The University of Western Ontario

School of Health Studies

Health Sciences 4721A-001
AGING & MARGINALIZED POPULATIONS

Instructor: Dr. Savundranayagam Fall 2024

Email: [email protected]
Office Room Number:
Office Hours: By appointment
Course Meeting Times:
Location:
Prerequisite: HS 2711

Prerequisite Checking
Unless you have either the requisites for this course or written special permission from your Dean to
enroll in it, you may be removed from this course and it will be deleted from your record. This decision
may not be appealed. You will receive no adjustment to your fees in the event that you are dropped
from a course for failing to have the necessary prerequisites.

Please refer to the Western’s current Academic Calendar at www.westerncalendar.uwo.ca.

Course Information
This blended course examines aging from the perspective of vulnerable, underrepresented, and at-risk
populations. Students will develop an understanding of the unique health experiences and challenges
faced by older individuals who are relegated to, or find themselves on, the margins of society. Students
will develop an understanding of how the intersection between age and other socio-demographic
characteristics (e.g., gender, ethnicity, socio-economic status, and sexual orientation) contributes to
marginality and challenging health experiences. Topics that will be covered include aging prisoners, LGBT
(lesbian, gay, bisexual, and transgendered) older adults, poverty, homelessness, elder abuse, and aging
with HIV/AIDS.

Learning Outcomes: Participation in this course will enable students to:

a) Be aware of the heterogeneity among older adults associated with socio-demographic
characteristics, such as gender, ethnicity, socio-economic status, and sexual orientation.
b) Relate observed health disparities to socio-demographic characteristics among older adults.
c) Articulate personal, cultural and societal attitudes affecting marginalization populations.
d) Develop the ability to bring a life course lens when assessing the strengths and challenges facing
marginalized populations.

CLASSROOM PROCEDURES
This course will be taught using interactive lectures, online discussions, and videos. Each week
starting on Sept. 11, 2024, the first session of each week will be in class and include an
overview of the scheduled topics. The second session will include online activities. Note: This is
a blended course, and a strong internet connection is required for the online components.

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Course Materials and Timetable
Course materials are available on Brightspace. Please note that the timetable is subject to change, as
needed, throughout the course.

Session: Date Readings/Assignments

1: Sept. 11 Course overview
Understanding Marginalization through the Life Course Perspective
• Vasas, E.B. (2005). Examining the margins: A concept analysis of marginalization.
Advances in Nursing Science. 28(3), 194-202.
Aging Prisoners
• Documentary: Prisoners of Age
• Maschi, T. M., Viola, D., & Sun, F. (2013). The high cost of the international aging
prisoner crisis: Well-being as the common denominator for action.
Gerontologist,53(4), 1-12.
Online Aging Prisoners
discussion • Documentary: Prisoners of Age (con’t)
• Canadian Human Rights Commission (2019), Aging and dying in prison: An
investigation into the experiences of older individuals in federal custody,
Canadian Human Rights Commission, CanLIIDocs 1773, https://canlii.ca/t/sjd8
• Discussion: Should aging prisoners be placed elsewhere?
2: Sept. 18 Health of LGB Elders
• Fredriksen-Goldsen, K. I., Emlet, C. A., Kim, H., Muraco, A., Erosheva, E. A.,
Goldsen, J., & Hoy-Ellis, C. P. (2013). The physical and mental health of lesbian,
gay male, and bisexual (LGB) older adults: The role of key health indicators and
risk and protective factors. The Gerontologist, 53(4): 664-675.
• Fredriksen-Goldsen, K. I. (2017). Dismantling the silence: LGBTQ Aging Emerging
from the Margins, The Gerontologist, 57(1): 121-128.
• Documentary: How We Got Gay
Discussion of Diversity Paper
Online Health care and LGBT Elders
discussion • Brotman, S., Ryan, B., & Cormier, R. (2003). The health and social service needs
of gay and lesbian elders and their families in Canada. The Gerontologist, 43(2),
192-202.
• Furlotte, C. & Gladstone, J. W. & Cosby, R. F. & Fitzgerald, K. (2016). “Could we
hold hands?”: Older lesbian and gay couples’ perceptions of long-term care
homes and home care. Canadian Journal on Aging, 35(4), 432-446.
• Film: If These Walls Could Talk II (35 min excerpt)
**Topics Due on Brightspace: Sept. 20, 2024 at 5pm
3: Sept. 25 Caregiving and LGBT Elders
• Brotman, S., Ryan, B., Collins, S., Chamberland, L., Cormier, R., Julien, D.,Richard,
B. (2007). Coming out to care: Caregivers of gay and lesbian seniors in Canada.
The Gerontologist, 47(4), 490-503.
Discussion:
• LGBT Elders: Case study analysis
• LGBT Elders in nursing home: Case study analysis
Health of Transgendered Older Adults

