CAPÍTULO 11: MARCO CONCEPTUAL
3.7 PUESTA EN MARCHA DEL PLAN DE CALIDAD
3.7.3 Control de Calidad en la Estación San Carlos:
Aging with Chronic Sexually Transmitted and Blood Borne Infections (STBBIs) Information Guides
www.catie.ca/en/resources/one-foot-forward-gipa-training-toolkit-module-10-active-aging-and-hiv www.catie.ca/en/resources/pocket-guide-aging-women-living-hiv
These resource guides were developed for older adults living with HIV. They provide basic information on living with HIV, health maintenance, community involvement and the challenges posed by aging with HIV.
Canadian AIDS Society
www.cdnaids.ca
HIV and Aging Fact Sheets
www.cdnaids.ca/hiv-and-aging
Canadian AIDS Society 190 O’Connor St., Suite 100 Ottawa, ON K2P 2R3 Tel: 613-230-3580 Toll Free: 1-800-499-1986 Fax: 613-563-4998 E-mail: [email protected]
The Canadian AIDS Society (CAS) is non-profit organization that represents community-based AIDS organizations across the country. They strive to strengthen the response to HIV/AIDS in Canada and enrich the lives of people and communities living with HIV/AIDS through promoting education and awareness, providing information and resources, mobilizing communities and advocacy.
Canadian Working Group on HIV and Rehabilitation
www.hivandrehab.ca
HIV and Aging
www.hivandrehab.ca/EN/HIV%20and%20Aging/HIVandAging.php
Canadian Working Group on HIV and Rehabilitation 1240 Bay St, Suite 600
Toronto, ON M5R 2A7 Tel: 416-513-0440 Fax: 416-595-0094
E-mail: [email protected]
The Canadian Working Group on HIV and Rehabilitation (CWGHR) is a national not for profit organization that responds to the rehabilitation needs of people living with HIV/AIDS. Their online section on HIV and Aging includes resources related to programs and services for those aging with HIV and clinical and research resources for service providers.
MIELS-Québec
www.miels.org
Vieillir avec le VIH-sida, nouvelle réalité et enjeux pour MIELS-Québec
www.miels.org/wp-content/uploads/2013/09/Vieillir-avec-le-VIH-sida-MIELS-Qc.pdf 625, avenue Chouinard Quebec, QC G1S 3E3 Tel: 418-649-1720 Fax: 418-649-1256 E-mail: [email protected]
MIELS-Québec is a non-profit community based organization providing HIV/AIDS services in Quebec. This French language reference document, created to inform their internal transformation, provides guidance in adapting existing HIV/AIDS programming and service provision to be inclusive to older adults living with HIV.
National Seniors Council
www.seniorscouncil.gc.ca/eng/home.shtml
Report on the Social Isolation of Seniors
www.seniorscouncil.gc.ca/eng/research_publications/social_isolation/page00.shtml
Phase IV, 8th Floor, Mail Stop 802
140 Promenade du Portage Gatineau, Quebec
K1A 0J9
The National Seniors Council provides advice to the Government of Canada on all matters related to the well-being and quality of life of seniors. This resource provides information on the impact of social isolation, the factors that increase the risk for older adults and ways to prevent or minimize its effects.
SageHealth Network
www.sagehealthnetwork.com/index.html
SageHealth Network Tel: 647-831-6630
Email: [email protected]
SageHealth Network is dedicated to promoting the sexual health, socialization and positive aging of older adults, seniors and caregivers. The SageHealth network provides a series of workshops which focus on a variety of issues including understanding and correcting negative stereotypes of aging, acknowledgment and advocacy of elder sexuality, and understanding how sexuality and intimacy contribute to positive ageing.
Sexuality and U
www.sexualityandu.ca
Sex over Fifty
www.sexualityandu.ca/sexual-health/sex-over-fifty
The Society of Obstetricians and Gynaecologists of Canada 780 Echo Drive Ottawa, ON K1S 5R7 Tel: 613-730-4192 Toll Free: 1-800-561-2416 Fax: 613-730-4314 E-mail: [email protected]
www.sexualityandu.ca is committed to providing credible and up-to-date information and education on sexual health for health care professionals and the general public. The Sex over Fifty section of their website includes strategies on how to address sexual health among older adults.
