Informative Papers, Reports and Web-site Resources

Continuing Care and Assisted Living

 Linkages between Chronic Illness and Home Care Donna Wilson February 2008

A research study using 2003/04, 2004/05, and 2005/06 data provided by Alberta Health and Wellness examined linkages between different definitions of chronic illness and home care services provided to clients. The study revealed information about the characteristics of publicly-funded home care service recipients.

Assisted Living Consultation Response: Health and Safety Spencer, C.

This paper takes a critical look at the adoption of the assisted living model for frail and vulnerable older adults in the province of British Columbia. The shift in B.C. follows the Alberta and American examples of policy initiatives to shift the delivery of care and services from long term care to assisted living.

Family Caregiving and Consequences for Carers: Toward a Policy Research Agenda
Janet E. Fast, Norah C. Keating, 2000

The purpose of this paper is to outline a research agenda that will lead to a better understanding of, and more informed decision making about, policies that affect those who care for adult family members in need. While the well-being of both those who give and those who receive care is likely to be affected by health and continuing care policies, the focus of this paper is on care providers.

Missing Pieces: A Case Study of the Conversion of an Alberta Nursing Home to Designated Assisted Living; Armstrong, Deber 2006

This case study documented the nature of changes in the financing and delivery of services with the conversion of a nursing home in small town Alberta to designated assisted living (DAL) and explored the effects on residents and families. It was funded in part by the M-THAC Opportunities Fund. The paper has been disseminated to the Alberta government, and to other stakeholders. A manuscript for submission to a peer-reviewed journal is in preparation.

Report on Selected Non-Subsidized Assisted Living Facilities for Seniors in Edmonton, Alberta - costs and considerations

A revealing 2004 report of additional expenses related to short-term health care needs in a sample of non-subsidized assisted living facilities for seniors in Edmonton, Alberta by the Advocacy Committee of the Society for the Retired and Semi-Retired in Edmonton Alberta. Click here for report.

Unfinished Business: The Case for Chronic Home Care Services, A Policy Paper

In this policy paper, author Dr. Marcus Hollander argues the case that home care, within an integrated model of care, has the potential to be a significant contributor to the increased efficiency and effectiveness of the Canadian health care system.

The National Evaluation of the Cost Effectiveness of Home Care (Canada)

The goal of this project, funded by Health Canada, was to determine whether home care for the elderly in British Columbia was a cost-effective alternative to residential long-term care for government funders. Among other key findings, the project determined that costs for home care clients, by level of care, are some 40 to 75 per cent of the costs of facility care.

Improving Continuity in Home Care Providers (Ontario)

Woodward, Abelson, Hutchinson, "My Home is Not My Home Anymore:" Improving Continuity in Home Care Providers, based on Ontario experiences, Canadian Health Services Research
Foundation, December 2001

Continuing Care Renewal or Retreat: BC Residential and Home Health Restructuring 2001-2004

An overview of changing policies in British Columbia by Marcy Cohen, Janice Murphy, Kelsey Nutland and Alex Ostry, April 4, 2005, BC Office of the Canadian Centre for Policy Alternatives (CCPA).

Home Care what we have, what we need Colleen Fuller

The overriding tension in the home care debate, like that which has dominated Canada's health care system since the first discussions about medicare emerged, is between those who want a home care program to provide a service, and those who want it to provide a return on investment. . . Canadians identify home care as a key to enable the elderly and the disabled to avoid institutionalization, yet at the same time they oppose public payment for non-medical home care services.

Medically Necessary? The Case for Fully Funded End-of-Life Care Donna Wilson

. . . the concept of "medically necessary" has broadly defined which health services will be publicly funded. As the concept of medically necessary could also define which services will not be publicly funded, it stands to reason that the issue of defining health services on the basis of whether they are considered medically necessary or not is of critical importance to Canadians.

Institutional Abuse and Neglect

Abuse in Institutions

This resource explores the current knowledge base on abuse in institutional settings with attention to prevalence, causes and prevention.

Is What We Have in Canada Working? A Look at the Use of Special Legislation to
Protect Older Persons in Care from Abuse and Neglect, Spencer, C.

Spencer's paper examines the laws in Canada to protect older adults in care facilities from mistreatment, as well as other approaches to abuse and neglect prevention in institutional settings.