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 Fredriksen-Goldsen, K. I., Cook-Daniels, L., Kim, H., Erosheva, E. A., Emlet, C. A., Hoy-
Ellis, C. P., . . . Muraco, A. (2014). Physical and mental health of transgender older
adults: An at-risk and underserved population. The Gerontologist, 54, 488–500. doi:
10.1093/geront/gnt021
Online Reflection: Gen Silent (access via library on Kanopy)
4: Oct. 2 HIV/AID and Aging
• Rosenfeld D., Bartlam B., Smith R. (2012). Out of the closet and into the
trenches: Gay male Baby Boomers, aging, and HIV/AIDS. The Gerontologist, 52,
255-264.
• Emlet, C.A. (2006). ‘You’re awfully old to have this disease’: Experiences of
stigma and ageism in adults 50 years and older living with HIV/AIDS. The
Gerontologist, 46, 781-790.
• Discussion: case studies
HIV/AID and Aging: Caregiving
• Pigg, S. (February 27, 2011). When HIV moves into nursing homes. In
healthzone.ca. Retrieved June 26, 2012, from
http://www.healthzone.ca/health/newsfeatures/article/945588--when-hiv-
moves-into-nursing-homes .
Discussion: case studies
Online Online
HIV/AID and Aging: Resilience
• Emlet, C.A., Shiu, C., Kim, H., & Fredriksen-Goldsen, K. (2017). Bouncing back:
Resilience and mastery among HIV-Positive older gay and bisexual men. The
Gerontologist, 57(S1), D40-S49.
• Harris, L., Emlet, C.A. Parker, C.P., & Furlotte, C. (2018). Timing of diagnosis:
Understanding resilience narratives of HIV positive older adults diagnosed pre-
and post-HAART. Journal of Gerontological Social Work, 61(1): 78-103.
Documentary: Aging POZivitely (35 minutes)
Online Reflection
5. Oct. 9 Exam 1
6: Oct. 16 Fall Break
7. Oct. 23 Diversity Paper: Professor-Group Consultations (Sign up on Brightspace) – Zoom
(Zoom) meetings
Diversity Paper Discussion: Connecting with community agencies
• Please come prepared to discuss strategies to connect with community agencies
that work with marginalized populations or populations at risk of
marginalization.
8: Oct. 30 Racialized Older Adults: Health care and service use
• Lavoie, JP, Guberman, N. & Brotman, S. (2010). Service use by immigrant
families caring for an older relative. In D. Durst and M. MacLean. Diversity and
aging among immigrant seniors in Canada: Changing faces and greying temples.
Temeron Books.
• Thomson, M S., Chaze, F., George, U, & Guruge, S. (2015). Improving immigrant
populations’ access to mental health services in Canada: A review of barriers
and recommendations. Journal of Immigrant and Minority Health. doi
10.1007/s10903-015-0175-3
Homeless Elders (Discussion)

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 McDonald, L., Dergal, J., & Cleghorn, L. (2007). Living on the margins: Older
homeless adults in Toronto. Journal of Gerontological Social Work, 49(1-2), 19-46.
9: Nov. 6 Poverty: The Retirement Income System in Canada
• Battle, K., Torjman, S., Mendelson, M., Caledon Institute of Social Policy, &
Canadian Electronic Library. (2012). Old age insecurity? Ottawa, Ont.: Caledon
Institute of Social Policy.
Elder Abuse
• Edwards, P., & Public Health Agency of Canada. (2012). Elder abuse in Canada.
Ottawa: Public Health Agency of Canada, Division of Aging and Seniors. Note:
read pages 5-30 only.
• DeLiema, M., Yonashiro-Cho, J., Gassoumis, Z. D., Yon, Y., & Conrad, K. J. (2018).
Using latent class analysis to identify profiles of elder abuse perpetrators. The
Journals of Gerontology: Series B, 79(5), e49–e58.
• Brijnath, B., Gahan, L., Gaffy, E., & Dow, B. (2020). "Build rapport, otherwise no
screening tools in the world are going to help": Frontline service providers'
views on current screening tools for elder abuse. The Gerontologist, 60(3), 472–
482.
• Case studies: diverse situations of elder abuse
• Discussion: Abused Older Men
Discussion: Identify patterns in diverse cases of elder abuse. What are unique
circumstances that perpetuate abuse of older adults?
10: Nov. 13 Exam 2
* Diversity Paper due on Nov. 15 at 5 p.m.
11: Nov. 20 Presentations (4) Please sign up on Brightspace
12: Nov. 27 Presentations (4)
13: Dec. 4 Presentations (4)

