Research on caregiver identity in the context of memory impairment has focused primarily on more advanced stages of the cognitive impairment trajectory (e.g., dementia caregivers), failing to capture the complex dynamics of early caregiver identity development (e.g., MCI; mild cognitive impairment caregivers). The aim of this study was to develop a nuanced understanding of how caregiver identity develops in family and friends of persons living with MCI. Using constructivist grounded theory (ConGT), this study explored caregiver identity development from 18 in-depth interviews with spouses ( n = 13), children ( n = 3), and friends ( n = 2) of persons recently diagnosed with MCI. The overarching themes influencing MCI caregiver identity development included MCI changes, care-related experiences, “caregiver” interpretation, and approach/avoidance coping. These themes influenced how participants primarily identified, represented as I am a caregiver, I am not a caregiver, or liminality (i.e., between their previous identity and a caregiver identity). Irrespective of their current self-identification, all conveyed thinking about their “future self,” as providing more intensive care. MCI caregiver identity development in family and friends is a fluid and evolving process. Nearly all participants had taken on care tasks, yet the majority of these individuals did not clearly identify as caregivers. Irrespective of how participants identified, they were engaging in care, and would likely benefit from support with navigating these changes and their new, ambiguous, and evolving roles.

Introduction Invasive medical procedures such as colonoscopies can cause psychological distress and anxiety. Mycolonoscopy.ca is a multilanguage website that provides online written and video information (individual items reported in prior publications to be highly rated by patients) regarding preparation and what to expect before, during, and after colonoscopy. Information about how to access the website is included with all colonoscopy appointment materials in Winnipeg, Manitoba. We evaluated the use of mycolonoscopy.ca among patients undergoing colonoscopy and examined the association between visitation to the website and patient outcomes. Methods A paper-based survey was distributed to patients attending their colonoscopy appointments between 11/2019 and 3/2020. Logistic regression analyses were performed to determine the factors associated with website visitation, procedural worry, and bowel preparation scores. Results Five hundred and ninety-three surveys were distributed, of which 506 were completed. 17.4% of participants had visited the website before their colonoscopy. Visitors to mycolonoscopy.ca were more likely to consume a split-dose bowel preparation (63.9%) compared with non-visitors (52.5%) (P = 0.006). 31.3% of website visitors were very/extremely worried about their colonoscopy compared with 17.9% of non-visitors. 76.6% of individuals agreed/strongly agreed that visiting the website helped them prepare for their colonoscopy and 69.7% who visited the website agreed/strongly agreed that it helped to reduce their stress/anxiety for the procedure. In multivariable analyses, visitation to website was associated with higher adequate bowel preparation (OR:10.55; 95% CI:1.35 to 82.4). Conclusion Use of an informative online platform such as mycolonoscopy.ca can help to improve patient education before colonoscopy, reduce worry surrounding the procedure, and improve bowel preparation.

In June 2016, Canada joined the handful of nations that have legalized physician-assisted dying (PAD). Yet, with legislation restricting PAD to the terminally ill, many have been left contending for the right to PAD in cases of debilitating chronic illness, including, but not limited to, severe mental illness. This commentary serves to evaluate and continue the discussion of Canadian PAD for the mentally ill as introduced by Karesa and McBride (2016), present and compare the results of our own research, and promote ongoing discourse on this subject. Karesa and McBride (2016) surveyed psychologists regarding a prospective role for their profession in the PAD process, as well as their attitudes toward PAD. We evaluate their methodology and findings, suggesting manners in which future investigations of psychologists’ attitudes toward PAD can be improved. Implementing some of these suggestions, our own study assessed n = 201 Canadian undergraduates’ attitudes toward PAD for 2 mental illnesses (schizophrenia, depression) as compared with PAD for physical illness (multiple sclerosis [MS]). In a repeated measures design, participants read vignettes depicting individuals who suffer grievously from 1 of MS, schizophrenia, or depression. In accordance with the primary hypotheses, schizophrenia and depression received lower levels of support for PAD, and were perceived as involving less suffering, rationality, and futility of treatment compared to MS. Our study provides further insight into the ways in which people differentiate physical and mental illnesses, and our discussion adds a Canadian perspective to a pressing subject that, to date, has not been thoroughly investigated.

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