Centre on Aging
25th Spring Symposium
May 5, 2008
Poster Session
- Unpaid Caregivers in Rural and Urban Canada: Their Perspectives on Services for People with Dementia
P. Hawranik, University of Manitoba; D. Forbes, University of Western Ontario; D. Morgan, University of Saskatchewan; B. Leipert, University of Western Ontario; M. Morkle-Reid, S. Henderson and D. Kingston, McMaster University; S. Peacock, University of Alberta; L. Jansen, University of Western Ontario; and S. Normand, University of Saskatchewan.
Abstract
Limited research examines the differences in use and non-use of services between rural and urban unpaid caregivers. It is known that there are unique challenges to accessing services in rural areas and that there are distinct issues that influence the accessibility and availability of services in rural compared to urban areas. However minimal information exists on these differences from the perspective of the unpaid caregivers. A descriptive interpretative study was conducted to identify the issues unpaid caregivers caring for someone with dementia experience (N=39). Two focus groups, one with rural caregivers and one with urban caregivers were held in each of the participating provinces of Ontario, Manitoba, and Saskatchewan. Rural caregivers (n=13) spoke of challenges related to their physical environment, the isolation and the limitations of home care services, as well as their reluctance to request services and the lack of knowledge of formal service providers. The urban caregivers (n=26) also expressed frustration with the lack of knowledge of formal service providers and the policies/actions of the home care program. In contrast to the rural caregivers, they spoke of feeling ‘lost’ after the diagnosis was made and the delay in obtaining a diagnosis.
- Challenges to Delivery of In-Home Services in Rural Manitoba
P. Hawranik, C. Lengyel, and P. St. John, University of Manitoba.
Abstract
Purpose/Objective: To describe the challenges/barriers to the planning and delivery of in-home services to older adults in rural Manitoba.
Method: The project consisted of two components: i) analysis of the regional reports of two rural health regions on the health status of the population, current programs and the identified needs of older adults; ii) two focus groups with 19 program managers who plan and are responsible for the delivery of community services for older adults in the two regions.
Results/Findings. Unique and common barriers/challenges to the delivery of in-home services were identified by both regions in their community needs assessments. Access to health services and transportation difficulties were described by both regions as important concerns. Housing, rapidly increasing senior population, low incomes, and unpaid caregiver stress were unique to each region. The focus groups revealed a number of common challenges such as: limited human resources; limited other resources (supportive housing, adequate means of communication); geography affecting disparity of resources within regions; challenging working conditions; and unpaid caregiver support in jeopardy. A number of challenges were identified that were unique to each region and included: competing priorities; lack of resources leading to inappropriate use of other services; expectations/demands that do not match with regional services/resources; and rapidly increasing number of seniors. A number of strategies were described by each region to address these challenges which included: take into own hands; partnerships; and go to where the people are.
Conclusion: The regions responded to their challenges using strategies that were creative and also unique to their region. The results of this phase of the project will determine the next steps in the project and will be outlined.
3.Mindreading Abilities in Healthy Elderly
Andrea S. Piotrowski and Lorna S. Jakobson, Department of Psychology, University of Manitoba.
