ABSTRACT
BACKGROUND/AIM: The age-friendly community movement is a community-level approach to promoting seniors' health that has yet to be thoroughly examined from an occupational perspective. Through the application of the Canadian Practice Process Framework to an age-friendly consultation process, the authors examined how age-friendly community consultations may provide strategies for occupational therapists to strengthen their work with communities. METHODS: A consultation with a rural Canadian community was guided by the Age-Friendly Rural/Remote Communities Initiative. Focus groups were held with 35 older adults to identify age-friendly features of the community. Twenty key informants who provide services to seniors were also interviewed individually. Following the community consultation, we examined the relationship between the age-friendly community consultation process and occupational therapy community development practice processes using the Canadian Practice Process Framework. RESULTS: The steps of the consultation process paralleled the occupational therapy practice process, with occupational issues implicitly identified in the age-friendly consultation. The age-friendly consultation process emphasised the importance of collaborative partnerships and the need for occupational therapists to adopt a facilitative rather than leadership role. Skills that enable occupation were used throughout this age-friendly consultation. CONCLUSIONS: The study suggests that the process of this age-friendly community consultation has relevance to occupational therapy theory and practice, and can provide a useful framework for collaborative consultative processes when working with communities.
Subject(s)
Activities of Daily Living , Independent Living/standards , Occupational Therapy/organization & administration , Professional-Patient Relations , Aged , Communication , Community Participation/methods , Environment Design/standards , Female , Focus Groups , Humans , Information Dissemination , Interviews as Topic , Male , Middle Aged , Models, Organizational , Nova Scotia , Occupational Therapy/methods , Occupational Therapy/standards , Program Development , Program Evaluation , Qualitative Research , Rural PopulationSubject(s)
Caregivers , Aged , Caregivers/economics , Caregivers/psychology , Family Relations , Health Services for the Aged , Home Health Aides , Humans , North AmericaSubject(s)
Patient Care Team , Patient-Centered Care , Residential Facilities , Female , Humans , MaleABSTRACT
Nursing home care is subsidized in all Canadian provinces, but residents must personally contribute to the cost. This paper explores policy issues that have led to differences in costs of nursing home care among provinces, and how policy and cost differences influence the experiences of married couples when one spouse requires nursing home care. The paper is based on a multiple-case study of three Canadian provinces, each of which had a different system for determining personal contributions to the cost of care. Cross-case analysis of payment systems showed that provinces addressed three main policy issues in determining the cost of care: (a) what costs should be the responsibility of nursing home residents, (b) how subsidies should be determined and (c) how community-dwelling spouses of nursing home residents should be assured of an adequate income. In provinces with policies that resulted in higher care costs to couples and lower amounts of income and assets available to the community-dwelling spouses, study participants described reduced discretionary spending, increased financial concerns and perceptions of system unfairness. This paper discusses the implications of these three policy issues and recent related changes to provincial policies.
