Recently published papers
Gibbs JC, McArthur C, Wark JD, Thabane L, Scherer SC, Prasad S, Papaioannou A, Mittmann N, Laprade J, Kim S, Khan A, Kendler DL, Hill KD, Cheung AM, Bleakney R, Ashe MC, Adachi JD, Giangregorio LM. The Effects of Home Exercise in Older Women With Vertebral Fractures: A Pilot Randomized Controlled Trial. Physical Therapy, pzz188. doi: https://doi.org/10.1093/ptj/pzz188
Lafortune C, Elliott J, Egan MY, Stolee P. The Rest of the Story: A Qualitative Study of Complementing Standardized Assessment Data with Informal Interviews with Older Patients and Families. Patient. 2017 Apr;10(2):215-224. doi: 10.1007/s40271-016-0193-9.
Kehler DS, Giacomantonio N, Firth W, Blanchard CM, Rockwood K, Theou O. Association Between Cardiac Rehabilitation and Frailty. Canadian Journal of Cardiology. doi: https://doi.org/10.1016/j.cjca.2019.08.032
Logan Ellis H, Wan B, Yeung M, Rather A, Mannan I, Bond C, Harvey C, Raja N, Dutey-Magni P, Rockwood K, Davis D, Searle SD. Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results. CMAJ January 06, 2020 192 (1) E3-E8; doi: https://doi.org/10.1503/cmaj.190952
Barkema WS, Heckman GA, Slaughter SE, Carrier N, Lengyel CO, Keller HH. Medical diagnosis does not influence food intake in frail long-term care residents. The Journal of Nursing Home Research Sciences Volume 5, 2019. doi: http://dx.doi.org/10.14283/jnhrs.2019.9
Carrier N, Villalon L, Lengyel C, Slaughter SE, Duizer L, Morrison-Koechl J, Keller H. Diet quality is associated with malnutrition and low calf circumference in Canadian long-term care residents. BMC Nutrition. doi: https://doi.org/10.1186/s40795-019-0314-7
Trinica V, Morrison J, Slaughter S, Keller H. Making the Most of Mealtimes (M3): effect of eating occasions and other covariates on energy and protein intake among Canadian older adult residents in long‐term care. Journal of Human Nutrition and Dietetics. doi: https://doi.org/10.1111/jhn.12686
Muscedere J, Afilalo J, Araujo de Carvalho I, Cesari M, Clegg A, Eriksen HE, Evans KR, Heckman G, Hirdes JP, Kim PM, Laffon B, Lynn J, Martin F, Prorok JC, Rockwood K, Rodrigues Manas L, Rolfson D, Shaw G, Shea B, Sinha S, Theou O, Tugwell P, Valdiglesias V, Vellas B, Veronese N, Wallace LMK, Williamson PR, for the Canadian Frailty Network. Moving Towards Common Data Elements and Core Outcome Measures in Frailty Research. The Journal of Frailty and Aging (JFA). doi: http://dx.doi.org/10.14283/jfa.2019.43
Abstract: With aging populations around the world, frailty is becoming more prevalent increasing the need for health systems and social systems to deliver optimal evidence based care. However, in spite of the growing number of frailty publications, high-quality evidence for decision making is often lacking. Inadequate descriptions of the populations enrolled including frailty severity and frailty conceptualization, lack of use of validated frailty assessment tools, utilization of different frailty instruments between studies, and variation in reported outcomes impairs the ability to interpret, generalize and implement the research findings. The utilization of common data elements (CDEs) and core outcome measures (COMs) in clinical trials is increasingly being adopted to address such concerns.