Abstract
Understanding mental states of others is integral to the establishment and maintenance of positive relationships between individuals (e.g., patients and caregivers). The ability to make inferences about the full range of mental states that cause action (beliefs, intentions, emotions, etc.) requires that one have a “Theory of Mind” (ToM; Premak & Woodruff, 1978). Whether or not this “mindreading” (mentalizing) ability is affected by healthy aging is not clear. In some research (Happé et al., 1998) ToM abilities were actually found to improve with age; this result, however, may have been related to participants’ level of education. After accounting for differences in cognitive ability, Maylor et al. (2002) found significant age-related deficits in performance on verbal and visual ToM tasks in individuals aged 75-89 compared to young adults. Age-related deficits have also been described when participants have had to make ToM judgments based on information provided in silent video clips (Slessor et al., 2007; Sullivan & Ruffman, 2004). These stimuli require the analysis of nonverbal cues signalling other people’s intentions, motivations, and beliefs that are present in natural social interactions (e.g., changes in facial expression or body posture). In these videos, participants viewed clips depicting common social situations and were asked to choose which of two presented words best described what the actor in the clip was thinking or feeling. The researchers demonstrated that young adults performed significantly better than healthy elderly even after controlling for fluid and crystallized intelligence. It was suggested that the poor performance of the healthy elderly participants in their study, however, appeared to reflect a general impairment in decoding cues rather than a specific problem with ToM. In the current study, we examined the impact of healthy aging on participants’ ToM abilities. Young adults (n=14) and healthy elderly participants (n=14), matched in education level, Mini Mental State Examination scores, WAIS-III Vocabulary (crystallized intelligence), and visual memory viewed silent video clips depicting two or more people in a social situation and then answered questions designed to assess (a) their visual memory, and (b) their ability to infer second-order false beliefs (a sophisticated ToM skill). Young adults outperformed healthy elderly participants on this task, F(1,24) = 11.55, p = .002, η2 = .325, even after controlling for group differences in performance on the Token Test and in WAIS-III Digit Symbol-Coding (a measure of fluid intelligence and processing speed that requires visual working memory). Possible reasons for this group difference are discussed, along with suggestions for future research examining the effects of healthy and pathological aging on mindreading skills.
4.Effects of Ankle Power Training on Movement Time, Reaction Time, Strength and Power in Older Women
Sandra Webber, Department of Physiology, University of Manitoba.
Abstract
Power declines earlier and to a greater extent than strength with age. Loss of muscle power is associated with declining function in older adults. Longer reaction times, coupled with a reduced ability to generate torque quickly, put older adults at risk in situations that demand fast movements. The purpose of this study was to compare the effects of two ankle power training programs (weight machines and bands) on movement time and secondarily, to look at the effects on reaction time, strength, and power. Fifty women, (70-88 years) with self-identified mobility limitations attended training sessions twice per week for 12 weeks after being randomized into one of three groups (Weights, Bands, Control). Movement time improved in the Weights group (14 ms faster, p = 0.04) and the Bands group (24 ms faster, p < 0.01). DF strength and power improved in all groups, with the greatest change occurring in the Weights group. Changes in PF strength and power were largely limited to the weight-trained subjects.
- Persistent Good Health as a Predictor of Later Self-Rated Health
Pascal Lambert, Madelyn Hall, & Barbara Payne, Faculty of Medicine, Department of Community Health Sciences, University of Manitoba
Abstract
Self-ratings of health have been found to be a reliable predictor of both morbidity and mortality in older adults. This study investigated“persistent good health” (PGH), defined here as the same ‘good’ or ‘excellent’ self-rating of health over two or more consecutive interview waves of the Aging in Manitoba study (AIM). The objective was to examine predictors of self-rated health after controlling for PGH. A regression model included variables of function, health, demographics, leisure activities and socioeconomic status from 3 waves of data (1990, 1996, and 2001) from 582 older adults. A lagged variable of self-rated health was included to control for PGH throughout all three waves. Results indicated that past self-rated health was highly predictive of current self-rated health (OR = 2.39, p < .0001). In addition, good or excellent self-rated health was predicted by factors such as having a lower number of chronic conditions (OR = 2.70, p < .0001), greater functional health (OR = 1.57, p < .01; OR = 1.36, p < .05; for ADL and IADL respectively), and participating in more leisure activities (OR = 1.76, p < .0001). Implications for future research using PGH are discussed.
- Staying Well in Later Life: Patterns and Predictors of Persistent Good Health
Barbara Payne, Pascal Lambert, Madelyn Hall, Faculty of Medicine, Department of Community Health Sciences, University of Manitoba.
