Recommendations Related to Visitor and Movement Restrictions in Long-Term Care and Retirement Homes in Ontario during the COVID-19 Pandemic: Perspectives of Residents, Families, and Staff.

In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents' health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.

Not Just One Long Vacation: Revisiting the Importance of Lifestyle Planning in the Transition to Retirement.

BACKGROUND: There is a need to further understand the nature and role of planning for one's lifestyle in retirement. OBJECTIVE: The purpose of this study was to examine retirement planning and how it impacts perceived preparedness and satisfaction with the retirement transition, as well as to explore personal experiences of retirement. METHODS: Canadians (n = 748) fully or partly retired participated in an online survey that included quantitative questions about perceived retirement preparedness and satisfaction and open-ended questions about retirement goals, fears, challenges, and advice. FINDINGS: Results determined that while both financial and lifestyle planning were significant predictors of higher perceived preparedness, only lifestyle planning was a significant predictor for satisfaction. Overall, no gender differences were detected. Open-ended comments highlighted the importance of planning for one's lifestyle in retirement, including meaningful activities and social connections. DISCUSSION: Individualized career advising as well as group-based educational programs or peer-assisted learning initiatives appear warranted to support people in planning for their lifestyle in retirement.

[Les retraités au Canada : portrait comparatif selon le statut d'immigrant].

La retraite au Canada a fait l'objet de plusieurs recherches, mais peu d'études ont comparé le passage de la vie active à la retraite des natifs et des immigrants ainsi que leurs caractéristiques une fois à la retraite, une lacune importante compte tenu de l'augmentation de la part des immigrants parmi les futures cohortes canadiennes de retraités. Cette étude descriptive vise à pallier cette lacune à l'aide des données de l'Enquête sociale générale de 2016. Les résultats montrent, entre autres, que les femmes et les hommes natifs ont plus de chances de prendre leur retraite que les immigrants, quel que soit le groupe d'âge étudié, et que l'âge moyen à la retraite des femmes et hommes immigrants est de deux ans supérieur à celui des natifs. Cette étude suggère que le statut d'immigrant implique une transition vers la retraite différente de celle vécue par les natifs ; différence qui devrait être considérée dans la structure du système de revenus de retraite.

Trends in Partial Disability-Free Life Expectancy between the Ages of 45 and 70 in Canada, 2000-2014.

To better evaluate the benefits of a possible increase in the normal retirement age, this article proposes to examine recent trends in the health status of Canadians between 45 and 70 years of age. Using the Sullivan method, trends from 2000 to 2014 in partial disability-free life expectancy (PDFLE) between the ages of 45 and 70 years are computed. Disability is estimated using attributes of the Health Utility Index correlated with the capacity to work, and is looked at by level of severity. Data from the Canadian Community Health Survey were used to estimate the prevalence of disability. Results reveal a slight increase in partial life expectancy between the ages of 45 and 70, and a larger number of those years spent in poor health since the beginning of the 2000s. Hence, this study brings no evidence in support of the postponement of the normal retirement age if this policy were solely based on gains in life expectancy.

Providing Medical Care at the End of Life - A Cross-Sectional Study of Long-Term Care Facilities in Switzerland.

The provision of high-quality palliative care in nursing homes (NHs) requires specific knowledge and skills among health professionals. The aims of the study were to assess quality of care during the dying process and quality of end-of-life of NH residents in the French and Italian parts of Switzerland. 90 residents died during the study period (mean age 88.7 years). Mean of the "End-of-Life in Dementia Scales - Comfort Assessment while Dying" score was 35.7 (theoretical range 14-42). Mean of the "Quality of Dying in LongTerm Care" score was 38.3 (theoretical range 11-55). In conclusion, the quality of dying and quality of end-of-life care in NH studied can be improved improved, in particular on the anticipation level. Die Bereitstellung einer qualitativ hochwertigen Palliativversorgung in Pflegeheimen erfordert spezifische Fähigkeiten. Ziel der Studie war es, die Qualität der Sterbebegleitung von Bewohnern, die in der französisch- und italienischsprachigen Schweiz in Pflegeheimen sterben, zu bewerten. 90 Bewohner starben während der Studiendauer (Durchschnittsalter 88,7 Jahre). Der mittlere Wert der «End-of-Life in Dementia Scales - Comfort Assessment while Dying¼ lag bei 35,7 (theoretischer Bereich 14-42). Der Mittelwert der Skala «the Quality of Dying in LongTerm Care¼ lag bei 38,3 (theoretischer Bereich 11-55). Zusammenfassend lässt sich sagen, dass die Qualität der Versorgung am Lebensende in den untersuchten Pflegeheimen verbessert werden kann, insbesondere im Hinblick auf die Antizipation.

