The social experience of aging with a chronic illness: perspectives of older adults with multiple sclerosis.

PURPOSE: The purpose of this study was to explore the social experiences of older adults with multiple sclerosis (MS) in order to recognize the changes in social experience and social needs that may occur with aging with a chronic illness. METHOD: Analysis of qualitative data from an exploratory study utilizing a phenomenological approach with 27 older adults with MS, aged 55 - 81. RESULTS: In-depth interviews revealed that the social experience was influenced by groups of factors including the person's social needs, experience of MS, values and expectations, characteristics of the social support system, the response of the support providers, and the accessibility of the social environment. The participants discussed concerns about the future adequacy of support. A process of negotiation was also described and was seen as an opportunity to change the social experience and social support received. CONCLUSION: This study provides an insider's view of the social changes that older adults living with MS experience. This study also identifies barriers to the acquisition of support and addresses the importance of appropriately responding to the changing needs of this population.

Trends in the utilization of specific health care services among older Manitobans: 1985 to 2000.

This paper examines 16-year trends in the utilization of hospital and physician services by Manitobans aged 75 and more, using data from the Manitoba Population Health Research Data Repository. Trends are examined across five measures of hospital services (separations, short-stay days, long-stay days, cataract surgeries, and hip/knee replacements) and two measures of physician care (overall visit rate, and proportion having seven or more visits). Results show changes in the utilization of these services among older adults living in Manitoba over time, with the extent of change varying with the service under consideration, age, and location of residence. Previously large utilization differentials are shown to be shrinking; for example, cataract surgery rates across regions and physician visit rates by age. For other services, such as the rates of hip or knee replacement surgery, the differences across regions are increasing. Findings indicate that global generalizations about the impact of older adults on the health care system are subject to question, as regional differences and differences between age groups (75-84, 85+) can be significant.

An approach to persons with chronic fatigue syndrome based on the model of human occupation: part one, impact on occupational performance and participation.

Chronic fatigue syndrome (CFS) is a prevalent and disabling condition that involves six or more months of unexplained fatigue severe enough to interfere with previous levels of occupational, educational, and/or social performance. The fatigue is accompanied by at least four of eight additional physical and cognitive symptoms (Fukuda et al., 1994). This paper conceptualizes the multiple factors that affect occupational adaptation in persons with CFS. The Model of Human Occupation (MOHO) if used as a framework for understanding the synergistic and evolving relationships between motivation, roles, habits, performance capacities, and the environment as they influence individuals with CFS. Examples from the literature, autobiographical accounts, and from practice experience are used to illustrate the experience and impact of CFS on everyday life.