Abstract
Persistent good health (PGH) is a label that has emerged from ongoing discussions and workshops with colleagues, policy makers and the lay public in efforts to gain a better understanding of what it means to ‘always be well’. Here we explore the prevalence and predictors of the concept, persistent good health, defined as the same ‘good’ or ‘excellent’ self-rating of health over two or more consecutive interview waves of the Aging in Manitoba study (AIM). AIM is a unique 30-year population based longitudinal study of aging. Only those participants with complete data from 1983, 1990, and 1996 and 2001 waves were included in these analyses (n=582). In total, 16 occurrences of PGH patters were identified and included consistency of high ratings over two (8), three (3) or four (1) waves of data. Predictors of the various patterns varied according to the pattern and time period examined. Future research employing the PGH concept to predict self-reported successful aging, health services utilization, homecare and nursing home use, and death, will be discussed along with the applications of the measure in clinical settings.
7.Relationship Between Socioeconomic Status and Psychotropic Drug Use Among the Elderly: A Review of Literature
B. Songul, Department of Community Health Sciences, University of Manitoba; J. Mignone, Department of Family Social Sciences, University of Manitoba; A.L. Kozyrskyj, Department of Community Health Sciences, University of Manitoba.
Abstract
The purpose of this literature review was to provide an updated review of the empirical evidence of the association between psychotropic drug use among the elderly and SES. Each article was examined for its purpose, methods, measures of SES and medication employed, findings, and limitations.
Most studies were conducted in community settings in Canada and the USA. There were methodological differences among the reviewed studies such as sources of data, SES and medications measures employed. High use of psychotropic drug among the elderly was associated with certain SES characteristics in the majority of studies: female, white, low education level, being widow in men and divorced in women, having been blue collar workers before retirement, poor health perception and low income. Notwithstanding the above mentioned evidence, some studies demonstrated there were no significant differences by gender, marital status and education.
High psychotropic drug use among the elderly is not only influenced by symptoms but also by low SES among the elderly population. Nonetheless, more research is needed to better identify the relationship between SES and psychotropic drug use among the elderly.
8.Differential Effects of Aging on a Visuomotor Paradigm
Lee A. Baugh and Jonathan J. Marotta, Perception and Action Lab, Department of Psychology, University of Manitoba.
Abstract
Objectives.The present study describes the use of a viewing window paradigm to examine the effects of aging in a complex visuomotor adaptation scenario. The natural process of aging has been shown to have detrimental effects on the ability to synthesize cross-modal information (a requirement in visuomotor transformations), but an in-depth examination using complex, realistic, goal driven tasks has yet to be performed. Method. Two groups of participants, a young adult control group (Age: 18-25) and an older adult group (Age: 60-80) completed a viewing window task that was controlled by the user via a touch screen. Four visuomotor “flip” conditions were created by varying the relationship between the participant’s movement, and the resultant on-screen movement of the viewing window: 1) No flip 2) X-Axis and Y-Axis body movements resulted in the opposite direction of movement of the viewing window. In each of the 3) Flip-X and 4) Flip-Y conditions, the solitary X- or Y-axes were reversed. Response times (ms) and movement of the window (represented by a series of x-axis and y-axis coordinates) were recorded. Results. A significant main effect of aging was found (p < .05), with the older participants requiring more scanning of the image than the younger control subjects to correctly identify it. Additionally, a Flip by Age interaction effect was observed, with the older participants demonstrating much higher scanning times during all of the visuomotor flip conditions. Examining the complexity of scan-paths revealed the aged participants had considerable difficulty in adapting to all of the flip conditions, and a tendency to revisit regions of the image previously explored. Conclusions. The present study demonstrates that task performance in viewing window paradigm decreases as part of the natural aging process. Not only did our aged participants require significantly more time scanning the presented object to identify it, but they also were differentially affected by the requirement of a visuomotor flip. Qualitative examination of scan-path revealed the aged participants demonstrated a repetition not seen in the younger controls. The results provide additional evidence that the mechanisms involved in visuomotor transformation are negatively affected by age.