Fernando SM, McIsaac DI, Rochwerg B, Cook DJ, Bagshaw SM, Muscedere J, Munshi L, Nolan JP, Perry JJ, Downar J, Dave C, Reardon PM, Tanuseputro P, Kyeremanteng K. Frailty and associated outcomes and resource utilization following in-hospital cardiac arrest. Resuscitation (2019). doi: https://doi.org/10.1016/j.resuscitation.2019.11.011
Holroyd-Leduc J, Harris C, Hamid JS, Ewusie JE, Quirk J, Osiowy K, Moore JE, Khan S, Liu B, Straus SE. Scaling-up implementation in community hospitals: a multisite interrupted time series design of the Mobilization of Vulnerable Elders (MOVE) program in Alberta. BMC Geriatr. 2019;19(1):288. Published 2019 Oct 25. doi: 10.1186/s12877-019-1311-z
Bellelli PG, Biotto M, Morandi A, Meagher D, Cesari M, Mazzola P, Annoni G, Zambon A. The Relationship Among Frailty, Delirium and Attentional Tests to Detect Delirium: A Cohort Study. European Journal of Internal Medicine. PMID: 31761505, doi: 10.1016/j.ejim.2019.09.008
Watt JA, Goodarzi Z, Angeliki Veroniki A, Nincic V, Khan PA, Ghassemi M, Thompson Y, Tricco AC, Straus SE. Comparative Efficacy of Interventions for Aggressive and Agitated Behaviors in Dementia: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2019;171(9):633-642. doi: 10.7326/M19-0993
Plante P, Angulo Mendoza GA, Archambault P. (En français) Analyse, développement et évaluation d’une formation médicale en ligne. Mediation & mediatisations. No. 2 (2019): https://revue-mediations.teluq.ca/index.php/Distances/article/view/95
Abstract (en français): Dans le cadre d’un projet intitulé “Evaluation of a context-adapted wiki-based decision aid supporting critically ill patients’ decisions about life-sustaining therapies,” financé par le Réseau canadien des soins aux personnes fragilisées, l’équipe de conception pédagogique de la Société pour l’apprentissage à vie (SAVIE) s’est joint au projet de recherche afin de développer une formation en ligne destinée aux médecins, aux étudiantes et aux étudiants tenant compte d’un certain nombre d’exigences techniques comme résultat d’une analyse de besoins. La formation a été développée par prototypage rapide.
Jayanama K, Theou O, Godin J, Cahill L, Rockwood K. Association of fatty acid consumption with frailty and mortality among middle-aged and older adults. Nutrition. 2019 Oct 11;70:110610. doi: https://doi.org/10.1016/j.nut.2019.110610
Ploeg J, Yous M-L, Fraser K, Dufour S, Garland Baird L, Kaasalainen S, McAiney C, Markle-Reid M. Healthcare providers’ experiences in supporting community-living older adults to manage multiple chronic conditions: a qualitative study. BMC Geriatrics. (2019) 19:316 doi: https://doi.org/10.1186/s12877-019-1345-2
Hill A, Ramsey C, Dodek P, Kozak J, Fransoo R, Fowler R, Doupe M, Wong H, Scales D, Garland A. Examining mechanisms for gender differences in admission to intensive care units. Wiley Online Library: Health Services Research, doi: https://doi.org/10.1111/1475-6773.13215
Abstract: Since the 1980 publication of the Black Report, there has been a growing awareness of social inequalities in health and health care use. Although ethnicity, age, socioeconomic status (SES), and others factors associated with health inequality have been identified, the mechanisms by which these factors work remain unclear. One example is the reported gender‐related difference in admission to intensive care units (ICUs). Despite the fact that women greatly outnumber men in older age‐groups, substantially more older men than older women are admitted to ICUs. This finding is present even after adjustment for differing rates of critical illness between older men and women.
Sawatzky R, Roberts D, Russell L, Bitschy A, Ho S, Desbiens J-F, Chan EKH, Tayler C, Stajduhar K. Self-Perceived Competence of Nurses and Care Aides Providing a Palliative Approach in Home, Hospital, and Residential Care Settings: A Cross-Sectional Survey. Canadian Journal of Nursing Research, doi: https://doi.org/10.1177/0844562119881043
Chamberlain SA, Duggleby W, Fast J, Teaster PB, Estabrooks CA. Incapacitated and Alone: Prevalence of Unbefriended Residents in Alberta Long-Term Care Homes. SAGE Journals, doi: https://doi.org/10.1177/2158244019885127
McCaskell DS, Molloy AJ, Childerhose L, Costigan FA, Reid JC, McCaughan M, Clarke F, Cook DJ, Rudkowski JC, Farley C, Karachi T, Rochwerg B, Newman A, Fox-Robichaud A, Herridge MS, Lo V, Feltracco D, Burns K, Porteous R, Seely AJE, Ball I, Seczek A, Kho ME. Project management lessons learned from the multicentre CYCLE pilot randomized controlled trial. Trials. 2019;20(1):532. https://doi.org/10.1186/s13063-019-3634-7
Abstract: Clinical trials management can be studied using project management theory. The CYCLE pilot randomized controlled trial (RCT) was conducted to determine the feasibility of a future rehabilitation trial of early in-bed cycling in the intensive care unit (ICU). In-bed cycling is a novel intervention, not typically available in ICUs. Implementation of this intervention requires personnel with specialized clinical expertise caring for critically ill patients and use of the in-bed cycle. Our objective was to describe the implementation and conduct of our pilot RCT using a project management approach.