Review of the Oral Disease-Systemic Disease Link

The relationship between oral health and systemic disease appears to be bi-directional and possibly a cause-effect relationship.

Seniors Need Resources to Pursue Complaints

An insightful article and overview by lawyer Mary A. Marshall, August 2005 Health Law in Canada

Missing voices: views of older persons on elder abuse World Health Organization, 2002.

Fear and Violence in Canada's nursing homes

A CBC News investigation has found that long -term care facilities can be dangerous places where residents attack residents, residents attack staff, and staff abuse residents.

Older Adults and the Law

  Access to Justice Network Alberta provides information and educational resources on justice and legal issues.  The section on You and the Law: Older Adults & Seniors Planning for the Future is a useful resource for seniors.

The Canadian Centre for Elder Law Studies

The Canadian Centre for Elder Law Studies ("CCELS") is a non-profit organization committed to enriching and informing the lives of older adults in their relationship with the law; to meet the increasing need for education and research in relation to legal issues of particular significance for older adults and to serve as a national focal point for this emerging field.

Seniors and the Law: A Resource Guide

This handbook, produced by the Alberta Civil Liberties Research Centre at the University of Calgary, provides a comprehensive overview of issues facing seniors, including abuse, legal rights and consumer protection.

Achieving Justice for Abused Seniors: The Search for Solutions

The author searches for answers to explain why abuse and violence against older adults are seldom reported to local law enforcement, and why the justice system is rarely invoked in elder abuse cases despite clear violations of criminal law.

Canadian Laws on Abuse and Neglect of Older Persons

Produced by the Canadian Network for the Prevention of Elder Abuse (ONPEA), this paper provides an overview of four main types of laws used in Canada to protect older adults from abuse and neglect. It also links to types of crimes covered under the Criminal Code of Canada.

Older Adults Knowledge Network (Oak-Net)

Oak-Net is funded by the Alberta Law Foundation. It is a repository of information on abuse of older adults and the law.

Advocacy Centre for the Elderly

The Advocacy Centre for The Elderly is a Toronto community based legal clinic for low income senior citizens. ACE provides direct legal services to low-income seniors, public legal education, and engages in law reform activities. ACE services and activities are in relation to areas of law of special importance to the seniors' population

Seniors and Medication

Why are doctors still prescribing neuroleptics? (free full text pdf file)

The specifically neuroleptic form of behavioural control is achieved by making patients psychologically Parkinsonian, which entails emotional blunting and consequent demotivation. Furthermore, chronic neuroleptic usage creates dependence, so that in the long term, Neuroleptics are doing most patients more harm than good. The introduction of 'atypical' neuroleptics (neuroleptically-weak but strongly sedative neuroleptics) has made only a difference in degree, and at the cost of a wide range of potentially fatal metabolic and other side-effects.

Treatment of dementia with anti-psychotic drugs has no benefit and can shorten lives

A December 2007 in-depth program reviews of the use of antipsychotic drugs for persons with dementia, with links to studies, drug use warnings and reports.

Use of Benzodiazepines in BC: Is it consistent with recommendations? 2004

The Therapeutics Initiative was established in 1994 by the Department of Pharmacology and Therapeutics in cooperation with the Department of Family Practice at The University of British Columbia to provide physicians and pharmacists with up to date, evidence based, practical information on rational drug therapy. The Initiative is an independent organization, which is at arms length from government, pharmaceutical industry and other vested interest groups.
The Therapeutics Initiative is funded by the BC Ministry of Health through a grant to the University of British Columbia.

Neuroleptic and benzodiazepine use in long-term care in urban and rural Alberta: Characteristics and results of an education intervention to ensure appropriate use

The incidence of adverse drug events in two large academic long-term care facilities

Health Canada Safety Information: Atypical Antipsychotic Drugs and Dementia

Manufacturing Addiction: The Over-Prescription of Benzodiazepines and Sleeping Pills

FDA Public Health Advisory, Antipsychotics in Elderly

Aripiprazole (marketed as Abilify); Clozapine (marketed as Clozaril); Olanzapine (marketed as Zyprexa); Olanzapine/Fluoxetine (marketed as Symbyax); Quetiapine (marketed as Seroquel);
Risperidone (marketed as Risperdal); Ziprasidone (marketed as Geodon)