ENDNOTES
(1) Public Health Agency of Canada. (2008). Canadian Guidelines for Sexual Health Education (3rd Ed.).
(2) Gott, M.C. (2001). Sexual activity and risk taking in later life. Health and Social Care in the Community, 9(2), 72–8; Lindau S.T., Schumm, M.A., Laumann, E.O., Levinson, M.D., O’Muircheartaigh C.A., and Waite L.J. (2007). A study of sexuality and health among older adults in the United States. The New
England Journal of Medicine, 357, 762–74.
(3) Gott, M., and Hinchliff, S. (2003). How important is sex late in life? The views of older people. Social
Science and Medicine, 56, 1617–28; Huang, J.H., Subak, L.L., Thom D.H., Van Den Eeden, S.K., Ragins
A.I., Kuppermann, M., Shen, H., and Brown, J.S. (2009). Sexual Function and Aging in Racially and Ethnically Diverse Women. Journal of the American Geriatrics Society, 57, 1362–8; Lindau et al 2007. (4) Gott and Hinchliff (2003). Lindau et al. (2007).
(5) Hartel, D.M., Schoenbaum, E.E., Lo, L., and Klein, R.S. (2006). Gender Differences in Illicit
Substance Use among Middle-Aged Drug Users with or at Risk for HIV Infection. Clinical Infectious
Diseases, 43, 525–31; Levy, B.R., Ding, L., Lakra, D., Kosteas, J., and Niccolai, L. (2007). Older
Persons’ Exclusion from Sexually Transmitted Disease Risk-Reduction Clinical Trials. Sexually
Transmitted Diseases, 34(8), 541–44.
(6) Statistics Canada. (2011). Census of Canada, Statistics Canada Catalogue no. 98-311-XCB2011018. (7) Public Health Agency of Canada. (2013). HIV and AIDS in Canada. Surveillance Report to
December 31, 2012.
(8) Public Health Agency of Canada. (2014). Report on Sexually Transmitted Infections in Canada: 2011. (9) Ibid.
(10) Estimated prevalence of HCV infection in Canada, 2011.
(11) Maes and Louis. (2003); Savasta, A.M. (2004). HIV: Associated Transmission Risks in Older Adults: An Integrative Review of the Literature. Journal of the Association of Nurses in AIDS Care, 15(1), 50–9. Public Health Agency of Canada (2012). 2012 HIV/AIDS Attitudinal Tracking Survey.
(12) Poynten, M.I., Grulich, A.E., and Templeton, D.J. (2013). Sexually transmitted infections in older populations. Current Opinion in Infectious Disease, 26, 80–5; Savasta. (2004).
(13) Tupper, K.W. (2013). Sex, drugs and the honour roll: the perennial challenges of addressing moral purity issues in schools. Critical Public Health, 24(2),115–131.
(14) Bodley-Tickell, A.T., Olowokure, B., Bhaduri, S., White, D.J., Ward, D., Ross, J.D.C., Smith, G., Duggall, H.V., and Goold, P. (2008). Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sexually Transmitted Infections, 84, 312–7; Levy et al. (2007).
(15) Orel, N. A., Spence, M. and Steele, J. (2005). Getting the Message Out to Older Adults: Effective HIV Health Education Risk Reduction Publications. Journal of Applied Gerontology, 24(5), 490–508. (16) Levy et al. (2007).
(17) Ibid.
(19) Public Health Agency of Canada (2014). Estimated prevalence of Hepatitis C Virus infection in
Canada, 2011.
(20) Abel, T., and Werner, M. (2003). HIV risk behaviour of older persons. European Journal of Public
Health, 13(4), 350–2; Linsk, N.L., Fowler, J.P., and Klein, S.J. (2003). HIV/AIDS Prevention and Care
Services and Services for the Aging: Bridging the Gap between Service Systems to Assist Older People. Journal of Acquired Immune Deficiency Syndromes, 33, S243–50.
