The population of older adults has grown rapidly in recent years and is expected to continue to grow into the middle of this century. The aging of the population means that nurses need to have specialized gerontological knowledge in order to properly care for older adults. In spite of the current need for specialists in this field, gerontological nursing is not a popular choice and nurses often lack adequate preparation to care for older adults. The complex reasons behind these issues are rooted in the history of the development of this specialty. This study takes a historical look at the development of gerontological nursing in British Columbia through the stories of seven nurse educators who were leaders and innovators in their field. The findings of the study tell a story of the nurses’ work to change unacceptable nursing practice, improve standards of care and professional status of gerontological nursing and advocate for older adults. In doing so, these nurses challenged cultural values about aging and care of older adults and worked toward giving gerontological nurses a voice in policy and decision-making. The findings from this study can be used to guide today’s gerontological nurses as they continue to develop this specialized field of nursing knowledge.

This dissertation examines the potential for professional/community planning to respond pro-actively and strategically to the impending demographic changes which will be brought about by the aging of the baby boom generation. This multi-phased investigation was designed to explore whether professional planning could uncover models and concepts which can be used to make cities and communities more age-friendly. Several conclusions can be drawn from the study. It was found that planners are not ready for demographic change nor are they prepared for helping create age-friendly cities. This is due to several reasons, including a lack of resources forcing them to concentrate on short-term, immediate issues; lack of power and credibility; and a perception that the elderly are a lower priority in society. For planners to become proactive and strategic in planning for age-friendly cities, they will need to re-examine their tendency to focus mainly on land use planning; focus on the long-term agenda; establish credibility with politicians; develop visionary skills; and become educators and facilitators, engaging key stakeholders and community groups. The data indicated that planners have a limited knowledge of gerontology. However, a high level of congruence was found between the newer planning models and key research dimensions in gerontology. If these two fields were to work closer together, each would become better equipped to produce knowledge which will help society deal with aging demographics. Evidence also showed congruence between the newer planning models, building age-friendly cities and the environmental agenda. Common factors such as urban intensification (particularly in the core), building more compact urban form and increasing multi-modal transportation options (including pedestrianism) help reduce sprawl, congestion and pollution and concomitantly help create an environment which is healthier and friendly to all ages, including seniors. Findings from this research are used to develop a hybrid “Wise Growth” planning model to encourage the development of age-friendly cities.

<p> The purpose of this project was to create a curriculum for adults over age 50 who are searching for employment. Older adults are more likely to be unemployed longer after a job loss, need to return to work after retirement, need health insurance or need to supplement their retirement income. They may desire social interaction, and/or need a sense of meaning in their lives that being employed can provide. Older adults are more likely to experience lower self-esteem and isolation than younger adults. This curriculum includes a focus on identifying and strengthening internal and external strategies and support systems for adults over 50 who are looking for employment.</p><p> This curriculum incorporates modules on the job search process, coping with stress, identifying transferable skills, resume creation, building computer skills including online professional networks, interviewing, and networking. It is hoped this curriculum will provide older adults with the skills and strategies to build greater confidence and secure employment that meets their unique needs to enhance their quality of life.</p>

<p> The population structure of the United States is changing; the older age group is increasing in size relative to the younger generation. The trend is expected to continue, especially starting in 2020, when the baby boomer population&mdash;estimated at 80 million&mdash;will be reaching their 65^th birthday, a time associated with increasing health complications, including depression and dementia. The study employed a holistic paradigm as the conceptual framework to examine the association between depression and dementia in older adults, and generated a grounded theory to illuminate the relationship between depression and dementia. This theory was then used to assess the efficacy of stimulation, a nurturing environment, and treatment provided by an adult day health care (ADHC) in ameliorating the symptoms and progression of both dementia and depression. The sample consisted of 60 clients from a California ADHC center who were diagnosed with depression and dementia and who had received at least 6 months of services at the center. Paired <i> t</i> tests tested the validity of the hypotheses on depression among older adults and its correlation with their cognitive abilities. The results of paired <i>t</i> tests indicated a significant reduction in the client's level of depression between the time of their admission and the time of their reassessment 6 months later. This study can provide data for the larger social change discussion as to what resources should be allocated to meet the quickly escalating health, economic, and humanitarian pressures of the baby boom cohort.</p>