[Sexual abuse in elderly]. / Les violences sexuelles faites aux personnes âgées.

Seniors at home and in institutions can be victims of sexual abuse. Older women are more often victims than men. Sexual violence is often accompanied by physical violence and theft of property. More often than among the youngest, the crime is passed over in silence with the authorities. The consequences of the assault are serious, especially when there is cognitive impairment in the victim.

[Geriatric Psychiatry in Nursing Homes in the Canton Basel-Stadt - The View of General Practitioners]. / Die hausärztliche gerontopsychiatrische Versorgung in Stadtbasler Alters- und Pflegeheimen.

Geriatric Psychiatry in Nursing Homes in the Canton Basel-Stadt - The View of General Practitioners Abstract. Background: This cross-sectional study intends to examine the potential need for an outpatient geronto-psychiatric service and evaluates GPs' views of the frequency of psychiatric symptoms among residents of nursing homes in the canton of Basel-Stadt, Switzerland. Results: Nine out of ten (89 %) see a need for a geronto-psychiatric service. Two thirds (58,9 %) of them prefer a service available during office hours. GPs estimate that 63 % of their nursing home residents suffer from psychiatric symptoms (dementia in 60 %, depression in 23 %, sleep disorders in 11 %). Antipsychotics are prescribed most often (in 50,6 %). Discussion: GPs in the canton of Basel-Stadt see a need for an outpatient geronto-psychiatric service. Psychiatric symptoms are common among residents of nursing homes.

Retirement Expectations of Older Workers with Arthritis and Diabetes Compared with Those of Workers with No Chronic Diseases.

ABSTRACTWe know little about the retirement plans of adults with chronic diseases. This research recruited Canadian workers 50-67 years of age from a national panel of 80,000 individuals (arthritis, n = 631; diabetes, n = 286; both arthritis and diabetes, n = 111; no chronic disabling conditions, n = 538). A cross-sectional survey asked participants about their expected age of retirement, future work plans, whether they were retiring sooner than planned, and bridged retirement. Chi-square analyses, analyses of variance, and regression analyses examined expectations and factors associated with them. Despite health difficulties, workers with arthritis and diabetes had retirement plans similar to those of healthy controls and consistent with normative expectations of working to a traditional retirement age. However, more respondents with arthritis or diabetes reported bridged retirement than healthy controls. Contrary to predictions, health factors accounted for less of the variance in retirement expectations than other factors. These findings point to the complexity surrounding retirement expectations and highlight person-job fit rather than disease factors alone.

The Unbearable Lightness of Being Retired.

ABSTRACTIn this qualitative study, I followed an approach to examine perceptions about retirement, using an interview guide informed by the life course perspective, among 26 men and women who had retired from positions as chief executive officers. Three key themes emerged: (1) the importance of productivity and networking as participants rose up the corporate ladder; (2) the sense of having a "best before" date and experiencing societal pressures to retire; and (3) struggles with feeling insignificant in retirement while desiring personal fulfillment through continued engagement in paid work. These findings shed light on the value of using a life course perspective to examine retirement as both a personal experience and as a social phenomenon. Findings also contribute to theoretical understandings of productive aging by illustrating how preconceptions about productivity contrast with ideations of a leisure-filled retirement in ways that can foreshorten the employment contributions of some individuals.

[Advance Care Planning in Swiss Nursing Homes: Results of a Focus Group Study]. / Advance Care Planning in schweizerischen Alters- und Pflegeheimen: Ergebnisse einer Fokusgruppenstudie.