(21) Schick, V., Herbenick, D., Reece, M., Sanders, S.A., Dodge, B., Middlestadt, S.E., and Fortenberry, J.D. (2010). Sexual Behaviors, Condom Use, and Sexual Health of Americans Over 50: Implications for Sexual Health Promotion for Older Adults. International Society for Sexual Medicine, 7(suppl5), 315–39. Stall, R., and Catania, J. (1994). AIDS Risk Behaviors among Late Middle-aged and Elderly Americans. Archives ofInternal Medicine, 154, 57–63.
(22) Canadian Liver Foundation (2010). New Canadian Liver Foundation Poll Finds Canadian Boomers
Have Active Sex Lives, But Many Aren’t Playing it Safe. Retrieved from www.liver.ca/Liver_News/
livernews10051001.aspx; Lindau et al (2007); Lindau S.T., Leitsch S.A., Lundberg, K.L., and Jerome, J. (2006). Older Women’s Attitudes, Behavior and Communication about Sex and HIV: A Community- Based Survey. Journal of Women’s Health, 15(6), 747–53; Maes, C.A., and Louis, M. (2003). Knowledge of AIDS, Perceived Risk of AIDS and At-Risk Sexual Behaviours among Older Adults.
Journal of the American Academy of Nurse Practitioners, 15(11), 509–16.
(23) Negin, J., Rozea, A., and Martiniuk, A. (2014). HIV behavioural interventions targeted towards older adults: a systematic review. BMC Public Health, 14, 507
(24) Statistics Canada. (2012). 2011 Census of Canada. Statistics Canada Catalogue no. 98-312-XCB2011039.
(25) Bateson, D.J., Weisberg, E., McCaffery, K.J., and Luscombe, G.M. (2012). When online becomes offline: attitudes to safer sex practices in older and younger women using an Australian internet dating service.
Sexual Health, 9, 152–159. Minichiello, V., Hawkes, G., and Pitts, M. (2011). HIV, Sexually Transmitted
Infections, and Sexuality in Later Life. Current Infectious Disease Report, 13, 182–7.
(26) Davis, T., and Zanjani, F. (2012). Prevention of HIV among Older Adults: A Literature Review and Recommendations for Future Research. Journal of Aging and Health, 24(8), 1399–1420.
(27) Zablotsky, D., Kennedy, M. (2003). Risk Factors and HIV Transmission to Midlife and Older Women: Knowledge, Options and the Initiatiion of Safer Sexual Practices. Journal of Acquired Immune
Deficiency Syndromes, 33, S122–S130.
(28) Gott, M., Hinchliff, S., and Galena, E. (2004). General practitioner attitudes to discussing sexual health issues with older people. Social Science and Medicine. 58, 2093–2103. Hinchliff, S. and Gott, M. (2011). Seeking Medical Help for Sexual Concerns in Mid- and Later Life: A Review of the Literature.
Journal of Sex Research, 48(2–3), 106–17. Iyer, K.V., Arumugam, V., Castor, T., Malik, R. and Ehrlich, A.
(2011). Physicians’ screening for HIV risk factors in older adults. Journal of the American Geriatrics
Society, 59,S200.
(29) Ibid.
(30) Nusbaum, M.R.H., Singh, A.R., and Pyles, A.A. (2004). Sexual Healthcare Needs of Women Aged 65 and Older. Journal of the American Geriatrics Society, 52, 117–22.
(31) Gott, M.C. (2001). Sexual Activity and risk taking later in life. Health and Social Care in the
Community, 9(2), 720–8.
(33) Rogstad, K.E. (2004). Sex, sun, sea and STIs: sexually transmitted infections acquired on holiday.
British Journal of Medicine, 329(7459), 214–7.
(34) Agate et al. (2003). Mairs, K., and Bullock, S.L. (2013). Sexual-Risk Behaviour and HIV Testing among Canadian Snowbirds Who Winter in Florida. Canadian Journal on Aging, 32(2), 145–58.
(35) Mairs and Bullock. (2013).
(36) Ontario Human Rights Commission. (2014). Age and Age Discrimination (fact sheet). Retrieved from
www.ohrc.on.ca/en/ageism-and-age-discrimination-fact-sheet. Revera and the International Federation on Ageing. (2012). Revera Report on Ageism. Retrieved from www.reveraliving.com/ About-Us/Media-Centre/Revera-Report-on-Ageism/docs/Report_Ageism.aspx
(37) Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living
with HIV/AIDS.
