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Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature132042
Source
Health Soc Care Community. 2012 Jan;20(1):103-12
Publication Type
Article
Date
Jan-2012
Author
Meredith B Lilly
Carole A Robinson
Susan Holtzman
Joan L Bottorff
Author Affiliation
Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. meredith.lilly@mcmaster.ca
Source
Health Soc Care Community. 2012 Jan;20(1):103-12
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
British Columbia
Burnout, Professional - epidemiology
Caregivers - psychology
Dementia - therapy
Family - psychology
Family Relations
Female
Home Care Services
Humans
Independent living
Male
Middle Aged
Qualitative Research
Sex Factors
Socioeconomic Factors
Abstract
After more than a decade of concerted effort by policy-makers in Canada and elsewhere to encourage older adults to age at home, there is recognition that the ageing-in-place movement has had unintended negative consequences for family members who care for seniors. This paper outlines findings of a qualitative descriptive study to investigate the health and wellness and support needs of family caregivers to persons with dementia in the Canadian policy environment. Focus groups were conducted in 2010 with 23 caregivers and the health professionals who support them in three communities in the Southern Interior of British Columbia. Thematic analysis guided by the constant comparison technique revealed two overarching themes: (1) forgotten: abandoned to care alone and indefinitely captures the perceived consequences of caregivers' failed efforts to receive recognition and adequate services to support their care-giving and (2) unrealistic expectations for caregiver self-care relates to the burden of expectations for caregivers to look after themselves. Although understanding about the concepts of caregiver burden and burnout is now quite developed, the broader sociopolitical context giving rise to these negative consequences for caregivers to individuals with dementia has not improved. If anything, the Canadian homecare policy environment has placed caregivers in more desperate circumstances. A fundamental re-orientation towards caregivers and caregiver supports is necessary, beginning with viewing caregivers as a critical health human resource in a system that depends on their contributions in order to function. This re-orientation can create a space for providing caregivers with preventive supports, rather than resorting to costly patient care for caregivers who have reached the point of burnout and care recipients who have been institutionalised.
PubMed ID
21851447 View in PubMed
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Physical activity correlates with arterial stiffness in community-dwelling individuals with stroke.

https://arctichealth.org/en/permalink/ahliterature257030
Source
J Stroke Cerebrovasc Dis. 2014 Feb;23(2):259-66
Publication Type
Article
Date
Feb-2014
Author
Ada Tang
Janice J Eng
Penelope M Brasher
Kenneth M Madden
Azam Mohammadi
Andrei V Krassioukov
Teresa S M Tsang
Author Affiliation
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, British Columbia, Canada.
Source
J Stroke Cerebrovasc Dis. 2014 Feb;23(2):259-66
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
British Columbia
Cardiovascular Diseases - diagnosis - etiology - physiopathology - prevention & control
Cross-Sectional Studies
Exercise Tolerance
Female
Humans
Independent living
Male
Middle Aged
Mobility Limitation
Motor Activity
Multivariate Analysis
Oxygen consumption
Prognosis
Pulse Wave Analysis
Risk factors
Sedentary lifestyle
Stroke - complications - diagnosis - physiopathology - rehabilitation
Vascular Stiffness
Abstract
Physical inactivity contributes to atherosclerotic processes, which manifest as increased arterial stiffness. Arterial stiffness is associated with myocardial demand and coronary perfusion and is a risk factor for stroke and other adverse cardiac outcomes. Poststroke mobility limitations often lead to physical inactivity and sedentary behaviors. This exploratory study aimed to identify functional correlates, reflective of daily physical activity levels, with arterial stiffness in community-dwelling individuals >1 year poststroke.
Carotid-femoral pulse wave velocity (cfPWV) was measured in 35 participants (65% men; mean ± SD age 66.9 ± 6.9 years; median time poststroke 3.7 years). Multivariable regression analyses examined the relationships between cfPWV and factors associated with daily physical activity: aerobic capacity (VO2 peak), gait speed, and balance ability (Berg Balance Scale). Age and the use of antihypertensive medications, known to be associated with pulse wave velocity, were also included in the model.
Mean cfPWV was 11.2 ± 2.4 m/s. VO2 peak and age were correlated with cfPWV (r = -0.45 [P = .006] and r = 0.46 [P = .004], respectively). In the multivariable regression analyses, age and the use of antihypertensive medication accounted for 20.4% of the variance of cfPWV, and the addition of VO2 peak explained an additional 4.5% of the variance (R2 = 0.249).
We found that arterial stiffness is elevated in community-dwelling, ambulatory individuals with stroke relative to healthy people. Multivariable regression analysis suggests that aerobic capacity (VO2 peak) may contribute to the variance of cfPWV after accounting for the effects of age and medication use. Whether intense risk modification and augmented physical activity will improve arterial stiffness in this population remains to be determined.
Notes
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PubMed ID
23473623 View in PubMed
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Resolving mobility constraints impeding rural seniors' access to regionalized services.

https://arctichealth.org/en/permalink/ahliterature123209
Source
J Aging Soc Policy. 2012;24(3):328-44
Publication Type
Article
Date
2012
Author
Laura Ryser
Greg Halseth
Author Affiliation
Rural and Small Town Studies Program, University of Northern British Columbia, Prince George, British Columbia, Canada. ryser@unbc.ca
Source
J Aging Soc Policy. 2012;24(3):328-44
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
British Columbia
Communication
Female
Health Services Accessibility - economics - organization & administration
Humans
Independent living
Interinstitutional Relations
Male
Rural Population
Social Work - organization & administration
Transportation
Abstract
Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.
PubMed ID
22720890 View in PubMed
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