Evaluation
Class attendance is mandatory. There will two examinations. These exams will be comprised of multiple
choice, true/false, and short answer questions. The content of examinations will be facilitated through
lecture material and assigned readings.

Exam 1 = 25% (Oct. 9, 2024; includes content from sessions 1-4, including online work)
Group Project (Total = 45%)
• Topic (Sept. 20, 2024, please see Appendix A on Brightspace)
• Diversity Paper = 25% (Nov. 15, 2024, please see Appendix A on Brightspace)
• Peer evaluation of individual contributions = 5% (Complete Group and Peer Assessment from 24
hours after group presentation)
• Presentation = 15% (scheduled between Nov. 20 – Dec. 4, 2024, please see Appendix B on
Brightspace)
Participation = 5% (please see Appendix C on Brightspace)
Exam 2 = 25% (Nov. 13, 2024; includes content after Exam 1)

No Final Exam

Note: Examinations must be taken on the day and time they are scheduled unless other arrangements
are made due to health reasons that can be fully documented according to the requirement of the

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School of Health Sciences program and the University of Western Ontario. If an examination is missed
without appropriate documentation as required, no make-up examination will be offered and the
student will forfeit that portion of the exam weighting. All approvals for make-up exams must be
processed through the School of Health Studies; once approved, they will notify the instructor as to
whether a make-up exam is to be scheduled.

Student Inquiries: Students may contact the instructor after class or via email using your UWO
email address. Emails can be send to our Teaching Assistant (TBA) or myself at
[email protected]. Please include “HS 3704A” in the email subject line. It is expected that
email communication will be used respectfully and judiciously.

Statement on Participation
In the School of Health Studies, each course instructor sets specific expectations for attendance
and participation that are specific to the course, teaching objectives, and learning outcomes.

Regular attendance is expected and essential for all courses, but particularly those that include
participation grades in their evaluation schemes. Participation means not only attendance, but
active engagement in the class, including (for example) contribution to small and large group
discussions, a demonstrated effort to prepare for class by completing assigned readings before
class, and following the instructor's guidelines for use of electronic devices during class time.
Students who miss classes, or parts of classes, are responsible for the material they have
missed. Instructors are not obliged to review the contents of missed lectures.

Statement on Generative Artificial Intelligence: This course aims to enhance a) your critical
thinking skills, b) ability to make evidence-based decisions, and c) writing skills. Accordingly, the
use of Generative Artificial Intelligence systems is not acceptable in the course. Violations of
this policy are covered under Western’s academic integrity and scholastic offence policies. This
course is an opportunity for you to engage with evidence on health and aging in scholarly and
ethical manner. As such, I trust you will maintain academic integrity in your written submissions.

Course/University Policies
1. The website for Registrar Services is http://www.registrar.uwo.ca.

In accordance with policy, the centrally administered e-mail account provided to students will
be considered the individual’s official university e-mail address. It is the responsibility of the
account holder to ensure that e-mail received from the University at his/her official university
address is attended to in a timely manner.

2. Academic Offences

Scholastic offences are taken seriously and students are directed to read the appropriate policy,
specifically, the definition of what constitutes a Scholastic Offence, in the Academic Calendar
(westerncalendar.uwo.ca).

Plagiarism

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 Student work is expected to be original. Plagiarism is a serious academic offence and
could lead to a zero on the assignment in question, a zero in this course, or your
expulsion from the university. You are plagiarizing if you insert a phrase, sentence or
paragraph taken directly from another author without acknowledging that the work
belongs to him/her. Similarly, you are plagiarizing if you paraphrase or summarize
another author’s ideas without acknowledging that the ideas belong to someone else.
All papers may be subject to submission for textual similarity review to the commercial
plagiarism detection software under license to the University for the detection of
plagiarism. All papers submitted will be included as source documents in the reference
database for the purpose of detecting plagiarism of papers subsequently submitted to
the system. Use of the service is subject to the licensing agreement, currently between
Western University and Turnitin.com (www.turnitin.com).

