Andrée Sévigny

On the track of evaluated programmes targeting the social participation of seniors: a typology proposal

ABSTRACT Nowadays, the social participation of seniors represents a central challenge for both individuals and collectivities. The participative perspective is indeed present in most of the contemporary discourses on ageing, and is viewed both as a way to manage the current demographic juncture and as a promising direction for enhancing seniors’ wellbeing and achievements. This article examines 32 programmes aimed at fostering the social participation of seniors that were both implemented and evaluated, and whose results were published between January 1970 and August 2011. Based on each programmes approach, a typology of social programmes is proposed. The programmes are grouped in five categories, ranging from programmes offering an individualised approach to socio-political programmes. Classification is based on the various ways the concept of social participation is defined and acted upon by the reviewed programmes. Far from being neutral, each category suggests a specific representation of the social roles of seniors. In addition, the paper discusses how the proposed typology can guide both policy and practice, linking identity and agency issues to organisational and structural considerations. Three uses for the typology are suggested: as a policy-making support, as an evaluative framework, and as an experimental space for community practice.

Helping Them Live Until They Die: Volunteer Practices in Palliative Home Care

Volunteers traditionally play an essential role in palliative care. Without them, many community and institutional programs would not survive. Despite the significant number of volunteers involved in palliative care, the nature and scope of their actions remain ambiguous. The blurred boundaries of their contribution create tensions between professionals, families, and volunteers with regards to patient care and sharing of responsibilities. This article reports on a comprehensive and descriptive qualitative study aimed at understanding volunteer practices in home palliative care in Canada through analysis of volunteers’ discourse. The conceptual framework not only allows for a description of volunteer practices but also for an understanding of those practices in terms of the meaning volunteers ascribe to their actions and interactions. The information gathered provides a better understanding of the place of volunteers within the palliative care system, thereby allowing communities to optimize their contribution to the palliative care mission.

Match between needs and services for participation of older adults receiving home care

Purpose – This paper aims to explore the match between needs and services related to participation for frail older adults receiving home care. Design/methodology/approach – A qualitative multiple case study was conducted with 11 triads each involving an elder, a caregiver and a healthcare provider working in a Health and Social Services Centers (HSSCs). Findings – Although HSSCs in Quebec are supposed to promote social integration and participation of older adults, services provided to the older adults in this study focused mainly on safety and independence in personal care, dressing, mobility and nutrition, without fully meeting older adults’ needs in these areas. Discrepancies between needs and services may be attributable to the assessment not covering all the dimensions of social participation or accurately identifying older adults’ complex needs; older adults’ and their caregivers’ difficulties identifying their needs and accepting their limitations and the assistance offered; healthcare providers’ l...

Preventive Home Visits for Older People: A Systematic Review.

L’augmentation du nombre de personnes âgées présentant des incapacités et ayant des maladies chroniques entraîne une hausse des besoins en services de santé à domicile. Le nombre d’études et de revues systématiques traitant des approches préventives pour cette clientèle a proliféré, générant un besoin de synthèse des connaissances. Nous avons mené une revue systématique de revues systématiques évaluant l’effet des programmes de visite préventive pour les personnes âgées. Des 5 973 citations identifiées dans plus de 30 bases de données de littérature grise et scientifique, 10 articles répondaient à tous les critères d’inclusion. Les revues systématiques étaient retenues si elles comprenaient des essais randomisés contrôlés comparant des interventions de soins à domicile offerts par un professionnel de la santé et ceux sans professionnels. Les interventions sont souvent des évaluations gériatriques globales et s’accompagnent de visites de suivi. Il ressort que les visites préventives multidimensionnelles à domicile ont le potentiel de diminuer la mortalité, en particulier chez les personnes âgées plus jeunes, et offrent aussi un potentiel d’amélioration de l’autonomie fonctionnelle. Toutefois, ces résultats doivent être interprétés avec prudence vue la diversité des interventions analysées.The rising number of older people living with disabilities and chronic diseases has increased home care needs. Studies and reviews exploring preventive approaches have proliferated, creating a need for a synthesis of evidence. We conducted a systematic review of systematic reviews to evaluate the effectiveness of preventive home visiting approaches for older people. Of the 5,973 citations identified in over 30 scientific and grey literature databases, 10 papers met all inclusion criteria. Systematic reviews were considered if they included controlled trials comparing interventions with and without professional home care. We found that interventions often included comprehensive geriatric assessments and follow-up visits. Results indicate that multidimensional preventive home visiting programs might have the potential to reduce mortality, in particular for younger subjects, and show a potential to improve functional autonomy, but these findings should be interpreted with caution due to the diversity of the interventions analysed.

Les facteurs favorisant ou contraignant l'engagement bénévole dans les organismes communautaires en soutien à domicile auprès des aînés

The reality of volunteering in nonprofit organizations who offer services to seniors at home was observed from the viewpoint of two types of actors: volunteers and coordinators. Our results suggest that there are three decisive stages in volunteering: recruitment, realization of volunteer activity, and pursuit of this commitment. For each of them, some factors are more influential than others. Their presence or absence makes possible or not the initiation of this commitment and its pursuit. In this context, a constant negotiation takes place between the actors. Each of them has to adapt himself to others. Nevertheless, this adaptation is limited. So, stability between the position of the organization and that of the volunteer is necessary. La réalité de l’engagement bénévole dans les organismes communautaires oeuvrant dans le domaine du soutien à domicile et venant en aide aux aînés a été observée sous l’angle de deux types d’acteurs: les bénévoles et les coordonnateurs. À la lumière de nos résultats, il apparaît que trois phases sont décisives dans l’engagement bénévole: le recrutement, la réalisation de l’action bénévole et le maintien de l’engagement. Pour chacune d’elles, des facteurs sont plus influents que d’autres. Leur présence ou leur absence rend possible ou non l’initiation de cet engagement et son maintien. Dans ce contexte, une négociation constante a lieu entre les acteurs. Chacun d’eux est amené à s’adapter à la réalité des autres. Cette adaptabilité est cependant limitée. Un équilibre entre la position de l’organisme et celle du bénévole est donc nécessaire.The reality of volunteering in nonprofit organizations who offer services to seniors at home was observed from the viewpoint of two types of actors: volunteers and coordinators. Our results suggest that there are three decisive stages in volunteering: recruitment, realization of volunteer activity, and pursuit of this commitment. For each of them, some factors are more influential than others. Their presence or absence makes possible or not the initiation of this commitment and its pursuit. In this context, a constant negotiation takes place between the actors. Each of them has to adapt himself to others. Nevertheless, this adaptation is limited. So, stability between the position of the organization and that of the volunteer is necessary.