University of Victoria

Critical Engagements with Aging: Challenging Dominant Paradigms and Seeking New Solutions

Significant changes in longevity and fertility as well as improvements in health care and social circumstances over the past half century have resulted in an unprecedented growth in the older adult population. Research that explores the impact of population aging on society has witnessed the influx of theoretical and empirical contributions from a wide range of disciplines, including Sociology. In this session, we welcome papers that cast a critical gaze on the phenomenon of population aging, the lived experience of old age, and the production of knowledge on these issues. Papers can be on topics as varied as apocalyptic demography, the medicalization of the older body and chronic conditions such as dementia and osteoporosis, discursive analyses of disciplinary knowledge on aging, issues of intersectionality and aging, the implications of changing family structure on social support and care in later life, and the social stigmatization of older adults, particularly older women. Explorations of new conceptualizations of aging and alternate approaches to the care of older adults are also welcome. Contributions on other topics will also be considered as long as they adhere to the broad critical focus that frames this symposium.

Chair: Andre Smith, PhD, University of Victoria, apsmith@uvic.ca

Session Organizer: Karen Kobayashi, University of Victoria, kmkobay@uvic.ca ; Andre Smith, University of Victoria, apsmith@uvic.ca

The Use and Reproduction of Discourses in Making Sense of Health and Social Care for Older Persons

Laura Funk, University of Manitoba, Laura_Funk@umanitoba.ca

In this paper, I highlight the various ways in which sense-making, as a social process among paid and unpaid care providers, involves drawing on and further reinforcing particular ideas and discourses which detract attention away from broader structural concerns shaping the delivery of care to older persons. Specifically, I bring together and extend findings from four separate qualitative research studies involving in-person interviews with family members and formal health care providers. I illustrate how participants tended to make sense of their experiences by drawing on and reproducing frameworks such as individual choice, familial responsibility, ageism and apocalyptic demography. I conclude by discussing potential implications for research, practice and policy related to formal and informal care for older persons.

Monday June 3, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-161

Intergenerational Family Relations Among Senior Canadian Immigrants

Valerie Preston, York University, vpreston@yorku.ca , Nancy Mandell, York University, mandell@yorku.ca , Katharine King, York University, kthrnking@gmail.com , Natalie Weiser, York University, nweiser@yorku.ca , Meg Luxton, York University, mluxton@yorku.ca , Ann Kim, York University, akim@yorku.ca

Aging, immigration and intergenerational relations have emerged as topics of both global and national significance. The ‘graying’ of the globe has meant that increasing numbers of people immigrate in their senior years. Since most immigration takes place within a family context, intergenerational relations become essential in understanding the complex ways in which aging, globalization and immigration intersect to construct new forms of later life families. Using a life course perspective, we discovered bidirectional intergenerational exchanges within later life families based on data gathered from twelve focus groups with over ninety immigrant seniors in Toronto. By concentrating on intergenerational relations, we outline the varied types of financial, emotional, and domestic care support experienced by senior immigrants in aging families. In this discussion, we reveal the ways in which different forms of later life families both shape, and are shaped by, processes of transnational aging and transnational family relations.

Monday June 3, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-161

Discontinuing Cholinesterase Inhibitor Therapy for Alzheimer’s Disease: The black Art of Negotiating Hope, Transition, and Ending

Andre Smith, University of Victoria, apsmith@uvic.ca , Karen Kobayashi, University of Victoria, kmkobay@uvic.ca , Neena Chappell, University of Victoria, nlc@uvic.ca

The issue of when to discontinue cholinesterase inhibitors (ChEIs) in the treatment of Alzheimer’s disease (AD) is highly debated given the absence of clear clinical guidelines about the long-term therapeutic value of this treatment. This study presents findings derived from 26 interviews with family caregivers to persons with AD who were withdrawn from ChEI therapy and four focus groups with 19 physicians who regularly prescribe ChEIs. The decision to discontinue ChEI therapy involved a complex interplay between caregiver appraisal of the drugs’ benefits and physician/specialist assessments of the patient’s condition. Physicians were influenced in their decisions to continue prescribing ChEIs by caregivers’ deeply felt narratives of subtle improvement and/or plateauing of symptoms. These narratives rarely offered physicians clear parameters from which to formulate an unambiguous clinical decision and served instead as the basis for caregivers to negotiate the continued prescribing of ChEIs on a precautionary basis, often over a period of several years. Discontinuation of ChEI therapy typically occurred either when care recipients experienced an adverse drug reaction or when they were transitioned to institutions. This study offers insight into the constructed nature of therapeutic benefit in the context of hope, uncertainty and controversy.

Monday June 3, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-161

Caregiving for Older Chinese Living with Cardiovascular Diseases: Barriers, Needs, and Service Gaps

Lichun Liu, University of Lethbridge, willaliu@hotmail.com

This paper examines the barriers, needs, and service gaps of Chinese Ontarians with cardiovascular diseases and their family caregivers in accessing health information, health care services, and community health promotion programs. Funded by the Heart and Stroke Foundation of Canada, this paper used mixed research methods in data collection, which involves focus groups (n=9), face-to-face / phone individual interviews (n=8), and an open-ended email survey. Sixty-two people participated in this research, which included 26 survivors with cardiovascular diseases, 29 caregivers, and 17 health care providers from across Ontario. A gender-based analysis was conducted by highlighting the intersectionality of gender, age, class (education and income), ethnicity, language, length and location of residence in Canada. This paper argues that integration and coordination of community services and programs are needed in order to improve accessibility to mainstream health information and ethnically friendly health care services among new immigrant seniors living with cardiovascular diseases.

Monday June 3, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-161