Mansfield A, Danells CJ, Inness EL, Musselman K, Salbach NM. A survey of Canadian healthcare professionals’ practices regarding reactive balance training. Physiotherapy Theory and Practice, doi: 10.1080/09593985.2019.1650856
Mann K, Lengyel CO, Slaughter SE, Carrier N, Keller H. Resident and Staff Mealtime Actions and Energy Intake of Long-Term Care Residents With Cognitive Impairment: Analysis of the Making the Most of Mealtimes Study. Journal of Gerontological Nursing. 2019;45(8):32-42. https://doi.org/10.3928/00989134-20190709-04
Thompson MQ, Theou O, Tucker GR, Adams RJ, Visvanathan R. Recurrent Measurement of Frailty Is Important for Mortality Prediction: Findings from the North West Adelaide Health Study. Journal of the American Geriatrics Society. doi: https://doi.org/10.1111/jgs.16066
Theou O, Andrew M, Suriani Ahip S, Squires E, McGarrigle L, Blodgett JM, Goldstein J, Hominick K, Godin J, Hougan G, Armstrong JJ, Wallace L, Ghazali Sazlina S, Moorhouse P, Fay S, Visvanathan R, Rockwood K. The Pictorial Fit-Frail Scale: Developing a Visual Scale to Assess Frailty. Can Geriatr J. 2019 Jun; 22(2): 64–74. 2019 Jun 30. doi: 10.5770/cgj.22.357
Harman LE, Guthrie DM, Cohen J, Declercq A, Fisher K, Goodridge D, Hirdes JP, Seow H. Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario. BMC Palliat Care. 2019; 18: 3. 2019 Jan 9. doi: 10.1186/s12904-018-0389-y
Song Y, Hoben M, Weeks L, Bostrom A-M, Goodarzi ZS, Squires J, Doan H, Wagg A, Reid RC, Estabrooks C. Factors associated with the responsive behaviours of older adults living in long-term care homes towards staff: a systematic review protocol. BMJ Open 2019;9:e028416. doi: 10.1136/bmjopen-2018-028416
Ploeg J, Valaitis RK, Cleghorn L, Yous M-L, Gaber J, Agarwal G, Kastner M, Mangin D, Oliver D, Parascandalo F, Risdon C, Dolovich L. Perceptions of older adults in Ontario, Canada on the implementation and impact of a primary care programme, Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY): a descriptive qualitative study. BMJ Open 2019;9:e026257. doi: 10.1136/bmjopen-2018-026257
Demery Varin MG, Stacey D, Baumbusch JL, Estabrooks C, Squires JE. Predictors of Nurses’ Research Use in Canadian Long-term Care Homes. The Journal of Post-Acute and Long-Term Care Medicine. DOI: https://doi.org/10.1016/j.jamda.2019.04.027
Fan-Lun C, Chung C, Lee EHG, Pek E, Ramsden R, Ethier C, Soong C. Reducing unnecessary sedative-hypnotic use among hospitalised older adults. BMJ Quality & Safety: 03 July 2019. doi: 10.1136/bmjqs-2018-009241
McDonald EG, Wu PE, Rashidi B, Forster AJ, Huang A, Pilote L, Papillon-Ferland L, Bonnici A, Tamblyn R, Whitty R, Porter S, Battu K, Downar J, Lee TC. The MedSafer Study: A Controlled Trial of an Electronic Decision Support Tool for Deprescribing in Acute Care. Journal of the American Geriatrics Society: 27 June 2019. https://doi.org/10.1111/jgs.16040
Muscedere J, Barrie C, Chan K, Cooper B, Critchley K, Kim P, Lorbergs A, Mackenzie I, Martineau C, Noseworthy T, O’Neil M, Resin J, Sinha S, Williams R. Frailty and Aging: How the Danish Experience Might Inform Canada. Healthcare Quarterly 22(1) April 2019 : 14-21.doi:10.12927/hcq.2019.25841
Abstract: Scandinavian countries are widely acknowledged as leaders in innovative models of care for their aging populations. To learn what might be potentially applicable to the health system in Canada, the Canadian Frailty Network (CFN) led a contingent of government, administrative, research and patient representatives to Denmark to directly observe Danish approaches for providing healthcare for older adults living with frailty. In this paper and based on what we learned from these observations, we discuss healthcare challenges faced by Canada’s aging population for which Danish strategies provide clues as to where and how to improve care and system efficiencies, thereby maximizing the value of Canadian healthcare.