Re-submission of Previously Graded Material

Without the explicit written permission of the instructor, you may not submit any
academic work for which credit has been obtained previously, or for which credit is
being sought, in another course or program of study in the University or elsewhere.

Use of Statistical Pattern Recognition on Multiple Choice Exams

Computer-marked multiple-choice tests and/or exams may be subject to submission for

similarity review by software that will check for unusual coincidences in answer patterns
that may indicate cheating.

3. Use of Electronic Devices

During Exams: Unless you have medical accommodations that require you to do so, or
explicit permission from the instructor of the course, you may not use any electronic
devices during ANY tests, quizzes, midterms, examinations, or other in-class evaluations.

During Lectures and Tutorials: Although you are welcome to use a computer during
lecture and tutorial periods, you are expected to use the computer for scholastic
purposes only, and refrain from engaging in any activities that may distract other
students from learning. From time to time, your professor may ask the class to turn off
all computers, to facilitate learning or discussion of the material presented in a particular
class. Unless explicitly noted otherwise, you may not make audio or video recordings
of lectures – nor may you edit, re-use, distribute, or re-broadcast any of the material
posted to the course website.

Personal Response Systems (“clickers”) may be used in some classes. For those classes
in which we use this technology, it is your responsibility to ensure that the device is
activated and functional. You must speak with the course instructor immediately, if you
have any concerns about whether or not your clicker is malfunctioning.

You must use only your own clicker. For all components of this course in which clicker
records are used to compute a portion of the grade:

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• The use of somebody else’s clicker in class constitutes a scholastic offence;
• The possession of a clicker belonging to another student will be interpreted as an attempt to
commit a scholastic offense

4. Academic Considerations and Absences from Lectures and Assessments

Religious Accommodation

When a course requirement conflicts with a religious holiday that requires an absence
from the University or prohibits certain activities, students should request (in writing)
any necessary academic considerations at least two weeks prior to the holiday to the
academic counsellors in their Home Department. Additional information is provided in
the Western Multicultural Calendar.

Academic Accommodation

Please contact the course instructor if you require lecture or printed material in an
alternate format or if any other arrangements can make this course more accessible to
you. Students with ongoing accommodation needs within this course are also
encouraged to contact Accessible Education, which provides recommendations for
accommodation based on medical documentation or psychological and cognitive
testing. The policy on Academic Accommodation for Students with Disabilities can be
found here.

Academic Consideration

The University recognizes that a student’s ability to meet their academic responsibilities
may, on occasion, be impaired by extenuating circumstances that are medical or
compassionate in nature. These extenuating circumstances may be acute (short term),
or it may be chronic (long term), or chronic with acute episodes. In all cases, students are
advised to consult with the academic counsellors in their home units, at their earliest
opportunity. Academic counsellors may refer students to Accessible Education for
ongoing academic accommodations.

Most forms of academic consideration require documentation, and this documentation

is to be submitted to academic counsellors within five (5) business days of their return to
academic responsibilities. Any such documents will be retained in the student’s file, and
will be held in confidence in accordance with the University’s Official Student Record
Information Privacy Policy. Once the petition and supporting documents have been
received and assessed, appropriate academic considerations shall be determined by
academic counseling, in consultation with the student’s instructor(s). Academic
considerations may include extension of deadlines, waiver of attendance requirements
for classes/labs/tutorials, arranging Special Exams or Incompletes, re-weighting course
requirements, or granting late withdrawals without academic penalty. Academic
considerations shall be granted only where the documentation indicates that the onset,
duration and severity of the illness are such that the student could not reasonably be
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 expected to complete their academic responsibilities. (Note – it will not be sufficient to
provide documentation indicating simply that the student “was seen for a medical
reason” or “was ill.”).

Whenever possible, students who require academic considerations should provide

notification and documentation in advance of due dates, examinations, etc. Under no
circumstances are students expected to submit rationales for (or documentation of) any
absences, to course instructors. Students are, however, required to follow-up with
course instructors, in a timely fashion, to identify the ways in which the academic
consideration will be implemented.