Advance Care Planning in Swiss Nursing Homes: Results of a Focus Group Study Abstract. Advance Care Planning (ACP) is a standardized consultation process in which patients define their therapy goals for future medical treatments with the help of a qualified health care facilitator. This way, ACP increases the probability that patients' wishes are fulfilled in case of decisional incapacity. The aim of this study was to implement a previously tested Swiss ACP program in two Swiss nursing homes to better understand the resulting processes, chances and difficulties. For this purpose focus group interviews were conducted after first implementation steps. The results show that an ACP implementation needs and must be coordinated with an approach covering the entire health system.

Retirement Transitions among Baby Boomers: Findings from an Online Qualitative Study.

ABSTRACTCanadian baby boomers began turning 65 - traditional retirement age - in 2011. How this generation perceives and experiences retirement may differ from preceding generations. In this online, grounded-theory study, 25 baby boomers who were approaching retirement or had recently retired participated in a multi-author blog about their retirement experiences and processes. We collected additional data via subsequent focus groups and participant interviews. Participants retired in several ways, including ceasing work, adopting casual or part-time work, and adopting new types of work. Findings highlighted three phases of the retirement transition: pre-retirement, characterized by both apprehension about retirement and idealization of the perfect retirement; the initial transition, which participants compared to an extended vacation, but in which they also struggled to adjust to increased amounts of free time; and mid-transition, when participants learned to balance structure and flexibility. Findings suggest that despite retirement transition challenges, many people have positive experiences with this transition.

Conceptual Models of Early and Involuntary Retirement among Canadian Registered Nurses and Allied Health Professionals.

ABSTRACTAvailability of health professionals is fundamental to population health. Multiple trends contribute to provider shortages. PURPOSE: Develop and validate conceptual models of early and involuntary retirement among registered nurses (RNs) and allied health professionals (AHPs). METHOD: A review of retirement literature (n = 23 studies). Any factor reported as predictive of early or involuntary retirement was incorporated into a model. To achieve face validity, we conducted interviews with Canadian RNs/AHPs (n = 14). RESULTS: The conceptual model of early retirement had eight categories (38 variables): workplace characteristics, socio-demographics, attitudes/beliefs, broader context, organizational factors, family, lifestyle/health, and work-related. The model of involuntary retirement had four categories (eight variables): broader context, socio-demographics, lifestyle/health, and family. Caregiving responsibilities (variable) was added based on interview data. DISCUSSION: RNs/AHPs consider many factors when contemplating retirement; some are sensitive to intercession, which generates possibilities for extending the work lives of older RNs and AHPs.

Gender and Relationship Status Interaction and Likelihood of Return to Work Post-Retirement.

Population aging is an issue of mounting importance throughout the industrialized world. Concerns over labour force shortages have led to policies that prolong working life. Accordingly, present-day workforce participation patterns of older individuals are extensively varied. This study utilized the 2007 General Social Survey to examine factors associated with post-retirement paid work, focusing on the interaction between gender and relationship status, among Canadians aged 50 to 74 who had retired at least once. We find that although being in a relationship is associated with a higher likelihood of post-retirement work for men, the opposite is true for women. Our findings suggest that the gendered association between relationship status and post-retirement work results partly from the gendered associations between relationship status and one's motivation for learning and community involvement, career orientation, and sense of independence. Gendered meanings of relationship status are thus revealed through analysis of post-retirement work.

Perceived Support and the Retirement Expectations of Sexual Minority Adults.

Despite the importance of retirement planning among an aging population, little is known about the retirement planning of sexual minority adults (e.g., gay, lesbian, bisexual) and their potentially unique challenges. We compared retirement planning perceptions of these adults with heterosexual adults and examined the potential role of social support. There were no significant differences between sexual minorities and heterosexual adults regarding their expected retirement age, certainty of retirement age, and anticipated income adequacy in retirement, and higher levels of perceived support were associated with younger anticipated retirement age and greater certainty in retirement planning perceptions. Perceived support also had a stronger association with retirement planning perceptions for sexual minority adults compared to heterosexuals, such that lower perceived support was associated with a later retirement age and less certainty about retirement age, and lower levels of perceived support were linked to diminished anticipated retirement income adequacy for sexual minority adults.