(38) Levy, B.R. (2003). Mind Matter: Cognitive and Physical Effects of Aging Self-Stereotypes. Journal of
Gerontology, 58B(4), P203–P211.
(39) Bodley-Tickell et al. (2008); Savasta. (2004).
(40) Mental Health Commission of Canada (2014). Topics: Seniors. Retrieved from
www.mentalhealthcommission.ca/English/issues/seniors Mental Health Commission of Canada (2011). Guidelines for comprehensive mental health services for older adults in Canada. Retrieved from
www.mentalhealthcommission.ca/English/system/files/private/document/mhcc_seniors_guidelines.pdf
(41) Patel, V., Flisher, A.J., Hetrick S., and McGorry, P. (2007). Mental health of young people: a global public-health challenge. The Lancet, 369, 1302–13.
(42) Lovejoy, T.I., Heckman, T.G., Sikkema, K.J., Hansen, N.B., and Kochman, A. (2014). Changes in Sexual Behaviour of HIV Infected Older Adults Enrolled in a Clinical Trial of Standalone Group Psychotherapies Targeting Depression. AIDS and Behaviour, doi: 10.1007/s10461-014-0746-7.
(43) Fredriksen-Goldsen, K., Kim, H.J., and Emlet, C. (2014). The relationship between self-stigma, self-efficacy, social support and HIV risk behavior among vulnerable older adults: implications for access to HIV prevention interventions. 6th IAS Conference on HIV Pathogenesis and Treatment,
Abstract no. CDC365; Foster, V., Clark, P. C., McDonnell Holstad, M. and Burgess, E. (2010). Factors Associated With Risky Sexual Behaviors in Older Adults. Journal of the Association of Nurses in AIDS Care, 23(6), 487–99.
(44) Institute of Economic Affairs. (2013). Work Longer, Live Healthier. The relationship between economic
activity, health and government policy. Retrieved from www.iea.org.uk/sites/default/files/publications/
files/Work%20Longer,%20Live_Healthier.pdf
(45) Murray, J., and Adam, B.D. (2001). Aging and HIV Risk among Gay Men. AIDS Committee of Toronto. Retrieved from www.actoronto.org/research.nsf/pages/ageing+and+hiv; Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living with HIV/AIDS.
(46) Centre for Addiction and Mental Health. (2010). Best practice guidelines for mental health promotion
programs. Retrieved from https://knowledgex.camh.net/policy_health/mhpromotion/mhp_older_
adults/Pages/protective_factors_mhp.aspx
(47) Agate, L.L., Mullins, J.M., Prudent, E.S., and Liberti, T.M. (2003). Strategies for Reaching Retirement Communities and Aging Social Networks: HIV/AIDS Prevention Activities among Seniors in South Florida.
(48) Statistics Canada. (2012). Social Participation and the Health and Well-being of Canadian Seniors. Catalogue no. 82-003-XPE.
(49) American Psychological Association. (2014). Fact Sheet: Age and Socioeconomic Status. Retrieved from www.apa.org/pi/ses/resources/publications/factsheet-age.aspx
(50) Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living
with HIV/AIDS.
(51) American Psychological Association. (2014); Grundy, E., and Sloggett, A. (2003). Health inequalities in the older adult: the role of personal capital, social resources and socio-economic circumstances. Social
Science and Medicine, 56, 935–47.