Zyprexa Warning

Aging: Drugged Up and Misdiagnosed

What People Need to Know About Psychiatric Drugs (free download from website)

Seniors and Drugs: Prescribed to Death

Medico-legal implications of drug treatment in dementia: prescribing out of license

Long Term Care Medical Directors Association of Canada

In July 2003, a group of concerned continuing care doctors from across Canada came together to advance the quality of care for the institutionalized elderly and people with disabilities. Medical directors from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia formed the Long Term Care Medical Directors Association of Canada. The association aims "to advocate for the improvement in the quality of long term care through the development and integration of the medical director in the management, education, clinical research, and service delivery of comprehensive long term patient care."
Check out the blog, accessed from News on the home page menu.

Research Group Web-sites

Consumers' Association of Canada (Alberta)

What You Need to Know About Private Long Term Care Insurance (Part 1)
What You Need to Know About Private Long Term Care Insurance (Part 2)

A must read for anyone contemplating purchasing long term care insurance or for those concerned about their long term care insurance policies. Hard copies of PART TWO of the series can be mailed to you by contacting Consumers' Association of Canada (Alberta) at (780) 426-3270 or - include your mailing address

Reading the Fine Print; Long Term Care Insurance; Armstrong, Deber 2006

An overview of the private health insurance sector in Canada with a focus on Long Term Care and Critical Illness policies sold in Canada and their potential for meeting the needs of Canadian families. This examination of the relative merits of new long-term care (and critical illness) policies in Canada included a comparison of three different policies

Hidden Costs: Invisible Contributions

The Hidden Costs-Invisible Contributions (HCIC) research program seeks to create a deeper understanding of the place in society of 'dependent' adults, specifically older adults and adults with chronic illness or disability. We are making explicit the costs of care and making visible the contributions of older adults and adults with chronic illness or disability.

Healthy Balance Research Program

The goal of the Healthy Balance Research Program is to better understand the connections between women's health and well-being, family life and earning a livelihood within Nova Scotia. The focus of current research is unpaid (informal) caregiving.

The Vanier Institute of the Family

The Institute is an acknowledged leader on issues affecting families. It advocates on behalf of Canada's 7.8 million families from the point of view that families are the key building block of society and that every Canadian is included in their context.

Canadian Policy Research Networks (CPRN)

Canadian Policy Research Networks creates quality research to guide social and economic policy decisions.

What's Fair? Ethical Decision-making in an Aging Society Nuala Kenny 2004

A joint report from CPRN's Family Network and The Change Foundation, with additional support from the Law Commission of Canada, proposes a new framework for policies that involve sharing scarce resources across generations. Nuala Kenny applies what she calls the "ethic of care" to the challenge of intergenerational equity.

Ethical Choices in Long-Term Care: What Does Justice Require?, (World Health 0rganization)

A society invites a dialogue about how best to structure the ethical framework within which equitable, fair, rational, and transparent decisions about long-term care can be made when it asks: "What long-term care needs exist?" "What resources are available to provide them?" "What does justice require?"

Embracing the Challenge of Aging, Special [Canadian] Senate Committee on Aging, March 2007

Predictions of an "age quake" have gripped the collective consciousness, warning of an impending inability to maintain current levels of public support to health and income. The Committee has heard evidence to the contrary, however. While the retirement of the baby boom generation is likely to have important consequences for the labour market, this will not necessarily lead to a reduction in the standard of living.

Ethics in an Aging Society: Challenges for Oral Health Care

The demographic reality of the Canadian population in the 21st century requires an in-depth understanding of the health care goals of older people, an analysis of the attitudes toward older people that affect societal decision making and the educational and policy changes required to effect positive change. . . A look at representative cases where oral health needs were not met uncovers some of the attitudes and values about oral health, the goals of health care and the unique circumstances of older people that present barriers to appropriate care.

Canadian Centre for Policy Alternatives

The CCPA is an independent, non-partisan research institute concerned with issues of social and economic justice. (search "seniors", "continuing care")

Untangling the spin about long-term care in BC 2005

The government's restructuring of continuing care services has caused undue suffering for some of the most frail and vulnerable members of our society and increased wait times for everyone requiring hospital services.

From Support to Isolation: The High Cost of BC's Declining Home Support Services

Reduced access to home support leaving frail seniors isolated and at risk, and families under pressure.