challenging to organize. Results suggest that the assistance provided during the group information session was sufficient to motivate and guide participants in recording their preferences. Whether interacting with the facilitator better prepares proxies to make substitute decisions on behalf of an incompetent older adult should be investigated in the future, with attention paid to healthcare and research decisions. ADs completed in isolation have been found to provide little guidance to surrogates who are later called upon to make substitute decisions. 10 Timely access by surrogates to completed ADs is also known to be problematic. Older adults and proxies attended the group information session. Further research is needed to determine whether this feature of the intervention allows proxies to gain better insight into recorded wishes.
Advance planning has increased over the last 2 decades in Canada. Nonetheless, further efforts are needed to encourage Canadians to voice their health care and research preferences in the event of incapacity. Physicians are well situated to promote advance planning to Canadians.
A large majority of Canadians are comfortable with proxy consent for low-risk research. Further work is needed to establish what kinds of research are considered to be low risk.
The private industry now provides better care to its residents. Improvement in care quality likely results in part from the closure of small homes and change in resident case-mix.
In the province of Quebec, Canada, long-term residential care is provided by two types of facility: privately owned facilities in which care is privately financed and delivered and publicly subsidised accredited facilities. There are few comparative data on the residents served by the private and public sectors, and none on whether their respective population has changed over time. Such knowledge would help plan services for older adults who can no longer live at home due to increased disabilities. This study compared (a) the resident populations currently served by private and public facilities and (b) how they have evolved over time. The data come from two cross-sectional studies conducted in - and -. In both studies, we randomly selected care settings in which we randomly selected older residents. In total, residents from settings assessed in - were compared to residents from settings assessed in -. In both study periods, older adults housed in the private sector had fewer cognitive and functional disabilities than those in public facilities. Between the two study periods, the proportion of residents with severe disabilities decreased in private facilities while it remained over per cent in their public counterparts. Findings indicate that private facilities care today for less-disabled older adults, leaving to public facilities the heavy responsibility of caring for those with more demanding needs. These trends may impact both sectors' ability to deliver proper residential care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.