The terms "public" and "private" are useful in describing the extremes ot human experience. Unfortunately, actual human experience is more complex than a simple dichotomy can convey. Are we public or private when making a telephone call from a phone booth. Neither? Both? A more apt model is that of a matrix of public and private experiences and spaces. At home watching television, we may be in a private space, but the experience has public overtones in that it is simultaneously shared by others. In a religious ceremony, on the other hand, we have private experiences, even when surrounded by others in a public space. Private experiences in public spaces are awkward for most of us. When the experience is mediated, however, it can take on positive qualities. Standing on line in a cafeteria (alone in a crowd) should be uncomfortable, but that feeling is mitigated by movement along a sequence of thresholds, gradations of space, and events. Despite initial discomfort, we become more comfortable in a communal experience. This project applies these ideas to a program at the scale of a community, in this case, a retirement community. For most people, the move into a retirement community is dreaded as representing a loss of freedom and individuality. This thesis's strategies of mediation attempt to mitigate the anxieties of a new environment, while still offering a varied and vital place for living.

The current study utilizes a life course approach in its exploration of the connection between life stage and psychological well-being, within the context of cancer caregivers. Further the study explores this connection in light of four possible mediating unmet needs factors that is unmet work or financial needs, unmet health care needs, unmet information needs and unmet future concerns needs as well as the extent to which these factors differ within each group. The study utilizes data from The Cancer Support Person’s Unmet Needs Survey (SPUNS) conducted by Campbell et al. in which a random, stratified sample of 1128 cancer survivors and their immediate caregivers, selected from the Cancercare Manitoba Cancer Registry, were surveyed (2009). The sample for the current study included 789 support persons selected for the study by the survivor for whom they cared. The study revealed that caregivers in midlife exhibited higher levels of unmet needs in work/ financial as well as future concerns life aspects. It is the expectation that the results of this study will enable practitioners to better support and fill the needs of caregivers allowing for improved quality of life and quality of care.

Abstract Objectives: This study aimed to investigate the number of food stores (FS) within 500m, 1000m and 1500m of Region of Waterloo schools and describe them by type: full-service restaurants, fast food restaurants, supermarket and convenience stores; and then by elementary and secondary school levels. In addition, the associations among FS counts, median family income for the school neighbourhoods and school level academic performance were also examined. Methods: Data for 2008 and 2010 on food stores, school addresses and school results on provincial academic tests (EQAO) were obtained from publicly available information (Region of Waterloo food inspection premises data; Waterloo Region District School Board and Waterloo Catholic District School Board; and Ontario’s Education Quality and Accountability Office (EQAO) as well as the Fraser Institute, respectively). The 2006 Statistics Canada census data on median household income for Dissemination Areas surrounding schools was used as the proxy for income. Food stores were classified into the four store types based on the North American Industry Classification System (NAICS). The ArcGIS program was used to geocode the addresses of food stores and schools in the Region of Waterloo. It was also used to create the buffer zones (500m, 1000m and 1500m) around schools and to calculate the number of food stores within each buffer. In addition, multiple linear regression and logistic regression were used to explore the associations between food store counts to school neighbourhood income and school level academic performance indicators. School neighbourhood family income, parent education, students’ competency in English and population density were considered as study covariates. Results: From 2008 to 2010, the number food stores of all types increased in the Region of Waterloo as a whole. However, within the three buffer zones (500m, 1000m and 1500m), while the number of full-service restaurants, convenience stores and total stores were higher in 2010 than in 2008, food store counts of fast food restaurants and supermarkets were not always higher in 2010 compared to 2008. Nevertheless, of all food story types, the counts were highest for fast food restaurants in both years (2008 and 2010) and at all buffer zones around schools (500m, 1000m and 1500m) as well as for the Region of Waterloo as a whole. In addition, negative associations were found between fast food restaurant, convenience store and total store counts and school neighbourhood family income. Furthermore, these associations remained robust even after controlling for population density. Regarding food store counts and students’ academic performance, most of the significant associations were negative and were found for supermarkets, convenience stores and total store, with more significant associations in 2010 than in 2008. Most of the significant associations were found for elementary schools and when EQAO scores were treated as continuous versus binary variables. Interestingly, Grade 3 EQAO scores tended to be associated with supermarket and total store counts, whereas Grade 6 EQAO scores tended to be associated with convenience store and total store counts. Although several associations became insignificant after adjusting for study covariates (school neighbourhood family income, parent education and students’ competency in English), many significant associations remained and followed the trends observed before controlling for the covariates. Implications for practice: The totality of evidence from the current study suggests that the number of food stores around a school has a relationship to academic performance even when key factors such as neighbourhood family income and parental education are considered. If such associations were confirmed and explained through further research, there would be potential policy implications, for example, regarding zoning of food stores around schools and school practices.

