Hospitalization at the end of life is common among LTC residents, and the likelihood of hospital transfers is increased for residents who are younger, have organ failure, lower care level needs, as well as among those who live in for-profit facilities. Particular emphasis should, therefore, be placed on targeting these groups to determine the appropriateness of hospital admission and possible ways of reducing transfers.

The Age-Friendly Manitoba Initiative was launched in 2008. A formative evaluation we conducted in 2011 with 44 participating rural and urban communities demonstrates considerable progress, with virtually all communities having formed an Age-Friendly Committee and conducting a community assessment to identify priorities for action. The majority of communities implemented one or more age-friendly projects. Major barriers to becoming age-friendly identified by participants included lack of funding; lack of capacity, particularly in small communities; and lack of leadership or direction. The study highlights the importance of strong leadership at all levels of government (municipal, provincial, federal); the need to support communities, particularly rural ones, as they try to become more age-friendly; and the importance of ongoing promotion of age-friendliness locally and more broadly (e.g., provincially).

Since the World Health Organization introduced the concept of ‘age-friendly’ communities in 2006, there has been rapidly growing interest in making communities more age-friendly on the part of policy makers world-wide. There is a paucity of research to date, however, that has examined age-friendliness in diverse communities, particularly in rural communities. The main objective of the study reported in this paper was to examine whether age-friendliness varies across community characteristics, such as a population size. The study was based on surveys administered in 56 communities throughout Manitoba, a mid-Western Canadian province, in the context of a needs assessment process for communities that are part of the Age-Friendly Manitoba Initiative. A total of 1,373 individuals completed a survey developed to measure age-friendliness. Domains included the physical environment; housing options; the social environment; opportunities for participation; community supports and health-care services; transportation options; and communication and information. Community characteristics were derived from census data. Multi-level regression analysis indicated that the higher the percentage of residents aged 65 or older, the higher the ratings of age-friendliness overall and, specifically, ratings of the social environment, opportunities for participation, and communication and information. Moreover, small communities located within a census metropolitan area and remote communities in the far north of the province emerged as having the lowest age-friendliness ratings. These findings suggest that communities are generally responsive to the needs of their older residents. That different results were obtained for the various age-friendly domains underscores the importance of considering age-friendliness in a holistic way and measuring it in terms of a range of community features. Our study further highlights the importance of differentiating between degrees of rurality, as different patterns emerged for communities of different sizes and proximity to a larger urban centre.

Research has shown that the level of activity of the residents of a city's neighbourhood is related to the availability of activity-related resources. This study aimed to characterise the housing environment in which many older adults live by exploring what activity-related resources were available in senior apartment buildings in one Canadian city, Winnipeg. Of 195 senior apartment buildings in the city, 190 were surveyed to examine whether variation in the buildings' activity resources was related to neighbourhood characteristics, particularly socio-economic status. Resources were classified as those for physical activities (e.g. exercise classes), social activities (e.g. card games), and services (e.g. a grocery-store shuttle). The neighbourhood characteristics were taken from census data and included socio-economic and socio-demographic measures. The apartment buildings varied considerably in the resources available, and a positive relationship was found between neighbourhood income and physical and social activity programmes and services. Lower residential stability and a higher percentage of residents living alone were also related to the buildings' resource-richness, and senior apartment buildings with limited activity-related resources clustered in disadvantaged neighbourhoods. How senior apartments are resourced should be examined in relation to the neighbourhood in which they are located.