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Neena L. Chappell is professor of sociology at the University of Victoria. She has served as president of the Canadian Association on Gerontology (2008-2012) and is president of Academy II (Social Sciences) of the Royal Society of Canada, 2011-13.
Marcus J. Hollander is president of Hollander Analytical Services Ltd. He has over 30 years of experience in health services research, evaluation, and administration, including working as director of the health network of the Canadian Policy Research Networks.
Table of Contents
List of Illustrations Preface Acknowledgements 1. Introduction 2. Population Health and Aging Introduction More Older Canadians Dependency Ratios: Cause for Concern? Interpreting Dependency Ratios The Health of Older Canadians Chronic Conditions Functional Disability Self-Perceptions of Health Summary Well-Being Frailty Subpopulations Summary Health Promotion and Disease Prevention Summary 3. Informal Care Introduction Social Support and Caregiving Caregiving in the West Caregiver Stress and Burden Understanding Caregiver Burden Other Directions in Caregiving Research Caregiving in the Future In Sum Social Policy and Caregiving Caregiving Policies and Programs in Canada International Experience The Need for Care for Caregivers Summary 4. The Evolution of Continuing Care for Older Adults Introduction The Historical Evolution of Continuing Care The Emergence of Social Security in Canada (1700s-1945) The Consolidation of Social Security (1945-early 1970s) Fiscal Retrenchment (early 1970s-early 1990s) Reform and Retrenchment (early 1990s-present) Current Concerns Discussion 5. The Economic Evaluation of Continuing Care Introduction An Overview of Economic Analysis The Cost-Effectiveness of the Maintenance and Preventive Function of Home Care Home Care as a Substitute for Residential Care The Cost-Effectiveness of Home Care Compared to Acute Care Hospitals The Cost-Effectiveness of Other Continuing Care Services Discussion 6. Delivering Care for Older Adults: Models of Integrated Care Introduction Examples of Successful Integrated Systems of Care Larger Provincial Models Smaller Models with Home, Community, and Residential Care Components Smaller, Integrated Community Based Models The Chronic Care Model Frameworks to Inform the Development of Integrated Systems of Care Delivery Three Highly Regarded Frameworks The Enhanced Continuing Care Framework Discussion Conclusion 7. Discussion and Blueprint for Action Introduction A Critical First Step Twenty Years of Policy Drift A Response to the Skeptics The Cost-Effectiveness Data No Longer Apply Actual Savings are Not Possible Large Scale Change is Not Feasible Getting it Right Conclusions References Index