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Speech And Swallowing Outcomes In Patients Treated For Oral Cavity Cancer, Victoria N. Lebedeva

Electronic Thesis and Dissertation Repository

This study investigated the natural history of speech and swallowing function of patients treated for oral cavity cancers (OCC) of the oral tongue and/or floor of mouth (FOM), and explored relationships among clinico-demographic and treatment-related variables and speech and swallowing performance. Patient-, disease- and treatment-related data were collected along with clinical outcomes data from medical charts of 72 individuals. Repeated measures analyses revealed changes in speech and swallowing function post-treatment with a general pattern of worse function at hospital discharge and improved function long-term post-treatment, although function did not return to baseline levels. Correlation and regression analyses identified that, in …

The Role Of Leisure In Older Adults Moving Homes, Kristin Prentice

Electronic Thesis and Dissertation Repository

Moving homes is a common experience for older adults in later life. Concomitant with moving is the transition process of adapting to the new home and developing a sense of place. When older adults change residences they experience disruption in place and risk losing identities. Leisure engagement has been known to help older adults adapt to new transitions in their life, such as death of a spouse, health decline and retirement. Leisure engagement has been linked to the development of sense of home and maintaining identity when moving to residential care settings and congregate living, however, these processes are not …

The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp

Electronic Thesis and Dissertation Repository

The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …

Lived Experience Of Having Difficult Conversations Among Care Partners Of Individuals With Parkinson's: An Occupational Science Perspective, Helen A. Reid

Electronic Thesis and Dissertation Repository

Difficult conversations, which can be challenging co-occupations, play an important role in the lives of care partners of individuals living with Parkinson’s disease. In our first study for this integrated-article thesis, we used a critical interpretive synthesis to explore how informal caregiving had been conceptualized in occupation-focused research. We found that an occupational perspective illuminated otherwise overlooked aspects of caregiving. In our second study, we used an occupational science lens to explore how seven care partners of individuals with PD experienced having difficult conversations within the caring role. We conducted two rounds of in-depth semi-structured interviews and used an American …

Exploring The Perspectives Of Older Adults And Health Care Providers On Patient Participation In Transitional Care From Hospital To Cardiac Rehabilitation During The Covid-19 Pandemic, Cecilia Flores Sandoval

Electronic Thesis and Dissertation Repository

Older adults who transition from hospital to cardiac rehabilitation settings often are vulnerable and at risk of experiencing adverse health care outcomes. Given the complexities of transitional care, it is crucial to engage older adults in the clinical decision-making process and to promote their active participation in their medical care. Older adults have unique ways of understanding their participation in the transitional care process. Gaining an in-depth understanding of their specific needs during this process can help inform clinical practice and interventions aiming to improve care for older adults living with cardiovascular disease. Focused ethnography methodology was used to explore …

Descriptive Analysis Of Fall-Related Injuries Among Older Adults In Ontario, Nicolette Lappan

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. The purpose of this study was to describe the characteristics of older adults who experienced fall-related injuries (FRIs) and the types of falls that caused them. We analyzed Ontario-wide secondary data from three databases (NACRS, DAD, RPDB) covering 2010-2014. Older adults (≥ 65 years) who visited emergency departments (ED) with FRIs were selected using ICD-10-CA codes for a fall and injury. Counts, measures of central tendency, and prevalence rates (crude, age- and sex-specific, age-standardized) were calculated. There were 304,610 (63.0% females) ED admissions (3,089 per 100,000 population) …

Fall Risk-Increasing Drugs And Gait Performance In Community-Dwelling Older Adults: Results From The Gait And Brain Study, Abdelhady Osman

Electronic Thesis and Dissertation Repository

Medication use and gait impairment are two of the most important risk factors for falls. Several drug classes have been classified as fall risk-increasing drugs (FRIDs). Gait is an important marker of overall health and independence in older adults. The overall aim of this thesis was to examine the relationship between FRIDs and gait performance in older adults through two studies. Firstly, our systematic review of twenty studies on the association between FRIDs and gait performance found that the use of drugs with sedative properties is associated with reduced gait speed. Secondly, we conducted a cross-sectional analysis of data from …