Studies of long-acting benzodiazepines (LABZ) use in elderly patients found an increased risk of deterioration in cognitive function, falls, hip fractures and car accidents. The purpose of this study was to identify the characteristics of physicians who prescribe LABZ to elderly patients. French language, increased number of years since medical school graduation, training as a general practitioner, physician gender and practice in a long-term care setting were risk factors for excessive prescribing of LABZ. Differences were also noted between the various provincial medical schools. University affiliation was associated with a decreased risk of being an excessive prescriber of LABZ. / Reduction of the amount of LABZ prescribed and drug-related illnesses will depend on the identification of potentially modifiable physician risk factors.

The primary purpose of this study was to explore the concepts of health and learning in the McGill Model of Nursing by examining the relationships between sense of coherence, self-directed continuing learning, and psychological well-being in a sample of white, middle class, English-speaking, elderly adults in a large, urban, long-term care residence. The secondary purpose was to contribute to the testing of the measurement instruments for use in studies with older adults. A quantitative, nondirectional, correlational design, using a sample of convenience, found a high positive correlation between sense of coherence and psychological well-being and a moderate positive correlation between sense of coherence and self-directed continuing learning. The results lend support to the relationship between health and learning in the McGill Model of Nursing and to the relevance of the model to gerontological nursing in long-term care. Further research is required to examine the relationship in other elderly populations.

As people age, they are increasingly likely to develop health problems that can lead to an impaired ability to perform essential activities of daily living (ADL). This decrease in functional ability may then result in an increased need for physical assistance which, in turn, may not be met. There has been little research on unmet need in the elderly and its association with psychological distress. This research used data from the Montreal Unmet Needs Study, a prospective cohort study of 576 women and 263 men designed to investigate self-reported unmet need for community-based services among the Montreal elderly aged 75 and older. Information on psychological distress and unmet need was obtained by self-report during in-depth face-to-face interviews at baseline, and again twelve months later. Interview information was supplemented with data provided by RAMQ and MEDECHO government databases. Multivariable linear and logistic regression models were used to investigate the associations between unmet need and psychological distress, and to determine the conjoint effect of both these factors on emergency department (ED) visits within the six months following the baseline interview. All analyses were stratified by sex. For elderly women, unmet need at baseline predicated increased psychological distress one year later. Conversely, psychological distress was not found to predict the development of any unmet need one year later. Both unmet need in IADL and increased psychological distress at baseline were found to be independent predictors of an increased likelihood of elderly women visiting an ED. For elderly men, unmet need was not found to be associated with psychological di / À mesure qu'ils vieillissent, les gens ont de plus en plus tendance à développer des problèmes de santé susceptibles de causer une dégradation de leurs capacités à effectuer des activités essentielles de la vie quotidienne (Activities of Daily Living). Cette diminution des capacités fonctionnelles peut entraîner une augmentation des besoins d'aide physique, qui à leur tour, ne peuvent toujours être comblés pour autant. Peu de recherches ont été menées sur les besoins non comblés des personnes âgées et leur relation avec la détresse psychologique. La recherche s'est appuyée sur les données de l'étude prospective de cohorte Montreal Unmet Needs Study à laquelle ont participé 576 femmes et 263 hommes et dont l'objectif consistait à étudier les besoins non comblés auto-déclarés en matière de services communautaires chez les personnes âgées de 75 ans et plus à Montréal. Les renseignements relatifs à la détresse psychologique et aux besoins non comblés ont été obtenus par auto-évaluation pendant les entrevues personnelles initiales au temps zéro et celles qui ont eu lieu douze mois plus tard. Les renseignements obtenus pendant les entrevues ont été complétés par de l'information provenant des bases de données gouvernementales de la RAMQ et MEDECHO. Les chercheurs ont utilisé les modèles de régression linéaire multivariable et de régression logistique pour étudier les corrélations entre les besoins non comblés et la détresse psychologique et pour déterminer l'effet conjoint de ces deux facteurs sur les visites au service des urgences pendant les six mois suivant les entrevues au temps zéro. Toutes les analyses ont ét