Laurel A. Strain

Confidants Do They Make a Difference in Quality of Life

This article empirically explores the interrelations of three variables-sex, marital status, and the confidant relationship-and their joint effects on quality of life. It draws on a stratified rand...

Lay Explanations of Chronic Illness in Later Life

This study explores lay explanations of chronic illness in later life. More specifically, perceived causes, treatment strategies, and perceived outcomes of arthritis and heart/circulatory problems from the perspective of older adults who have such problems are examined. Variations in these explanations according to selected sociodemographic and health status characteristics are explored. Among the arthritis sufferers, the most prevalent explanations were physical work/working conditions, age, and injury, whereas those with heart/circulatory problems most often explained the cause as due to tension/stress, physiology, or heredity. A variety of treatments were identified, including doing nothing, seeking or continuing medical treatment, altering lifestyle, and using folk remedies. Selected sociodemographic and health status characteristics appear important for understanding explanations about arthritis, although it is primarily health status indicators that emerge for heart/circulatory problems. Directions for future research are highlighted.

Good Health What does it Mean in Later Life

Although the gerontological literature abounds with references to health status, the meaning of good health to older adults is not readily apparent. Drawing on data from a random sample of 743 individuals aged 65 and over residing in Winnipeg, Manitoba, Canada, perceived definitions of the concept for age peers and for younger age groups are examined. These definitions include a general feeling of well-being, the absence of symptoms, and being able to do usual activities. The extent of congruency in the definitions for different age groups is also considered. Attempts to identify associated sociodemographic characteristics, health status, and health beliefs are largely unsuccessful, although ones own health situations appears important to consider. The relationship between various definitions and perceived health status, life satisfaction, and service utilization are explored. Directions for future research are discussed.

Social Networks and Patterns of Social Interaction among Ever-Single and Separated/Divorced Elderly Canadians

This paper examines the social networks and patterns of social interactions of two relatively neglected marital status groups of elders, namely the ever-single and the separated/divorced. Drawing on data from the 1985 General Social Survey conducted by Statistics Canada, comparisons are made both between and among the 224 ever-single and 126 separated/divorced Canadians aged 65 and over. When controlling for age, gender, education and health status, ever-single individuals tend to have smaller family networks, a similar number of friends, and similar living arrangements as the separated/divorced. In-person contact with siblings is significantly associated with being ever-single while no differences emerge for contact with other relatives or with friends. Differences among the ever-single and among the separated/divorced are also assessed.

Cognitively Impaired Older Adults: Risk Profiles for Institutionalization

BACKGROUND This study focused on the identification of risk profiles for institutionalization among older adults diagnosed with cognitive impairment-not dementia or dementia in 1991/92 and subsequent institutionalization in the following 5-year period. METHODS Data were from a sample of 123 individuals aged 65+ and their unpaid caregivers in Manitoba, Canada. Cluster analysis was conducted using baseline characteristics of age, cognition, disruptive behaviors, ADLs/IADLs, use of formal in-home services, and level of caregiver burden. RESULTS Three distinct groups emerged (high risk [n = 12], medium risk [n = 40], and low risk [n = 71]). The high-risk group had the poorest cognitive scores, were the most likely to exhibit disruptive behaviors, were the most likely to need assistance with ADLs and IADLs, and had the highest level of burden among their caregivers. Follow-up of the groups validated the risk profiles; 75% of the high-risk group were institutionalized within the next 5 years, compared to 45% of the medium-risk group and 21% of the low-risk group. DISCUSSION The risk profiles highlight the diversity among individuals with cognitive impairment and the opportunity for differential targeting of services for the distinct needs of each group.

Rural-Urban Differences among Adult Day Care Participants in Manitoba

Rural-urban differences in the characteristics of 44 individuals entering the province-wide Adult Day Care program throughout Manitoba are examined. In addition, the rural-urban differences along various social and social psychological indicators after participants have been in the program are explored. The results indicate that there are many similarities and relatively few differences between the urban and the rural ADC participants. Any differences which do emerge portray the rural participants as more socially integrated and with higher levels of perceived health than the urban participants. Implications for assessment for entry into Adult Day Care are discussed.

Cognitive Impairment, Disruptive Behaviors, and Home Care Utilization

Disruptive behaviors by an elder with cognitive impairment, such as violence, abrupt mood swings, and overt inappropriate sexual behaviors have been known to create caregiver distress, but little is known about how these behaviors may influence the use of home care services by that elder or their informal caregiver. The purpose of this study is to explore the associations between type of cognitive impairment (cognitive impairment with no dementia, and dementia), selected disruptive behaviors, and the use of four home care services (homemaking/cleaning, personal care, in-home nursing, home-delivered meals). Secondary data analysis from the 1991-1992 Manitoba Study on Health and Aging data set was conducted, using a sample of 124 community-dwelling elders and their unpaid caregivers. Multivariate analysis revealed that disruptive behaviors were significantly associated with the use of two services: personal care and home-delivered meals. Being cognitively impaired with dementia was significant for only home-delivered meals. Overall functional status of the elder emerged as a consistent predictor.

The Need for Social Science Research on Technology and Aging

Neena L. Chappell has a PhD in sociology. She was founding director of the Centre on Aging at the University of Manitoba and currently is director of the Centre on Aging at the University of Victoria. She has published extensively in gerontology, including authoring or coauthoring three books, over 100 articles in referred journals, chapters in book.\~ and governmental and agency reports. Her research is in the areas of informal care, formal care, and the evolution of health and social policy for seniors.