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Considering Seniors’ Mental Health in Federal and Provincial Policies in Canada: Focus on Home Care and Long-Term Care Where have we been? Where are we going? And why does it matter?

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Title: Considering Seniors’ Mental Health in Federal and Provincial Policies in Canada: Focus on Home Care and Long-Term Care Where have we been? Where are we going? And why does it matter?
Author: Wilson, Kimberley
Department: Department of Family Relations and Applied Nutrition
Program: Family Relations and Applied Nutrition
Advisor: Tindale, JosephLero, Donna
Abstract: Increased life expectancies and the prevalence of chronic illness in late life have illuminated a structural lag in our healthcare systems. While Canada’s publicly insured healthcare system was designed around acute illness, older adults use home and long-term care services more than other age groups. There is also a need for understanding the impact and prevalence of mental illnesses in late life. Given that older adults with mental illness frequently use services outside of the publicly insured healthcare system, this dissertation explores how provinces have organized home and long-term care to support older adults with mental health issues. This research is guided by the political economy theory of aging and the life course theoretical perspective. Qualitative methods including the Policy Triangle Framework and Framework Analysis were used in this comparative analysis of Alberta, British Columbia, Nova Scotia, and Ontario. Through analysis of 23 policy documents and 18 key informant interviews, findings are organized by themes associated with research questions. This includes analysis of the content of the policies, and an exploration of the key drivers, processes, context, and actors/champions that interact to shape policymaking. Current policy gaps and alignment with evidence in the field are examined. Cross-provincial analysis found that seniors’ mental health falls between gaps in policies. Furthermore, mental health strategies focus on children/youth, and aging policies often minimize mental health issues beyond dementia. Provincial political ideologies and contexts influence messaging in policies, as evidenced by a residualist social welfare model in Alberta. Apocalyptic demography, especially intergenerational justice, is found within policy documents, focusing on “fair” and “equitable” systems that meet the needs of seniors without compromising other populations. Across provinces there is divergence from research in terms of the perspective around mental illness and dementia. Instead of taking an integrated view, policy silos and legacies separate dementia as a medical/organic issue and mental illness as a psychiatric issue. Promising innovations are also highlighted. Theses findings contribute to the literature about seniors’ mental health policy in Canada. Challenges to doing applied health policy analysis in an ever-changing landscape are discussed, and future research directions and policy recommendations are offered
URI: http://hdl.handle.net/10214/8792
Date: 2015-04


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