With the predicted increase in the age of Canada's overall population, it is estimated that by 2020, up to 75% of nurses' time will be spent with older adults. It is recognized that care of older adults occurs in a cultural context in which the older members of society are poorly valued, often referred to as ageism. Based on the premise that attitudes affect behavior and knowledge acquisition, a comparative cross-sectional study using the Attitudes Toward Old People scale measured nursing students' attitudes at different points in a baccalaureate nursing program. Although analysis of variance revealed no significant differences in students' attitudes during the 4 years, post hoc analysis revealed a drop in positive attitudes and a rise in negative attitudes at the beginning of the second and fourth years of the baccalaureate program.

The philosophical orientation of Gadamerian hermeneutic phenomenology is explored in this paper. Gadamer offers a hermeneutics of the humanities that differs significantly from models of the human sciences historically rooted in scientific methodologies. In particular, Gadamer proposes that understanding is first a mode of being before it is a mode of knowing; what this effectively offers is an alternative to the traditional way of understanding in the human sciences. This paper details why the work of hermeneutics is not to develop a procedure for understanding, but to clarify the conditions of understanding. In this explication, the author examines the hermeneutic experience and, in the process, relates it to both the practical and the historical horizons of the lifeworld of health professionals, particularly nurses.

Recognizing that older adults are among the biggest consumers of medication, and the demographic group most likely to suffer an adverse drug reaction (ADR), this paper details the findings from a recent study on how older adults come to understand medication and its related use. Using a qualitative content analysis method, semi-structured interviews were conducted with 21 individuals from British Columbia, Canada. Study participants ranged in age from 65 to 89 years (male=9, female=11). Using NVIVO® 7 software, data were subjected to comparative thematic content analysis in an effort to capture the role of medication use in the context of everyday living as understood by older adults. While there was variability in how older adults come to understand their medication use, an overarching theme was revealed whereby most participants identified their prescription medications as being life-sustaining and prolonging. Deeper thematic content analysis of participant narratives drew attention to three key areas: (A) medications are viewed as a necessary, often unquestioned, aspect of day-to-day life (B) a relationship is perceived to exist between the amount of medications taken and ones current state of health (C) the overall medication experience is positively or negatively influenced by the doctor patient relationship and the assumption that it is the physicians role to communicate medication information that will support everyday living. The article concludes that medical authority and the complexities surrounding medication use need to undergo significant revision if community dwelling older adults are to experience greater success in safely managing their health and medication-related needs.

Purpose – The purpose of this paper is to understand how changes in an older adult’s physical capacity alter their bathing preferences, how the care environment incorporates residents’ values and beliefs around bathing to fulfil these changing care needs, and how institutional factors, such as staff scheduling and communication processes, influence Resident Care Aides’ (RCAs) bathing practices. Design/methodology/approach – A multiple methods approach involving surveys and interviews with residents and RCAs in a Canadian residential care facility. This paper draws mostly from the semi-structured, qualitative interviews with older adult residents (n=9; Mini Mental Status Exam (MMSE) scores > 15) and RCAs (n=10) on two nursing units offering different bathing options. Findings – Decreasing energy levels and physical decline were commonly cited reasons for residents’ changing bathing preferences. Residents were overall very appreciative of the bathing care they received in residential care, and identified the weekly tub bath as an anticipated encounter where they experienced a valued social interaction with their assigned RCA. While identifying bathing as an occasionally stressful aspect of their work, RCAs also described the bathing experience as an intimate bonding activity. The study identified bathing as an important activity in residential care. Originality/value – Previous studies have focused on moderate to severely cognitively impaired older adults’ and their demonstration of agitated behaviours during bathing. Most participants in this study had only minor cognitive impairment, as measured by MMSE scores (average score=20.6); therefore, this study provides insight into the experiences and needs of older adults whose perspective is not generally reflected in the literature.

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