Click here to read about our Denmark initiative and how learning from this trip is being put into practice, and a return visit from Danish officials to Canada where they learned more about frailty innovations in the works here—such as those featured in CFN’s Innovation Showcase in September 2018, like the COACH program in PEI and the Hospital Without Walls in Ontario.
Jones A, Bronskill SE, Agarwal G, Seow H, Feeny D, Costa A. The primary care and other health system use of home care patients: a retrospective cohort analysis. CMAJ Open May 23, 2019 vol. 7 no. 2E360-E370 https://doi.org/10.9778/cmajo.20190038
Hebert PC, Morinville A, Costa A, Heckman G, Hirdes J. Regional variations of care in home care and long-term care: a retrospective cohort study. CMAJ Open May 19, 2019 vol. 7 no. 2 E341-E350 https://doi: 10.9778/cmajo.20180086
Abstract: Many aging adults undergo progressive loss of autonomy, develop increasingly complex medical needs and experience multiple care transitions. We sought to determine the degree of variation in rates of transfer from home care services and long-term care in several Canadian jurisdictions.
Squires JE, Aloisio LD, Grimshaw JM, Bashir K, Dorrance K, Coughlin M, Hutchinson AM, Francis J, Michie S, Sales A, Brehaut J, Curran J, Ivers N, Lavis J, Noseworthy T, Vine J, Hillmer M, Graham ID. Attributes of context relevant to healthcare professionals’ use of research evidence in clinical practice: a multi-study analysis. Implementation Science 2019 14:52 https://doi.org/10.1186/s13012-019-0900-8
McCarron TL, Moffat K, Wilkinson G, Zelinsky S, Boyd JM, White D, Hassay D, Lorenzetti DL, Marlett NJ, Noseworthy T. Understanding patient engagement in health system decision-making: a co-designed scoping review. Systematic Reviews 2019 8:97 https://doi.org/10.1186/s13643-019-0994-8
Adekpedjou R, Stacey D, Briere N, Freitas A, Garvelink MM, Joyce Dogba M, Durand PJ, Desroches S, Croteau J, Rivest L-P, Legare F. Engaging Caregivers in Health-Related Housing Decisions for Older Adults With Cognitive Impairment: A Cluster Randomized Trial. The Gerontologist, gnz045, https://doi.org/10.1093/geront/gnz045
Abstract: Informal caregivers are rarely as involved as they want to be in the housing decisions of cognitively impaired older adults. Lack of awareness of available options and their benefits and risks may lead to decisions that do not reflect older adults’ preferences, and to guilt and regret. We assessed the effect of training home care teams in interprofessional shared decision-making (SDM) on the proportion of caregivers who report being active in this decision.
Maltais M, Aubertin-Leheudre M, Dray C, Fielding RA, Rolland Y, Cesari M, Vellas B. Highlights from the 2019 International Congress on Frailty and Sarcopenia Research. J Frailty Aging (2019). https://doi.org/10.14283/jfa.2019.13
Krawczyk M, Sawatzky R. Relational use of an electronic quality of life and practice support system in hospital palliative consult care: A pilot study. Palliat Support Care. 2018 Mar 8:1-6. doi: 10.1017/S1478951518000020
White DE, Virk N, Jackson M, Stelfox HT, Wasylak T, Ghali W. Experimenting with Governance: Alberta’s Strategic Clinical Networks. Healthcare Quarterly 21(4) January 2019; 37-42.doi:10.12927/hcq.2019.25742.
