The Older, the Happier?: A Cross-Sectional Study on the "Paradox of Aging" in China.

The "paradox of aging" refers to the phenomenon that even though people's physical health and functions may decline when they enter later adulthood, their happiness does not necessarily. Previous studies have shown that older adults' better emotional regulation skills may contribute to the maintenance of their happiness. This study aims to examine the relationship between age, health, and happiness, and the moderating role of emotional stability.

Caregiver Experiences Across Three Neurodegenerative Diseases: Alzheimer's, Parkinson's, and Parkinson's With Dementia.

Objective: This article asks whether distinct caregiver experiences of Alzheimer's disease (AD), Parkinson's disease (PD), and Parkinson's disease with dementia (PDD) spouses are accounted for by disease diagnosis or by a unique combination of symptoms, demands, support, and quality of life (QOL) cross disease groups.

Method: One hundred five live-in spouse caregivers (71.4 ± 7 years) were surveyed for persons with AD (39%), PD (41%), and PDD (20%).

Accuracy of Caregiver Proxy Reports of Home Care Service Use.

Although much of the research on service use by older adults with dementia relies on proxy reports by informal caregivers, little research assesses the accuracy of these reports, and that which does exist, does not focus on home care services. This brief report compares proxy reports by family caregivers to those with dementia with provincial Ministry of Health records collected for payment and monitoring. The four home care services examined include home nursing care, adult day care, home support, and respite care.

Cognitive functioning, cognitive reserve, and residential care placement in patients with Alzheimer's and related dementias.

Objective: To test the hypothesis that patients with mild to moderate dementia with higher initial cognitive reserve (higher education levels exhibit faster cognitive decline at later stages of disease progression as they approach residential care (RC) placement.

Method: Two provincial administrative databases were used. One contained individuals' scores of cognitive functioning (assessed at 6- to 12-month intervals using the Standardized Mini-Mental State Examination, SMMSE, 2007-2014) and education level; the second (BC Ministry of Health Home and Community Care database, 2001-2014) contained individuals' RC placement; N = 10531.

Cholinesterase Inhibitor Utilization: The Impact of Provincial Drug Policy on Discontinuation.

Background: In October 2007, British Columbia started to cover the cost of cholinesterase inhibitors (ChEIs)-donepezil, galantamine, and rivastigmine-for patients with mild to moderate dementia and prominent Alzheimer's disease.

Objectives: To examine the impact of this policy on persistence with ChEIs.

Methods: A population-based cohort study was conducted using British Columbia administrative health data.

A More Nuanced Discussion Required.

Williams and colleagues make a valuable contribution to the home care policy literature, however, their arguments are not always convincing. Missing is a more nuanced discussion of research showing that even when governments provide more supportive services for older adults, families continue to provide care, and a discussion of alternative forms of caring that may arise in the future such as care from siblings and non-married older adults helping one another. Drawing on research pointing to several countries that offer caregivers a range of services would also have been helpful.

Family Involvement in Nursing Homes: Are Family Caregivers Getting What They Want?

The provision of person-centered care for nursing home residents with dementia suggests the need for family caregiver involvement. In this article, we argue that optimal family involvement differs by family caregiver and therefore depends on the degree to which family caregivers consider their own involvement to be important. In this Canadian study, we compare the importance that 135 family caregivers of residents with dementia place on 20 kinds of involvement with the degree to which they perceive opportunities for involvement.

Relationship and stage of dementia differences in caregiver perspectives on the meaning of activity.

Caregivers of persons living with dementia (PWD) taking cholinesterase inhibitors, who care 3 + h over three days/week, were interviewed. This study uses thematic content analysis to compare responses to the open-ended question " What do you believe getting involved in activities outside the home means for someone with dementia?" in spouse ( n = 613) and adult-children ( n = 260) caregivers, and across mild ( n = 314) and moderate-severe stages ( n = 280). For adult-children caregivers, activity participation promotes independence in their parents.

Meaningful activity for persons with dementia: family caregiver perspectives.

Dementia threatens the capacity to engage in activity, suggesting meaningful activity may be helpful for persons with dementia (PWDs). This study explores the concept of meaningful activity, as defined by caregivers of PWDs. Family caregivers of PWDs, who provide 3 hours of care over 3 days/week, were interviewed after 6 months of cholinesterase inhibitors (ChEIs) therapy.

Caregiver Well-Being: Intersections of Relationship and Gender.

We know much about caregiving women compared with caregiving men and caregiving spouses compared with caregiving adult children. We know less about the intersections of relationship and gender. This article explores this intersection through the well-being (burden and self-esteem) of caregivers to family members with dementia.

Relocation and Social Support Among Older Adults in Rural China.

