the meaning of 65 signs used for driving, warnings, and way-finding. Healthy older adults were generally good at sign comprehension but had difficulty with way-finding signs. Older adults with cognitive impairment had poorer sign comprehension overall and particular difficulty with way-finding icons and signs that had icons only. In Experiment 2, healthy older adults were asked the meaning of signs containing icons only, or icons and text. A significant improvement in comprehension was found when text was added. An important implication of this work is that the assessment of sign comprehension needs to involve a broad and heterogeneous sample of older adults reflecting the range of perceptual and cognitive abilities represented in the population.

Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis explores the enactment of multiple roles for family members providing home-based palliative care to seniors with advanced cancer. Family members had multiple expectations to provide care but felt their expectations of services were unmet. The process of enacting multiple roles was depicted by three interrelated themes: balancing, re-prioritizing, and evolving. Positive and negative health responses resulted from attempts to minimize personal health while simultaneously maintaining health. “True” family-centred care was found to be lacking, but should be a goal of health professionals involved in end-of-life care.

These two studies are designed to evaluate the reactions of male nurses aged 45 years and older toward ageism. The goal of the first study is to test the prestigious work domain model of psychological disengagement resulting from a previous study conducted among female nurses. This model has been confirmed through path analyses conducted on a sample of 236 male nurse technicians; by the same token, it has been shown to apply in the case of lower-status employees working in a prestigious field. In particular, the more a male nurse aged 45 and older experiences relative personal deprivation, the more he discredits feedback from his co-workers and superiors; such discrediting, in turn, leads to devaluation of the domain of work, which in turn lowers self-esteem. The goal of the second study is three-fold, namely: (a) testing the disengagement model among 419 male nurse clinicians; (b) extending this model through the addition of ageist communication as a variable triggering personal relative deprivation; and (c) constructing a scale of ageist communication. Path analyses have again confirmed that the way a domain is appreciated influences the negative impact that devaluation can produce on self-esteem, regardless of the gender or status of the employee working in that field. In addition, these results demonstrate the central role played by communication in the workplace as a vehicle of ageism and as a precursor of ageing employees' discomfort. The discussion covers the implications of ageing employees' reactions toward ageism as well as the consequences of depreciatory language and exclusionary communication practices in the workplace.

In an age of globalization and privatization, local governments and municipalities are searching to define their social role and place. In an aging society such as Canada, arguing that promoting the legal rights of older persons should be part of the legal authority of the municipal government is not simple. It is easier to abide by the position that, without an efficient centralized machinery, social and environmental problems will remain unsolved or unaddressed.

This article presents a different understanding of the place of municipal government in Canada. The goal of this article is to present an original legal-policy argument: It is time for local communities and local governments in Canada to use their legal authorities to enact local bylaws that define and establish the rights of their older citizens. The argument maintains that local municipalities hold the legal power and the social potential to make a significant contribution in the legal sphere for promotion of the rights of older people, and that this power has been neglected.

The article supports the argument on three pillars: (1) an empirical analysis of bylaws in different municipalities across Canada; (2) a socio-legal analysis of the advantages of municipal law as a tool for social change; (3) a case analysis of a recent municipal legal reform in British Columbia.