(52) Food Banks Canada. (2013). Hungercount. Retrieved from www.foodbankscanada.ca/FoodBanks/ MediaLibrary/HungerCount/HungerCount2013.pdf; Guelph and Wellington Task Force for Poverty Elimination. (2012). Older Adults Living on a Low Income. Retrieved from www.gwpoverty.ca/ wp-content/uploads/2012/09/02.-OLDER-ADULTS-LIVING-IN-LOW-INCOME2.pdf
(53) American Psychological Association. (2014). HIV/AIDS & Socioeconomic Status. Retrieved from
www.apa.org/pi/ses/resources/publications/factsheet-hiv-aids.aspx
(54) Morton, C.R., Kim, H., and Treise, D. (2011). Safe Sex after 50 and Mature Women’s Beliefs of Sexual Health. The Journal of Consumer Affairs, 45(3), 372–90; Neundorfer, M.M., Harris P.B., Britton P.J., and Lynch, D.A. (2005). HIV-Risk Factors for Midlife and Older Women. The Gerontologist, 45(5), 617–25. (55) Canadian Aids Society. (2013). HIV and Aging in Canada: Prevention. Retrieved from www.cdnaids.ca/
files.nsf/pages/hiv_aging_4-prevention-factsheet/$file/HIV_aging_4-Prevention-FactSheet.pdf; Morton, Kim, and Treise. (2011).
(56) O’Shea, J. (2006). HIV Risk-Taking among Older Gay Men. Concordia University. Retrieved from
www.citation.allacademic.com//meta/p_mla_apa_research_citation/1/0/3/0/4/pages103049/ p103049-1.php
(57) Coleman, C.L., Jemmott, L., Jemmott, J.B., Strumpf, N., and Ratcliffe, S. (2009). Development of an HIV Risk Reduction Intervention for Older Seropositive African American Men. AIDS Patient Care and
Sexually Transmitted Diseases, 23(8), 647–55. Murray and Adam. (2001).
(58) King, S.D., and Orel, N. (2012). Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs. Journal of Gay and Lesbian Social
Services, 24(4), 346–70.
(59) Politi, M. C., Clark, M.A., Armstrong, G., McGarry, K. A., and Sciamanna, C.N. (2009). Patient-Provider Communication about Sexual Health among Unmarried Middle-aged and Older Women. Journal of
Geriatric Internal Medicine, 24(4), 511–6.
(60) Fredriksen-Goldsen, K.I., Cook-Daniels, L., Kim, H.J., Erosheva, E.A. et al (2013). The Gerontologist, doi:10.1093/geront/gnt021
(61) Australia Federation of AIDS Organizations. (2007). Out Late. A guide for older men coming out. Retrieved from www.acon.org.au/sites/default/files/OutLate07_webversion.pdf
(62) Wooten-Bielski, K. (1999). HIV and AIDS in Older Adults. Geriatric Nursing, 20(5), 268–72.
(63) Canadian Institute for Health Information. (2011). Seniors and the Health Care System: What is the
Impact of Multiple Chronic Conditions? Retrieved from https://secure.cihi.ca/free_products/
(64) Canadian Institute for Health Information (2011); Justice, A., and Falutz, J. Aging and HIV: an evolving understanding. Current Opinion in HIV and AIDS, 9, 291–93.
(65) Corcoran, K., McNab, J., Girgis, S., and Colagiuri, R. (2011). Is Transport a Barrier to Healthcare for Older People with Chronic Diseases? Asia Pacific Journal of Health Management, 7(1), 49–56. (66) Orel, Wright, and Wagner. (2004); Siegel, K., Schrimshaw, E.W., and Dean, L. (1999). Symptom
interpretation: Implications for delay in HIV testing and care among HIV infected later middle-aged and older adults. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 11(5), 525–35. (67) Maes and Louis. (2003).
(68) Smith, R.D., Delpech, V.C., Brown, A.E., and Rice, B.D. (2010). HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS, 24(13), 2009–15.
(69) Beaulaurier, R.L., Craig S.L., and De La Rosa, M. (2009). Older Latina Women and HIV/AIDS: An Examination of Sexuality and Culture as they Relate to Risk and Protective Factors. Journal of
Gerontological Social Work, 52(1), 48–63; Wooten. (1999).
(70) Nusbaum, Singh, and Pyles. (2004).
(71) Beaulaurier, Craig, and De La Rosa. (2009); Orel, Wright, and Wagner. (2004); Levy et al. (2007). (72) Williams, K., and Kemper, S. (2010). Exploring Interventions to Reduce Cognitive Decline in Aging.
Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51.
(73) Anand, P., Springer, S.A., Copenhaver, M.M., and Altice, F.L. (2010). Neurocognitive Impairment and HIV Risk Factors: A Reciprocal Relationship. AIDS and Behavior, 14(6), 1213–26.