Examination Conflicts

A student completing tests or examinations with flexible submission times (e.g., where
one or more evaluation is a take-home assessment) cannot request alternative
arrangements unless a conflict cannot be avoided by rescheduling writing the exam to a
different time within the window specified by the instructor. This applies to direct
conflicts as well as “heavy load” conflicts (e.g., three exams within a 23-hour period).
The student should discuss any concerns about a potential conflict and/or request
academic considerations with their academic counselling unit prior to the deadline to
drop a course without academic penalty

In the case of online tests and examinations, use of a “Conflict Room,” wherein student
can write two proctored exams concurrently, will be interpreted as arrangements for
continuous proctoring.

5. Contingency Plan for an In-Person Class Pivoting to 100% Online Learning

In the event of a situation that requires this course to pivot to online content delivery, all
remaining course content will be delivered entirely online, either synchronously (i.e., at the
times indicated in the timetable) or asynchronously (e.g., posted on OWL for students to view at
their convenience). The grading scheme will not change. Any remaining assessments will also be
conducted online as determined by the course instructor

Note that disruptive behaviour of any type during online classes, including inappropriate use of
the chat function, is unacceptable. Students found guilty of Zoom-bombing a class or of other
serious online offenses may be subject to disciplinary measures under the Code of Student
Conduct.

6. Online Proctoring

Tests and examinations in this course may be conducted using a remote proctoring
service. By taking this course, you are consenting to the use of this software and
acknowledge that you will be required to provide personal information (including some
biometric data) and the session will be recorded. Completion of this course will require
you to have a reliable internet connection and a device that meets the technical
requirements for this service. More information about this remote proctoring service,

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 including technical requirements, is available on Western’s Remote Proctoring website at:
https://remoteproctoring.uwo.ca.

7. Grades

Where possible assignment objectives and rubrics will be posted on OWL.

Generally, students can expect some form of feedback on their performance in a course before
the drop date.

□ November 13th, 2023 (for first term half-courses)

A+ 90-100 One could scarcely expect better from a student at this
A 80-89 Superior work that is clearly above average
B 70-79 Good work, meeting all requirements and eminently
satisfactory
C 60-69 Competent work, meeting requirements
D 50-59 Fair work, minimally acceptable.
F below 50 Fail

Rounding of Grades (for example, bumping a 79 to 80%):

This is a practice some students request. The final grade documented is the grade that you
have achieved. There is no rounding to the next grade level, or ‘giving away’ of marks.
Please don’t ask me to do this for you; the response will be “please review the course
outline where this is presented”.

Appealing a Grade Within this Course

You have the right to appeal any grade within this course. The grounds for a grade appeal
may be one or more of: medical or compassionate circumstances, extenuating
circumstances beyond the student’s control, bias, inaccuracy, or unfairness. All grounds
advanced in a request for relief must be supported by a clear and detailed explanation of
the reasons for the request together with all supporting documentation.

Appeals generally proceed in this order:

1. Course instructor (informal consultation)

2. Department Chair (submission of written request)
3. The Dean of the Faculty (submission of written request)

In the case of perceived procedural unfairness, steps 2 and 3 are carried out within the
Department and Faculty offering the course. In the case of extenuating medical or
compassionate circumstances that impact on a grade, steps 2 and 3 are carried out within
a student’s Home Department and Faculty.

A request for relief against a mark or grade must be initiated with the instructor as soon as
possible after the mark is issued. In the event that the instructor is not available to the
student, or fails to act, or if the matter is not resolved satisfactorily with the instructor, a

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 written request for relief must be submitted to the Chair of the Department within three
weeks of the date that the mark was issued. In the case of a final grade in a course, the
written request for relief must be submitted to the Chair of the department by January
31st (for first-term half courses) or June 30th (for second-term half courses or full-year
courses

8. Support Services

Health and Wellness:

Information regarding health and wellness-related services available to students may be

found at http://www.health.uwo.ca/.

Students who are in emotional/mental distress should refer to Mental Health@Western

(http://www.health.uwo.ca/) for a complete list of options about how to obtain help.

There are various support services around campus and these include, but are not limited
to:

Student Development Centre -- http://www.sdc.uwo.ca/ssd/

Ombudsperson Office -- http://www.uwo.ca/ombuds/

9. Student Code of Conduct

The purpose of the Code of Student Conduct is to define the general standard of conduct
expected of students registered at Western University, provide examples of behaviour that
constitutes a breach of this standard of conduct, provide examples of sanctions that may be
imposed and set out the disciplinary procedures that the University will follow. For more
information, visit https://www.uwo.ca/univsec/pdf/board/code.pdf

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