Objectives: China's economic reforms have led to millions of citizens being relocated to support infrastructure development, reduce poverty, and address ecological, disaster-related and other concerns. This study expands on previous research on the implications of relocation in China by examining the impact of rural elders' relocation on the perceived availability of emotional, instrumental, and financial support.

Methods: Data were drawn from the Ankang Study of Aging and Health conducted with a representative sample of 1,062 rural residents aged 60 and over living in Ankang, China.

Spouse and adult child differences in caregiving burden.

This study compared the correlates of burden for spouse and adult child caregivers at two points in time and assessed whether correlates at T(1) predicted burden at T(2). The sample consisted of 878 caregivers to older adults throughout British Columbia who were prescribed cholinesterase inhibitors. Burden was measured six months after the older adult was prescribed the medication and one year later (n = 759).

Change and predictors of change in social skills of nursing home residents with dementia.

Background: Social skills are of primary importance for those with dementia and their care providers, yet we know little about the extent to which basic social skills can be maintained over time and the predictors of change.

Methods: A total of 18 nursing homes with 149 newly admitted residents with moderate to severe dementia, 195 direct care staff, and 135 family members, in British Columbia, Canada, contributed data on change in social skills from admission to 6 months and 1 year later.

Results: Three-quarters of residents maintained or improved their basic social skills during both the time periods.

The conceptualization and measurement of individualized care.

Individualized nursing care, a form of person-centered care delivery, is accepted as best practice, yet its implementation into actual care is far from complete. Appropriate measures of this elusive concept are needed to better understand barriers to implementation. This study explored and tested the convergent validity and the reliability of 2 individualized nursing care measures.

Filial caregivers; diasporic Chinese compared with homeland and hostland caregivers.

This paper examines the distinctiveness and similarities of diasporic Chinese Canadian caregivers to older adults compared with Hong Kong Chinese and Caucasian Canadian caregivers. Particular interest lies in whether filial responsibility, actual caregiving behaviours, health and a variety of structural characteristics cluster in ways that suggest these three groups of filial caregivers are distinctive. Data were collected using face-to-face interviews.

Aging and late-life depression.

Objectives: The objective of this study is to examine the relationship between age and depression among people aged 65 and older.

Method: The study uses three waves of longitudinal data (1991, 1996, 2001) from a community and institutional sample of Canadians aged 65 and older. The study uses generalized linear mixed-model techniques to estimate the trajectories of depressive symptoms and major depression in late life.

Social support, caregiving, and aging.

This article reviews the international English-language literature on social support and caregiving in gerontology since the early 1990s. The literature has grown, but consensus on the terms' meaning and measurement is lacking. Interest is ongoing in practical help, in benefits of social support, and in demands and negative outcomes for caregivers, with growing but less emphasis on more theoretical questions, on negative outcomes from the receipt of support, and on positive consequences of providing care.

An evidence-based policy prescription for an aging population.

In this paper, the authors provide a policy prescription for Canada's aging population. They question the appropriateness of predictions about the lack of sustainability of our healthcare system. The authors note that aging per se will only have a modest impact on future healthcare costs, and that other factors such as increased medical interventions, changes in technology and increases in overall service use will be the main cost drivers.

Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time.

This study examines the three facets of psychological resilience (i.e., perceived control, commitment to living, challenge versus stability) as predictors of depressive symptoms over time among spousal caregivers of persons with Alzheimer disease; these resilience factors were considered over and above dementia-related and socio-demographic control variables.

Caregivers--who copes how?

Within gerontological caregiving research, there is a major emphasis on stresses and burdens of this role. Yet there has been little attention directed toward the coping strategies that caregivers engage in to cope with this role and the factors that influence their adoption of different coping strategies. This article examines coping strategies and change in coping strategy over a 1-year period.

Measurement and analysis of individualized care inventory responses comparing long-term care nurses and care aides.

Purpose: Motivating and enabling formal caregivers to provide individualized resident care has become an increasingly important objective in long-term care (LTC) facilities. The current study set out to examine the structure of responses to the individualized care inventory (ICI).

Design And Methods: Samples of 242 registered nurses (RNs)/licensed practical nurses (LPNs) and 326 care aides were recruited from 54 LTC facilities in 3 of 5 British Columbia health authorities.

Increasing value for money in the Canadian healthcare system: new findings and the case for integrated care for seniors.

Given the recent economic climate and increasing costs in the Canadian healthcare system, we must ensure that we are getting the best value for money possible. This article presents new findings and a broad weight of evidence to make the case that it is possible to obtain better value for money in our healthcare system by adopting models of integrated care delivery for seniors and others with ongoing care needs.

Caregiving: predicting at-risk status.

Despite the focus on burden of caregiving in gerontological research, studies have shown that few caregivers are overly burdened. This article compares predictors of role-specific burden and two quality-of-life measures among caregivers experiencing heavy care demands to assess role-impact on each. The study included 92 community-based caregivers on Vancouver Island.