(74) Brennan, D.J., Emlet, C.A., and Eady, A. (2011). HIV, Sexual Health and Psychosocial Issues Among Older Adults Living with HIV in North America. Ageing International, 36, 313–333. Ontario HIV Treatment Network (2012). Evidence Informing the Intersection of HIV, Aging and Health: A Scoping
Review. Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People
Living with HIV/AIDS.
(75) Brennan, Emlet and Eady (2011). Illa, L., Echenique, M., Stain Jean, G., Bustamante-Avellaneda, V. et al (2010). Project ROADMAP : Reeducating Older Adults in Mainting AIDS Prevention : A Secondary
Intervention for Older HIV-Positive Adults. ADIS Education and Prevention, 22(2), 137–47. Negin,
Rosea and Martiniuk (2012),
(76) Canadian AIDS Society. (2013). HIV and Aging in Canada: Prevention.
(77) Emlet, C.A. (2006). A Comparison of HIV Stigma and Disclosure Patterns between Older and Younger Adults Living with HIV/AIDS. AIDS Patient Care and STDs, 20(5), 350–8.
(78) Minichiello, Hawkes, and Pitts. (2011); Public Health Agency of Canada. (2013). Population-Specific
HIV/AIDS Status Report. People Living with HIV/AIDS.
(79) Emlet. (2006).
(80) Emlet, C.A. (2008). Trust and consequences: a qualitative exploration of HIV disclosure in older adults.
AIDS Care, 20(6), 710–7.
(81) Emlet. (2008).
(83) Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living
with HIV/AIDS.
(84) Linsk, Fowler, and Klein. (2003).
(85) Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living
with HIV/AIDS.
(86) Goulet, J.L., Fultz, S.L., McGinnis, K.A., and Justice, A.C. (2005). Relative prevalence of comorbidities and treatment contraindications in HIV-mono-infected and HIV/HCV-co-infected veterans. AIDS, 19(suppl 3), S99–S105. Lancombe, K. and Rockstroh, J. (2012). HIV and viral hepatitis coinfections: advances and challenges. Gut, 61(suppl 1), i47–i58.
(87) Althoff, K.N., McGinnis, K.A., Wyatt, C.M., Freiberg, M.S. et al (2014). Comparison of Risk and Age at Diagnosis of Myocardial Infarction, End-Stage Renal Disease, and Non-AIDS-Defining Cancer in HIV Infected Versus Uninfected Adults. Clinical Infectious Diseases, doi: 10.1093/cid/ciu869. Public Health Agency of Canada. (2013). Population-Specific HIV/AIDS Status Report. People Living with HIV/AIDS. (88) Brañas, F., Berenquer, J., Sánchez-Conde, M., López-Bernaldo de Quirós, J.C., Miralles, P., Cosín, J.,
and Serra, J.A. (2008). The Eldest of Older Adults Living with HIV: Response and Adherence to Highly Active Antiretroviral Therapy. American Journal of Medicine, 121(9), 820–4.
(89) Orel, Spence, and Steele. (2005).
(90) Emlet, C.A., Tozay, S., and Raveis, V.H. (2010). “I’m Not Going to Die from the AIDS”: Resilience in Aging with HIV Disease. The Gerontologist, 51(1), 101–11; Rueda, Law, and Rourke. (2014). (91) Rueda, Law, and Rourke. (2014).
(92) Gonzalez, J.S., Batchelder, A.W., Psaros, C. and Safre, S.A. (2011). Depression and HIV/AIDS Treatment Nonadherence: A Review and Mea-Analysis. Journal of Acquired Immune Deficiency
Syndrome, 58(2), doi:10.1097/QAI.0b013e31822d490a. Minichiello, Hawkes, and Pitts. (2011).
(93) Rueda, Law, and Rourke. (2014). (94) Negin, Rozea and Martiniuk (2014).
(95) Emlet, Tozay, and Raveis (2010); Janssen, B.M., Regenmortel, T.V., and Abma, T.A. (2011). Identifying sources of strength: resilience from the perspective of older people receiving long-term community care. European Journal of Ageing, 8, 145–56.