Older Adult Care Transition Experience Following Inpatient Rehabilitation, Patricia Versteegh

Electronic Thesis and Dissertation Repository

The internationally used 15 item Care Transition Measure (CTM-15) has been primarily used to assess the care transition experience among adults transitioning from acute care to home. Although the CTM-15’s psychometric properties have been established in this population, the ability of the CTM-15 to reliably discriminate a good from a bad care transition experience among older adults (60 or more years of age) moving from an inpatient rehabilitation setting to home is unclear. The purpose of this prospective observational cohort study was to: 1) evaluate the psychometric properties of the CTM-15 when used among older adults transitioning from an inpatient …

Population-Based Studies On Medications And Fall-Related Injury In Older Adults, Yu Ming

Electronic Thesis and Dissertation Repository

Background: Fall-related injuries in older adults result in serious consequences to individuals and health care system, especially with the increasing aging population. The purpose of this study was to (1) describe medication prescription patterns within one year prior to fall-related injuries; (2) identify medication classes prescribed within 30 days prior to the injury that were associated to fall-related injury; and (3) examine the association between fall-related injuries and continuous use or new initiation of most commonly prescribed medications.

Methods: Studies used administrative health care data in Ontario. Study 1 described the frequency of medications prescribed to older adults within one …

Exploring Co-Occupation Between University Students And Older Adults Living Together In A Retirement Home, Rachel J. Gorjup

Electronic Thesis and Dissertation Repository

Intergenerational housing programs in which young and older adults live together have been implemented worldwide, yet research exploring these programs is sparse. An important component of intergenerational living seems to be the activities that young and older adults engage in together. Taking a lens of co-occupation, that is everyday occupations performed together by two or more people, this thesis explored how university students and older adults, living together in a retirement home, enacted co-occupations and the factors that shaped these co-occupations. A focused ethnography, involving interviews and observations, was used to gain insight into the co-occupational experiences of the students …

When Life Gives You Lemons: The Development And Validation Of The Resilience Scale For Older Adults, Claire A. Wilson

Electronic Thesis and Dissertation Repository

The study of resilience, or positive adaptation in the face of adversity, is important across the lifespan, but may be particularly relevant for older adults who tend to experience an increasing number of challenges. Traditionally, resilience assessment has largely focused on child and young-to-middle aged adult populations, and as such, the literature is lacking a validated resilience measure developed specifically for older adults. This dissertation aimed to improve the measurement of resilience in older populations by developing and validating a new resilience measure that is relevant and appropriate for older adults. In Study 1, a qualitative metasynthesis was conducted to …

Health-Seeking Behaviour Related To Selected Dimensions Of Wellness In Community-Dwelling Older Adults, Navjot Gill

Electronic Thesis and Dissertation Repository

Older people generally prefer to ‘stay-put' in their own homes. Informed by the Seven Dimensions of Wellness, a component of the International Council on Active Ageing (ICAA) Model, measures of physical function (i.e. physical), fall risk (i.e. environmental), and psychosocial factors (i.e. emotional, spiritual and social) related to wellbeing were selected. It is assumed that they intersect to influence the health-seeking behaviour of older adults ageing-at-home. The primary objective of this cross-sectional design study was to investigate the relationship among dimensions of well-being, including physical function, fall risk, psychosocial factors, and awareness of community support services, with health-seeking behaviour in …

Feasibility Of Dual-Task Gait Assessment And Association With Cognitive Impairment Subtypes In A Memory Clinic Setting, Stephanie Cullen

Electronic Thesis and Dissertation Repository

The objectives of this thesis were 1) to assess feasibility and practicality of gait performance to help differentiate cognitive diagnoses, 2) to assess differences in gait speed and dual-task gait cost across the cognitive spectrum, and 3) to determine if poor baseline gait performance is associated with future cognitive decline, all within a clinical setting. Patients at the Aging Brain and Memory Clinic completed gait assessment, consisting of a usual gait trial and three dual-task gait trials, in addition to cognitive and clinical assessments. Patients who had two clinic visits during the study period were also included in a longitudinal …

