title: Participation needs of older adults having disabilities and receiving home care: met needs mainly concern daily activities, while unmet needs mostly involve social activities.
abstract: BACKGROUND
  Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers.
  
  
  METHODS
  A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods.
  
  
  RESULTS
  Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility.
  
  
  CONCLUSIONS
  This study highlights the complexity of older adults' participation needs, involving daily as well as social activities. Properly assessing and addressing these needs is thus necessary to improve older adults' health and well-being. Discrepancies in the various actors' perceptions of participation needs must be further explored. Additional research would help better understand how to optimize the contribution of community organizations and caregivers.
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Pier-Luc.Turcotte@USherbrooke.ca.|Research Centre on Aging, Health and Social Services Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada. Pier-Luc.Turcotte@USherbrooke.ca.
authors.forename: Pier-Luc
authors.initials: PL
authors.lastname: Turcotte
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Nadine.Lariviere@USherbrooke.ca.
authors.forename: Nadine
authors.initials: N
authors.lastname: Larivière
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Johanne.Desrosiers@USherbrooke.ca.|Research Centre on Aging, Health and Social Services Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada. Johanne.Desrosiers@USherbrooke.ca.
authors.forename: Johanne
authors.initials: J
authors.lastname: Desrosiers
authors.affiliation: Faculty of Nursing Sciences, Université Laval, Québec City, Québec, Canada. philippe.voyer@fsi.ulaval.ca.|Québec Centre for Excellence in Aging, Québec City, Québec, Canada. philippe.voyer@fsi.ulaval.ca.
authors.forename: Philippe
authors.initials: P
authors.lastname: Voyer
authors.affiliation: Department of Family Medicine, Université de Montréal, Montréal, Québec, Canada. nathalie.champoux@umontreal.ca.|Research Centre of the University Institute of Geriatrics of Montreal, Montréal, Québec, Canada. nathalie.champoux@umontreal.ca.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Champoux
authors.affiliation: Department of Leisure, Culture and Tourism Studies, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada. helene.carbonneau@uqtr.ca.
authors.forename: Hélène
authors.initials: H
authors.lastname: Carbonneau
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. annie.carrier@usherbrooke.ca.|Research Centre on Aging, Health and Social Services Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada. annie.carrier@usherbrooke.ca.
authors.forename: Annie
authors.initials: A
authors.lastname: Carrier
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. melanie.levasseur@usherbrooke.ca.|Research Centre on Aging, Health and Social Services Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada. melanie.levasseur@usherbrooke.ca.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Levasseur
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003256:Community Participation / Q000379:methods / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D020380:Needs Assessment; D036301:Qualitative Research; D011792:Quebec