The influence of Driving Status on Transportation Challenges Experienced by Older Adults.

We explored the severity, number, and reasons for transportation challenges experienced by older adult drivers, nondrivers who live with a driver, and nondrivers who do not live with a driver. A random sample of 1,670 Atlantic Canadian community-dwelling older adults completed a mailed survey. Drivers comprised 80% of the participants. Just more than one fifth of participants experienced at least occasional transportation challenges. Two thirds of nondrivers who lived with a driver reported having no transportation challenges. Almost half of the nondrivers who did not live with a driver indicated never experiencing transportation challenges, and 84% of drivers had no transportation challenges. Nondrivers who did not live with a driver experienced greater frequency and severity of transportation challenges. This research contributes to our understanding of the characteristics of older adults with different driving statuses and their transportation challenges, which can contribute to providing appropriate transportation supports for older adults in the future.

Examining an occupational perspective in a rural Canadian age-friendly consultation process.

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.

The everyday experience of living with and managing a neurological condition (the LINC study): study design.

BACKGROUND: The impact of neurological conditions on individuals, families and society is increasing and having a significant economic impact in Canada. While some economic data is known, the human costs of living with a neurological condition are poorly understood and rarely factored into future burden analyses. The "Living with the Impact of a Neurological Condition (LINC)" study aims to fill this gap. It seeks to understand, for children and adults with neurological conditions, the supports and resources that make everyday life possible and meaningful. METHODS/DESIGN: The LINC study is a nested study using mixed methods. We are interested in the following outcomes specifically: health status; resource utilization; self-management strategies; and participation. Three studies captured data from multiple sources, in multiple ways and from multiple perspectives. Study One: a population-based survey of adults (n=1500), aged 17 and over and parents (n=200) of children aged 5 to 16 with a neurological condition. Study Two: a prospective cohort study of 140 adults and parents carried out using monthly telephone calls for 10 months; and Study Three: a multiple perspective case study (MPCS) of 12 adults and 6 parents of children with a neurological condition. For those individuals who participate in the MPCS, we will have data from all three studies giving us rich, in depth insights into their daily lives and how they cope with barriers to living in meaningful ways. DISCUSSION: The LINC study will collect, for the first time in Canada, data that reflects the impact of living with a neurological condition from the perspectives of the individuals themselves. A variety of tools will be used in a combination, which is unique and innovative. This study will highlight the commonalities of burden that Canadians living with neurological conditions experience as well as their strategies for managing everyday life.

Directions for advancing the study of work transitions in the 21st century.

OBJECTIVES: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada. PARTICIPANTS: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society. METHODS: A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know. FINDINGS: Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions. CONCLUSIONS: Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work.

Three policy issues in deciding the cost of nursing home care: provincial differences and how they influence elderly couples' experiences.

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.

Effects of workplace policy on continuing professional development: the case of occupational therapy in Nova Scotia, Canada.

BACKGROUND: Continuing professional development is essential for professionals to remain competent, and for effective recruitment and retention. PURPOSE: This paper reports a qualitative study of the effects of workplace policy on continuing professional development on a small, dispersed profession in a resource-challenged province, using the case example of occupational therapy in Nova Scotia. METHODS: The study used a multi-methods design, theoretically based on institutional ethnography. Methods were critical appraisal of the literature, interview and focus group data collection with 28 occupational therapists and 4 health services administrators, and a review of workplace policy. RESULTS: The study identified a policy wall. Notable policies were those which defined who is responsible for continuing professional development, and which limited employee benefits and work flexibility options for those with family duties. It appears that a female-dominated profession, such as occupational therapy, may also face gender-based challenges. PRACTICE IMPLICATIONS: Suggestions are offered for workplace policy makers, unions, provincial regulatory organizations, and health professionals. The findings are generally applicable to any small, dispersed health profession operating in resource-challenged conditions.