An Existential Perspective on Death Anxiety, Retirement, and Related Research Problems.

Aspects of existentialism relevant to existence and death anxiety (DA) are discussed. Included are the "thrownness" of existence, being-with-others, the motivational influence of inevitable death, the search for meaning, making the most of existence by taking responsibility for one's own life, and coping with existential isolation. The attempted separation of DA from object anxiety is a significant difficulty. The correlations among age, gender, and DA are variable. Personality and role-oriented problems in the transition to retirement are discussed along with Erikson's notion of "generativity" as an expression of the energy and purpose of mid-life. Furthermore, methodological and linguistic problems in DA research are considered. The article suggests qualitative methodologies as an interpersonal means of exploring DA within the contexts of psychotherapy and counselling.

Changes in Physical Activity and Function with Transition to Retirement Living: A Pilot Study.

This pilot study examined changes in physical activity and function among older adults moving from community dwellings to retirement living. Twelve community-dwelling older adults, recruited from the wait-lists of two retirement living facilities, were assessed prior to and following the transition to retirement living. Physical activity was assessed using an Actigraph (GT3X+) activity monitor; physical activity by type was reported with the CHAMPS activity questionnaire. Physical function was assessed using the Senior Fitness Test. Objectively monitored total physical activity decreased after the transition to retirement living (p = 0.02). Reports of physical activity by type indicated that only activities of daily living decreased (p < 0.01) although intentional exercise increased (p < 0.03) with the transition. Endurance and strength also improved (p < 0.05 and p < 0.04). Pilot results indicate that possible physical benefits accrue from retirement living, although efforts to reduce sedentary time are needed.

[Adapting physical activities for an active retirement]. / Adapter les activités physiques pour une retraite sportive.

The benefits of doing adapted physical exercise for elderly people have been proven. For more than thirty years, the French Federation for an Active Retirement has been striving to help people age well by proposing multiple activities to remain in good health after the age of 50. Doctors, activity leaders and federal instructors are attentive to each individual's capacities.

Retirement Policies and Support for Emergency Service Personnel: The Transition to Retirement.

The aim of this study was to explore policies and procedures to support employees who retire from the emergency services. Interviews were conducted with participants who were familiar with existing policies and procedures in a large ambulance (n = 8) and fire (n = 6) service in Ireland. Four key themes were identified: (1) "I don't think it's a job at 65 to be running out on an emergency ambulance"; (2) "They do genuinely feel a wee bit isolated"; (3) improving the "cultural shock"; and (4) "I just keep going and hope for the best". Findings point towards retirement as a major life change and highlight a need for more structured, effective pre-retirement preparation. Factors unique to emergency service personnel include the physical and emotional stress involved in emergency service; a strong identification with the service; and a lack of clarity about rules and entitlements, requiring better information and preparation.

[Living environment and activation of early maladaptive schemas specific to the elderly: Comparative study among 80 individuals]. / Milieu de vie et activation des schémas cognitifs dysfonctionnels au troisième âge : étude comparative réalisée chez 80 sujets âgés.

INTRODUCTION: Early maladaptive schemas described by Young may be identified in the elderly. They represent models and themes of emotions, memories, thoughts and bodily sensations experienced by the individual. This study aims to evaluate the activation of early maladaptive thoughts in the elderly depending on their living environment. METHODS: The Young Schema Questionnaire--short form--was administered to 80 elderly individuals (40 living in a nursing home, and 40 in their own home with at least one person). The studied schemas that were most relevant to the elderly were the maladaptive schemas of abandonment, emotional deprivation, mistrust, exclusion, dependency, vulnerability and emotional overcontrol. The Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale were administered to eliminate dementia or depression among individuals. RESULTS: Individuals living in a nursing home, compared to their controls had increased activation of schemas of emotional deprivation (22.5% vs. 7.5%), abandonment (15% vs. 0%), mistrust (32.5% vs. 2.5%), exclusion (7.5% vs. 0%), and emotional overcontrol (25% vs. 2.5%). The activation of maladaptive schemas was significantly elevated in nursing homes for those 5 schemas, while there was no difference in activation between the 2 groups concerning the schemas of dependency and vulnerability. DISCUSSION: The activation of early maladaptive schemas of emotional deprivation, abandonment, mistrust, exclusion, and emotional overcontrol is higher in individuals living in nursing homes compared to a control group of individuals living in their homes with at least one companion. This schema activation may be related to a lack of emotional and family support in the elderly.