Gibbs JC, McArthur C, Milligan J, Clemson L, Lee L, Boscart VM, Heckman G, Stolee P, Giangregorio LM. Measuring the Implementation of Lifestyle-Integrated Functional Exercise in Primary Care for Older Adults: Results of a Feasibility Study. Can J Aging. 2019 Apr 5:1-17; DOI: 10.1017/S0714980818000739.
Chamberlain SA, Duggleby W, Teaster P, Estabrooks C. Characteristics and unmet care needs of unbefriended residents in long-term care: a qualitative interview study. Aging & Mental Health 2019, DOI: 10.1080/13607863.2019.1566812
Bagshaw S, Adhikari N, Burns K, Friedrich J, Bouchard J, Lamontagne F, McIntyre L, Cailhier J-F, Dodek P, Stelfox H, Herridge M, Lapinsky S, Muscedere J, Barton J, Griesdale D, Soth M, Ambosta A, Lebovic G, Wald R. Selection and Receipt of Kidney Replacement in Critically Ill Older Patients with AKI. CJASN March 2019, CJN.05530518; DOI: https://doi.org/10.2215/CJN.05530518
Morrison J, Laur C, Keller H. SCREEN III: working towards a condensed screening tool to detect nutrition risk in community-dwelling older adults using CLSA data. European Journal of Clinical Nutrition (2019). DOI: https://doi.org/10.1038/s41430-019-0411-3
You JJ, Allatt P, Howard M, Carole A Robinson, Jessica Simon, Rebecca Sudore, Amy Tan, Carrie Bernard, Marilyn Swinton, Xuran Jiang, Doug Klein, Michael McKenzie, Gillian Fyles and Daren Keith Heyland. Short Graphic Values History Tool for decision making during serious illness. BMJ Supportive & Palliative Care doi: 10.1136/bmjspcare-2018-001698
Stolee P, Elliott J, Byrne K, Sims-Gould J, Tong C, Chesworth B, Egan M, Ceci C, Forbes D. A Framework for Supporting Post-acute Care Transitions of Older Patients With Hip Fracture. https://doi.org/10.1016/j.jamda.2019.01.147
Chamberlain S, Hoben M, Squires J, Cummings G, Norton P, & Estabrooks C. (2019). Who Is (Still) Looking After Mom and Dad? Few Improvements in Care Aides’ Quality-of-Work Life. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 38(1), 35-50. doi:10.1017/S0714980818000338
Theou O, Jayanama K, Fernández-Garrido J, Buigues C, Pruimboom L, Hoogland AJ, Navarro-Martínez R, Rockwood K, Cauli O. Can a Prebiotic Formulation Reduce Frailty Levels in Older People? J Frailty Aging 2018;8(1):48-52
Van Scoy LJ, Day AG, Howard M, Sudore RL, Heyland DK. Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers. DOI: https://doi.org/10.1016/j.jpainsymman.2019.01.008
Cho N, Boland L, McIsaac DI. The association of female sex with application of evidence-based practice recommendations for perioperative care in hip fracture surgery.
Kim DH, Afilalo J, Shi SM. Evaluation of Changes in Functional Status in the Year After Aortic Valve Replacement. JAMA Intern Med. February 4, 2019. doi:10.1001/jamainternmed.2018.6738
Campitelli MA, Maxwell CJ, Maclagan LC, Ko DT, Bell CM, Jeffs, L, Morris AM, Lapane KL, Daneman N, Bronskill SE. One-year survival and admission to hospital for cardiovascular events among older residents of long-term care facilities who were prescribed intensive- and moderate-dose statins.
Abstract: Statins are used widely in older adults, particularly those living in long-term care facilities (LTC). In Ontario, over one-third of all residents of LTC are statin users, including 28% of frail residents who have a limited likelihood of 1-year survival; nearly one-quarter of users received high doses. Historically, however, randomized clinical trials studying the efficacy and safety of statins rarely include adults aged 75 years and older, and most have not included LTC residents. This leaves clinicians with little guidance when making ongoing decisions about treatment with statins, such as the appropriate dosing. This study sought to examine the rates of 1-year survival and admission to hospital for cardiovascular events among older LTC residents who were prescribed intensive-dose statins compared with those receiving moderate-dose statins. A retrospective cohort study using population-based administrative data from Ontario identified 21 808 residents in LTC who were 76 years of age and older and were prevalent statin users, and categorized residents as intensive- or moderate-dose users. The rates of mortality and admission to hospital for cardiovascular events at 1 year were similar between LTC residents taking intensive-dose statins compared with those taking moderate-dose statins. This lack of benefit should be considered when prescribing statins to vulnerable LTC residents who are at potentially increased risk of statin-related adverse events.