Cognitive Impairment And The Mediterranean Diet: A Canadian Perspective, Ivan Culum

Electronic Thesis and Dissertation Repository

Global life expectancy has increased steadily over the past century and is projected to continue increasing. Life expectancy increases are co-occurring with a reduction of fertility rates in many economically developed countries, which is resulting in an aging population, meaning that the proportion of older adults within the total world population will continue to increase. This is of particular concern as there is a rise of chronic neurodegenerative diseases among older adults, such as dementia, where the number of global deaths more than doubled since the turn of the century, making dementia the fifth leading cause of death worldwide. Dementia …

Asset-Based Community Capacity Building: A Process For Expanding A Retirement Home Physical Activity Program, Charlotte W. Crombeen

Electronic Thesis and Dissertation Repository

The population is aging rapidly and physical inactivity and sedentary behaviour are on the rise, a trend noticed at a northern Ontario retirement home looking to improve the choices for, and attendance at, physical activities provided for residents. A community capacity building (CCB) approach using an asset-based, partnership methodology was utilized to create internal and external asset maps. These maps were used to inform potential partnerships within the community. Partnerships were recommended with a university, college, and two high schools, whose staff and students could help to implement new physical activities. Walking and gardening clubs were presented as examples that …

The Phenomenology Of Masters Alpine Ski Racers: Experiencing Ski Racing In Old Age, Carly Litchfield

Electronic Thesis and Dissertation Repository

This thesis is a study of the lived experience of ten older adult alpine ski racers in their continued participation in ski racing. The aim of this study was to gain an understanding of the experiences of these older adults as they continued to compete in ski racing. Masters skiers between the ages of 69 and 82 participated in individual interviews lasting between 30 and 60 minutes. Data analysis was completed using van Manen’s phenomenological methods and the visual technique of mind mapping. The major theme that emerged was the importance of being a ski racer to participants’ identities. The …

Examining The Roles Of Life Satisfaction, Meaning In Life, And Daily Hassles In Predicting Suicide Ideation Among Community-Residing Older Adults, Orsolya Gyorgy

Electronic Thesis and Dissertation Repository

Research is needed testing models that potentially promote psychological well-being and reduce suicide risk in later life (Heisel, 2006). In the present study, we tested Shmotkin (2005) and Shrira’s (2011) theory proposing that subjective well-being and meaning in life serve unique as well as interrelated roles in promoting psychological functioning in the face of adversity. We specifically investigated whether life satisfaction and meaning in life are more strongly inter-correlated in the presence of daily hassles, and tested the premise that when either life satisfaction or meaning in life is low, the other variable is more strongly associated with suicide ideation, …

Antihyperglycemic Medications And Hypoglycemia In Older Adults With Diabetes, Kristin K. Clemens

Electronic Thesis and Dissertation Repository

Background: In the last decade, several new antihyperglycemic medications have been approved to treat people with diabetes. However, the hypoglycemia risk of these medications in older adults in routine clinical practice remains unclear. Further, there is limited understanding as to how these medications are being prescribed to older adults in our region.

Methods: We carried out retrospective, population-based studies of adults age 66 and older in Ontario, Canada using linked healthcare databases. We first investigated the real-world hypoglycemia risk of 2 antihyperglycemic medications – glyburide and modified-release gliclazide. In an ecological study, we then examined trends in antihyperglycemic medication prescriptions, …

Investigating Personality Vulnerability To Suicide Ideation In Community-Residing Older Adults, James Andrew Mcclure

Electronic Thesis and Dissertation Repository

This study assessed associations between suicide ideation and personality characteristics in a sample of community-residing adults 65 years of age and older. Measures of personality, suicide ideation, and depression were administered at two time points 6-12 months apart. Multiple linear regression analyses were employed to investigate cross-sectional and longitudinal associations between personality characteristics and suicide ideation. A total of 106 older adults (mean age=74.2 years, SD=5.8, including 78 women) completed both phases of the study. The majority of participants included in this study were relatively emotionally and psychologically healthy. Within this sample of older adults, more severe suicide ideations was …