title: Seniors' perspectives on care: a case study of the Alex Seniors health clinic, Calgary.
abstract: BACKGROUND
  Primary care initiatives face an imperative to not only reduce barriers to care for their patients but also to uniquely accommodate the complex needs of at-risk patient populations. Patient-centered multidisciplinary care team models for primary care, like the Alex Seniors Clinic, are one approach for providing comprehensive care for marginalized seniors. The purpose of this qualitative study was to explore patient perspectives on the responsiveness of the Alex Seniors Clinic to their stated health needs.
  
  
  RESULTS
  Themes reflected participants' perspectives on factors impacting their health needs as vulnerable seniors as well as on the measures that the Alex Seniors Clinic has taken to meet those needs. Factors impacting health included: the nature of their relationships to the physical environment in which they lived, the nature of the relationships they had to others in that environment, and independence and autonomy. Participants identified accessibility, respect and support, and advocacy as the ways in which the clinic was working to address those health needs.
  
  
  CONCLUSIONS
  While respect and support, as well as advocacy, effectively addressed some patient needs, participants felt that accessibility problems continue to be health-related barriers for clinic patients. This may be due to the fact that issues of accessibility reflect larger community and social problems. Nevertheless, it is only through engaging the patient community for input on clinic approaches that an understanding can be gained of how closely a clinic's care goals are currently aligning with patient perspectives of the care and services they receive.
authors.affiliation: Department of Family Medicine, University of Calgary, Faculty of Medicine, Health Sciences Centre, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. marta.shaw@ucalgary.ca.|Faculty of Social Work, University of Calgary, 2500 University Dr. N.W, Calgary, AB, T2N 1 N4, Canada. marta.shaw@ucalgary.ca.
authors.forename: Marta
authors.initials: M
authors.lastname: Shaw
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Calgary, Faculty of Medicine, Health Sciences Centre, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. crypien@ucalgary.ca.
authors.forename: Candace
authors.initials: C
authors.lastname: Rypien
authors.affiliation: Department of Family Medicine, University of Calgary, Faculty of Medicine, Health Sciences Centre, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. ndrummon@ualberta.ca.|Department of Family Medicine, University of Alberta, 1702 College Plaza, Edmonton, AB, T6G 2C8, Canada. ndrummon@ualberta.ca.|Department of Family Medicine, 1702 College Plaza, Edmonton, AB, T6G 2C8, Canada. ndrummon@ualberta.ca.
authors.forename: Neil
authors.initials: N
authors.lastname: Drummond
authors.affiliation: Department of Communication and Culture, Faculty of Communications and Culture, University of Calgary, 2500 University Dr. N.W, Calgary, AB, T2N 1 N4, Canada. pmharasym@gmail.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Harasym
authors.affiliation: Department of Family Medicine, University of Calgary, Faculty of Medicine, Health Sciences Centre, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, T2N 4 N1, Canada. lnixon@ucalgary.ca.
authors.forename: Lara
authors.initials: L
authors.lastname: Nixon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003151:Community Health Centers / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D011795:Surveys and Questionnaires