Heckman GA, Hirdes JP, Hébert PC, Morinville A, Amaral ACKB, Costa A, McKelvie RS. Predicting Future Health Transitions Among Newly Admitted Nursing Home Residents With Heart Failure. JAMDA 2018 12 17 online (in press). DOI: https://doi.org/10.1016/j.jamda.2018.10.031
Abstract: To understand how a heart failure diagnosis and admission health instability predict health transitions and outcomes among newly admitted nursing home residents, a retrospective cohort study of linked administrative data was conducted involving older adults, aged 65 years and above, admitted to nursing homes in Ontario, Alberta, and British Columbia, Canada, from 2010 to 2016. The final sample included 143,067 residents. Adverse events were most common in the first 90 days. A diagnosis of heart failure predicted worsening health instability, hospitalizations, and mortality. The magnitude of the impact of a heart failure diagnosis was greatest for lower baseline health instability. Residents with the highest degree of health instability were also most likely to die in hospital. A diagnosis of heart failure and health instability provide complementary information to predict transfers, deaths, and adverse outcomes. Clearly identifying these at-risk patients may be useful in targeting interventions in nursing homes.
Barclay R, Webber S, Ripat J, Grant T, Jones C. A, Lix L M., Mayo N, van Ineveld C, Salbach N M. Safety and feasibility of an interactive workshop and facilitated outdoor walking group compared to a workshop alone in increasing outdoor walking activity among older adults: a pilot randomized controlled trial. https://doi.org/10.1186/s40814-018-0367-4
Constantinescu A, Li H, Yu J, Hoggard C, Holroyd-Leduc J. Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 37(4), 390-399. https://doi.org/10.1017/S0714980818000417.
Dupuis-Blanchard S, Gould O. Nursing Homes Without Walls for Aging in Place. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 37(4), 442-449. https://doi.org/10.1017/S0714980818000272
Konietzny C, Kaasalainen S, Dal-Bello Haas V, Merla C, Te A, Di Sante E, . . . Hadjistavropoulos, T. (2018). Muscled by the System: Informal Caregivers’ Experiences of Transitioning an Older Adult into Long-term Care. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 37(4), 464-473. doi:10.1017/S0714980818000429
Giguère A, Farmanova E, Holroyd-Leduc JM, Straus SE, Urquhart R, Carnovale V, Breton E, Guo S, Maharaj N, Durand PJ, Légaré F, Turgeon AF, Aubin M. Key stakeholders’ views on the quality of care and services avilable to frail seniors in Canada. BMC Geriatrics 2018 18:290. BMC Geriatrics201818:290. https://doi.org/10.1186/s12877-018-0969-y
Abstract: Frail seniors often receive ineffective care, which does not meet their needs. It is still unclear how healthcare systems should be redesigned to be more sensitive to the needs and values of frail seniors and their caregivers. We thus aimed to describe key stakeholders’ perspectives on the current healthcare and services available to frail seniors. Our findings suggest redesigning assessment, communication with frail seniors and their caregivers, targeting care and services to the needs, and integrating care better across settings and in time. A systematic identification of frail older people is the first step to adapt healthcare systems to this population’s needs. Participation of frail older people and their caregivers to decision making would also allow choosing care plans meeting their care goals. The integration of care and services across settings, over time, and with various providers, is also needed to meet frail senior needs.
(2018) Dying in Long-Term Care: Perspectives from Sexual and Gender Minority Older Adults about Their Fears and Hopes for End of Life, Journal of Social Work in End-of-Life & Palliative Care,
Maxwell CJ, Campitelli MA, Diong C, Mondor L, Hogan DB, Amuah JE, Leslie S, Seitz D, Gill S, Thavorn K, Wodchis WP, Gruneir A, Teare G, Bronskill SE. Variation in the health outcomes associated with frailty among home care clients: relevance of caregiver distress and client sex. BMC Geriatr. 2018; 18:211. Epub 2018 Sep 12.