Idosos e mulheres imigrantes à margem: o caso das badanti na Itália / Vieux et femmes immigrees en marge: le cas des "badanti" en Italie / Old persons and immigrated women marginalization: the case of "badanti" in Italy

Na Itália, há alguns anos, uma nova profissão nasceu como resposta adaptativa ao envelhecimento da população: a das badanti. Esse termo popular designa as mulheres imigrantes trabalhadoras no domicílio de pessoas idosas. Esse fenômeno de sociedade diz respeito a quatro milhões de pessoas, contando os assistidos e as trabalhadoras. Essas pessoas se encontram à margem da sociedade e são desconsideradas. A desqualificação é implícita, inscrita na própria denominação. Badanti vem do verbo "badare", que significa "vigiar de perto", "guardar": a empatia inscrita no termo "care" ou "ajuda" não está presente. Esse welfare feito em casa, que se revelou um recurso diante da carência de serviços públicos, fez explodir as numerosas contradições que constituirão o objeto de nossa análise. A crônica dos jornais diários sobre incidentes fez vir à tona delitos, abandonos e litígios no momento de heranças, e também contradições nos grupos intermediários. O sindicato, por exemplo, é levado a gerir as guerras entre pobres: as badanti e os idosos aposentados. Todavia, a contradição mais saliente se encontra no cerne da atividade. A profissão apresenta várias facetas e, ao lado da identificação da badante com o assistido, encontramos a humilhação e o ressentimento que resultam das condições de exercício da atividade: a "domesticidade" e a "servidão".(AU)

En Italie, depuis quelques années, un nouveau métier est né en tant que réponse adaptative au vieillissement de la population: celui des "badanti". Ce terme populaire désigne les femmes immigrées travaillant au domicile des personnes âgées. Ce phénomène de société concerne quatre millions de personnes, en comptant les assistés et les travailleuses. Ces personnes se trouvent en marge de la société et sont déconsidérées. La disqualification est implicite, inscrite dans la dénomination même. "Badanti" vient du verbe "badare", qui signifie "surveiller de près", "garder": l'empathie inscrite dans le terme "care" ou "aide" n'est pas présente. Ce "welfare" fait maison, qui s'est révélé une ressource face à la carence de services publics, a fait exploser les nombreuses contradictions qui feront l'objet de notre analyse. La chronique des faits divers a fait émerger des délits, des abandons, des litiges lors des successions et aussi des contradictions dans les corps intermédiaires. Par exemple, le syndicat, est amené à gérer des guerres entre pauvres: les "badanti" et les vieux retraités. Toutefois, la contradiction la plus saillante se trouve au cœur de l'activité. Le métier présente plusieurs facettes et à coté de l'identification de la "badante" avec l'assisté, nous trouvons l'humiliation et le ressentiment qui résultent des conditions d'exercice de l'activité: la "domesticité" et la "servitude".(AU)

During the last years a new trade appeared in Italy as an adaptive answer to the problems arising from the ageing process of population: that of "badanti". This popular term designates the immigrated women working at old persons homes. This social phenomenon concerns four million people, including workers and assisted. These persons are marginalized and discredited. Discredit is implicit in the denomination itself. "Badanti" comes from the verb "badare" that means "to strictly survey", "to control": the empathy inscribed in the words "care" or "help" is not present. This contribution will analyze this homemade welfare, that, even if it is allowing to face the lack of public services, is disclosing several contradictions. Newspapers are reporting crimes, abandons, arguments for successions, and even contradictions inside mediation organizations. Trade unions have to manage, for example, wars between poor people: "badanti" and old-age pensioners. Anyways, the most sensible contradiction is at the core of the activity. The trade presents several faces and, besides the identification of the "badante" with the assisted person, we find the humiliation and resentment, which result from the conditions of domestic labour and servitude.(AU)