9.Older Adults’ Helpseeking Attitudes and Treatment Beliefs Concerning Mental Health Problems
Tiffany Scott, MA, Corey S. Mackenzie, PhD, Amber Mather, BA, Jitender Sareen, MD, Department of Psychology, University of Manitoba.
Abstract
Objectives. Older adults with mental health problems are especially unlikely to seek professional mental health services. It is not clear, however, whether their helpseeking attitudes and treatment beliefs contribute to this problem. The objectives of this study were to compare older adults’ attitudes and beliefs to younger adults’ and to examine the influence of age on these variables after controlling for other demographic variables, prior helpseeking, and mental disorders. Methods. We analyzed cross-sectional data from part II of the National Comorbidity Survey Replication, consisting of 5,692 community-dwelling adults 18 years of age and older. Participants responded to three questions assessing attitudes toward seeking professional mental health services and one question examining beliefs about the percentage of people with serious mental health concerns who benefit from professional help. We used logistic regression to predict positive versus negative attitudes and beliefs from age, gender, education, and race/ethnicity, as well as prior helpseeking and mood and/or anxiety disorder diagnosis. Results. Overall, more than 80% of participants exhibited positive helpseeking attitudes and more than 70% reported positive treatment beliefs. In contrast to the modest effect of age on beliefs, adults 55 to 74 years of age were more than twice as likely to report positive helpseeking attitudes as younger adults. Conclusion. Older adults’ positive attitudes and treatment beliefs are unlikely barriers to their use of mental health services. This finding, which is consistent with recent positive views of aging, suggests that enabling resources and need factors are more likely explanations for older adults’ low rates of mental health service use.
10.The Personal Care Home Door Swings Both Ways: The Experience of Older Women Whose Spouses are in Personal Care
Colette D. Pancoe, Faculty of Social Work, University of Manitoba.
Abstract
This research project is a work in progress intending to serve as partial requirement for a Master’s Degree in Social Work. This exploratory research project aims to use a socialist feminist theoretical basis and feminist narrative qualitative methodology based on semi-structured one-on-one interviews. The central question to this research is: What are the experiences of older women whose spouses have been admitted to a personal care home in Winnipeg, Manitoba, in the past 1-9 months? The research objectives are: 1) to explore how personal care home placement of husbands affects their wives’ formal support systems consisting of the PCH, community-based health and social services, finances, banking, housing and transportation. 2) to explore how personal care home placement of husbands affects their wives’ informal support systems (consisting of the spousal relationship, other (non-spousal) family, friends and neighbours). 3) to explore the formal and informal support system needs of older wives whose husbands have been placed in a personal care home. The proposed research would begin to address a gap in the academic dialogue, as well as in policy and in social work practice about how formal and informal support structures impact older women whose spouses have relocated to a personal care facility.
- Seniors’ Contributions to Manitoba
Shari Fournier, Verena Menec, PhD, Centre on Aging, University of Manitoba.
Abstract
Seniors are often perceived as the recipients of services. The purpose of this study was to determine seniors’ contributions across multiple domains, focusing specifically on seniors in Manitoba. Data sources included: the National Survey of Giving, Volunteering and Participating; the General Social Survey Cycle 17 – Social Engagement; and, the Survey of Household Spending.
In 2001, there were 157,191 Manitobans aged 65 and over. Among other findings, the data showed that 7% were actively employed, two thirds of whom worked full time. In 2000, 32% spent nearly 8.8 million hours in volunteer activities, and 83% gave charitable donations totalling nearly $67.5 million, which was more money per capita than any other age group in the province. In 2003, 88% were politically active in some way including voting, attending public meetings, signing petitions, and expressing views by contacting a newspaper or politician. In that year, nearly one-fifth of Manitoba’s voters were seniors.