Betty Havens

Predictors of successful aging: a twelve-year study of Manitoba elderly.

In Manitoba, Canada, a representative cohort of elderly individuals ages 65 to 84 (n = 3,573) were interviewed in 1971 and the survivors of this cohort were reinterviewed in 1983. This analysis assesses the determinants of successful aging--whether or not an individual will live to an advanced age, continue to function well at home, and remain mentally alert. Over 100 separate indicators of demographic and socio-economic status, social supports, health and mental status in 1971 were available as potential predictors of successful aging. Indicators of access to health care over the period 1970-82 and indicators of diseases over this period were also available as predictors. Those who aged successfully were shown to have greater satisfaction with life in 1983 and to have made fewer demands on the health care system than those who aged less well. Despite the large number of potential predictors of successful aging which were examined, only age, four measures of health status, two measures of mental status, and not having ones spouse die or enter a nursing home were shown to be predictive of successful aging.

Using administrative data to predict important health outcomes. Entry to hospital, nursing home, and death.

This paper assesses our ability to use administrative data for developing indicators of health status. Traditionally, measures of health status have been derived from interviews. Here indicators from administrative data and from interviews are compared, i.e., their ability to predict important health outcomes for a large representative sample of elderly residents of Manitoba, Canada. Indicators of health status derived from an administrative data system and from health interviews are shown to provide roughly similar predictions of nursing-home entry. Administrative data provide significantly better predictions of death and future hospital entry than do variables from interview data.

Long-Term Care Diversity within the Care Continuum

Long-term care spans a broad range of very diverse services and a pivotal location within the overall continuum of health and health care. Changes in one component of care affect and are affected by all other components as health care may be characterized as a dynamic series of interdependent processes and persons. The current state of Canadian health care, in general, and long-term care, in particular, demands the skilful juggling of universality and diversity to maximize both these characteristics without sacrificing either. In an atmosphere of reform and fiscal restructuring, the organizational, utilization and financing implications for this system on a tightrope are substantial. The challenges are of major proportions in maintaining a balance while securing a future system that is efficient, efficacious, equitable, effective and empowering.

Conjoint Research Interviews With Frail, Elderly Couples: Methodological Implications

In this phenomenological study, frail, rural elderly couples were interviewed as dyads. Couples participated in semistructured interviews and jointly constructed their responses. The elderly couple or dyad was the unit of inquiry, data collection, and analysis. The study sought to maximize the understanding of the couple as a unit as partners negotiated and constructed their responses. The method of data collection provided opportunity to observe the verbal and nonverbal interaction of the couple, the process used to construct the conjoint dialogue, and the content of the discourse. The couple conversation was richer in content and more effective in addressing the research question than were individual interviews. This article focuses on the methodological issues as they relate to the couple as the dyadic unit of research. Dialogue from the study illustrates the richness of the data gathered using this method.

Integrating a Performance-Based Observation Measure of Functional Status into a Population-Based Longitudinal Study of Aging

Over the past 15 to 20 years there has been discussion and debate in the gerontological literature about the relative merits of self-report versus performance-based observational (PBO) measures of functional status. In 2001 the Aging in Manitoba Longitudinal Study had the opportunity to add a PBO measure of functional status and use it together with two self-report measures on a sub-sample of 138 participants. The PBO measure that was used was the Performance Assessment of Self-Care Skills, Version 3.1 (Home). Using ranks of the proportion of participants who were independent in nine different tasks, no significant correlations were found between the performance measure scores and either of the self-report measures. This finding suggests that using self-report data rather than performance data could lead program developers and policy makers to different conclusions about the extent of need for assistance among older adults.

Structural Inequalities, Informal Networks: A Comparison of Native and Non-Native Elderly

This study examines a comparative sample of native and non-native Canadian elderly. Findings indicate that the native population is seriously disadvantaged in terms of housing and health care services. In terms of informal networks and assistance to the elderly, native Canadians rely almost exclusively on informal networks while others receive some assistance from formal agencies as well. These and other issues are discussed relative to future research and the development of theory.

Evaluating support services to seniors A discussion of collaborative research

The difficulties involved in attempting to turn collaboration into partnership are revealed in this article about the relationship between research funders and researchers, specifically government funders and university researchers. Some discussion revolves around the relationships between researchers and among the researchers, practitioners, and consumers. This article also discusses collaborative research relationships by using the evaluation of a support program to seniors as an illustration. Also addressed are how the research revealed the success of the program and the frustrations encountered when government would not act on the findings.

Overview of Longitudinal Research on Aging

A brief introduction to gerontological longitudinal research methods and analysis is provided. The gerontological research questions that demand longitudinal study are identified. The use of secondary data analysis is shown to be essential to these studies. These analyses present opportunities to maximize both longitudinal research strategies and research efficiencies. The importance of administrative and financial stability for maintaining data bases for longitudinal research is presented by using examples. A brief overview of major Canadian longitudinal studies of aging and selected studies in other countries is provided. Finally, many sources of both quantitative and qualitative data for longitudinal gerontological studies are identified.

Healthy Aging: Insights for Research and Policy

In times of health reform, fiscal restraint and population aging, it becomes increasingly imperative to understand what must be done to better link research and policy in the health area. In this paper, the major determinants of healthy aging are discussed in terms of current conceptual frameworks of health, measurement, methodologies, and data sources. In order to maximize the benefits for the health of current and future Canadian seniors, policy recommendations are made to Statistics Canada, Health Canada, and the Seniors Independence Research Program (SIRP) which cover a range of issues related to measurement and data sources, health services, health status, economic status, and education. Coauthors are J. Dawe, R. Evans, V. Marshall, P. Clarke, D. Norris, J. Hagey, E. Shapiro, R. Wilkins, and B. Havens.