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Objective: Long-term care (LTC) facilities are increasingly intent on creating a “homelike” atmosphere for residents. Although residential staff are integral to the construction of a home within LTC settings, their perceptions have been relatively absent from the literature. Method: Thirty-two LTC staff participants were interviewed about their experiences and perceptions of the physical environment and conceptualizations of home, and thematic analyses were conducted. Results: An overarching category—interpersonal relationships—emerged from our analyses emphasizing the importance of relationships in creating a homelike environment within institutional settings. Sub-themes that inform our understanding include the following: (a) Staff members’ perceptions of home; (b) “Their second home”: Adjustment to and familiarity in LTC; and (c) “We become family”: Relationality makes a home. Discussion: The study provides evidence to inform current policies and practices in LTC. Specifically, enough time and space should be given to residents and staff to create and maintain personal relationships to make residential care homelike. [ABSTRACT FROM AUTHOR]

The development of effective interventions for mild cognitive impairment (MCI) in older adults has been limited by extensive variability in the conceptualization and definition of MCI, its subtypes, and relevant diagnostic criteria within the neurocultural, pharmaceutical, and gerontological communities. A scoping review was conducted to explore the conceptual development of MCI and identify the resulting ethical, political, and technological implications for the care of older adults with MCI. A comprehensive search was conducted between January and April 2013 to identify English-language peer-reviewed articles published between 1999 and 2013. Our analysis revealed that the MCI conceptual debate remains unresolved, the response to ethical issues is contentious, the policy response is limited, and one-dimensional and technological interventions are scarce. Reflections on the conceptual, ethical, and policy responses in conjunction with the identification of the needs of older adults diagnosed with MCI highlight significant opportunities for technological interventions to effectively reposition MCI in the aging care discourse. [ABSTRACT FROM AUTHOR]

Objective: To obtain improved quality information regarding psychiatrist waiting times by use of a novel methodological approach in which accessibility and wait times are determined by a real-time patient referral procedure.Method: An adult male patient with depression was referred for psychiatric assessment by a family physician. Consecutive calls were made to all registered psychiatrists (n = 297) in Vancouver. A semistructured call procedure was used to collect information about the psychiatrists' availability for receipt of this and similar referrals, identify factors that affect psychiatrist accessibility, and determine the availability of cognitive-behavioural therapy (CBT).Results: Efforts were made to contact 297 psychiatrists and 230 (77%) were reached successfully. Among the 230 psychiatrists contacted, 160 (70%) indicated that they were unable to accept the referral. Although 70 (30%) indicated that they might be able to consider accepting a referral, 64 (91% of those who would consider accepting the referral) indicated that they would need to review detailed, written referral information and could not provide estimates of the length of wait times if the patient was to be accepted. Only 6 (3% of the 230 psychiatrists contacted) offered immediate appointment times and their wait times ranged from 4 to 55 days. When asked whether they could provide CBT, most (56%) psychiatrists in clinical practice answered maybe.Conclusions: Substantial barriers exist for family physicians attempting to refer patients for psychiatric referral. Consolidated efforts to improve access to psychiatric assessment are needed. [ABSTRACT FROM AUTHOR]