Psychogeriatric client identification project : phase 1 - final report

The Psychogeriatric Client Identification Project, contracted by the Continuing Care Division and conducted by the Gerontology Research Centre at Simon Fraser University, provides a comprehensive description of the diverse client groups that are typically included under the umbrella term, "psychogeriatric." Traditionally, psychogeriatric clients have been categorized according to medical diagnoses. The current research project adopted a different approach to identifying client needs by using an inclusive definition of the psychogeriatric population and by describing clients in relation to both behavioural characteristics and diagnosis. The focus of the project was on identifying the unique characteristics, behaviours and corresponding needs of client subgroups for the purpose of planning and delivering appropriate services. The specific project objectives were to: 1. describe the characteristics of the various psychogeriatric subgroups, with particular emphasis on behaviours that pose significant care and management challenges within facility and community settings; 2. summarize statistical information on prevalence and projected numbers for British Columbia for the various subgroups; and 3. identify the availability of a model of psychogeriatric care and services that could be applied to policy development and resource planning.Table of Contents: Executive Summary; INTRODUCTION 1: A. Background and Project Objectives; B. Definition of Terms and Behavioural Classification Scheme; C. Report Organization. LITERATURE REVIEW & EPIDEMIOLOGIC/STATISTICAL DATA: A. Introduction; B. PART 1 - Problem Behaviours; Multi-Category Studies: Community; Multi-Category Studies: Institution; Agitated! Aggressive Behaviour; Physical; Verbal; Agitated/Non-Aggressive-Physical; Agitated/Non-Aggressive-Verbal; Ideational; Emotional/Affective Disturbance; Socially Unacceptable Behaviour; Problematic ADLs/Coping Strategies. C. PART 2 - Client Identification by Psychiatric Diagnosis: Prevalence of Psychiatric Disorders: Dementia; Delirium; Mood Disorders; Anxiety Disorders; Schizophrenia and Paranoia; Substance Dependence/Abuse. D. Summary and Conclusions. CONSULTATION PROCESS: A. Research Design/Methods; B. The Sample: Key Informant Survey Participants; Focus Group Participants; C. Data Collection and Analysis. IV RESEARCH FINDINGS: Key Informant Survey: A. Characteristics of Survey Respondents; B. Agency Characteristics; C. Description of Client Characteristics/Behavioural Disturbances and Service Response; D. Most Problematic Client Behaviours; E. Assessment of Facility and Community-Based Resources/Needs; F. Description of Behavioural Disturbance Categories/Groupings; G. Behavioural Disturbance Frequency Ratings; H. Behavioural Disturbance Difficulty Ratings; I. Behaviour Management Difficulty Ratings; J. Specialized Programs/Approaches and Suggested Improvements; K. Utility of Behavioural Classification Scheme; L. Suggested Program Improvements; Focus Group Sessions; M. Summary of Focus Group Results: BC Caregivers\u27 Support Group; Frontline Direct Care Nursing Staff. V CONCLUSIONS AND RECOMMENDATIONS: A. BC Prevalence Estimates by Diagnoses; B. Recommendations Related to Client Subgroups and Resource Needs; C. Recommendations for Future Study. REFERENCES; APPENDICE

Mature students in the persistence puzzle: an exploration of the factors that contribute to adult learners\u27 quality of life and retention in post-secondary education

Mature Students in the Persistence Puzzle explored new theoretical directions and methodological approaches for studying adult learners’ quality of life and retention in the first year of general arts and science programs in a university-college environment. The study was conducted to broaden and deepen our understanding of the multifaceted nature of mature students’ lives and those factors exerting important influences on mature students’ educational commitment and persistence. Because there are few studies that focus on adult learners’ post-secondary experiences and fewer still that incorporate detailed student perspectives, results will provide valuable information for informing institutional student retention policies and practices. An adult quality of life conceptual framework was used to explore the broad connections between health and learning, based on a synthesis of social ecology, health promotion, adult learning, and student development research. Mixed methods included a phenomenological hermeneutical-based approach for conducting in-depth interviews with first-year students aged 25-72 years. Phenomenological methods were also used to facilitate a faculty focus group to identify the teaching and learning strategies that support mature students’ educational commitment and persistence. The naturalistic inquiry findings were complemented by standard multiple regression analyses performed on the age-aggregated data of the 2005/06 Pan-Canadian Study of College Students and First Year Outcomes. In summary, eight main themes emerged from the qualitative data analysis focusing on: a) major life transitions; b) multifaceted educational goals; c) awareness of personal assets; d) relationships with professors; e) peer relationships; f) life-role conflicts; g) supportive institutional infrastructure; and h) experiential learning opportunities. Faculty members reinforced the importance of student-faculty relationships and experiential learning during the focus group. The multiple regression model contributed significantly to the prediction of intentions to persist or withdraw, educational commitment, confidence, and satisfaction. Overall, study findings revealed that goal orientation, perceived relevance of studies, student-faculty relationships, and financial concerns were the most influential contributors to mature students’ educational commitment and persistence. The implications for faculty, student-development staff, and educational leaders were discussed, along with practical strategies for creating and maintaining a health-promoting campus environment to optimize adult learners’ quality of life and retention