Denise Cloutier

Denise Cloutier
Professor, Acting Associate Dean, Research
Health geography; health services research; older adults; long-term care; rural health

PhD (Guelph)

Office: DTB B360

The Caregiver Journey help sheet, a collaboration with Taylor Hainstock.

I am a Full Professor in the Department of Geography, and a Research Affiliate with the Institute on Aging and Lifelong Health at the University of Victoria where I have been since 2001. As a health and social geographer, I am primarily interested in geographies of aging, ultimately in the ‘continuum of care’ for older adults. Recently, I take a lifecourse perspective in these studies. I aim to understand the trajectories (geographical, educational, occupational, relational, health and illness etc.) that influence the health and well-being of individuals. I am interested in integrated models of care that focus on issues such as continuity, availability, access and equity whether people live in their own homes in the community (e.g., housing, transportation, amenities, and services and urban/rural residence) or in facilities (e.g., assisted living and nursing homes). In 2019, I was thrilled to receive the Provosts’ Community Engaged Scholar Award for my community-based scholarship.

My research and teaching focus on a wide array of methodologies - quantitative, qualitative, indigenous, and mixed methods approaches.  I have been fortunate to teach these methods courses at the graduate and undergraduate level. Courses I have taught include: Introduction to Human Geography, Environment and Health, Disaster Planning and Community Resilience, Health and Place, and Exploring Aging through Film. I am passionate about supporting students to be lifelong learners and critical thinkers. I love to encourage anything that nurtures the ‘research bug’. I have recently taken on the position of Faculty Advisor and Steering Committee Chair for the Population Health Data Analysis Program and Education and Training Unit for Population Data BC.


My research reflects a strong commitment to understanding the wide-ranging experiences and improving the daily lives of older adults and their families in terms of healthy aging, care and health services delivery.  I have conducted research with many specific population groups including individuals living in rural and small town environments, persons living with dementia, those who are socially isolated, home care clients, palliative care clients, and stroke survivors.  My research has been funded by the Canadian Institutes of Health Research, Social Sciences and Humanities Research Council of Canada, Michael Smith Foundation for Health Research, the United Way, and the World Health Organization. My current research program, funded by the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research, has focussed on understanding care transitions and trajectories from home care to acute care to residential care and predictors of care transitions for older adult clients and their families. A related newly completed research project examined the implementation of a new care delivery model for residential care in British Columbia.

My work has been published in journals such as Progress in Human Geography, the Gerontologist, Journal of Gerontology, Social Sciences and Medicine, Health and Place, Journal of Aging Studies, Canadian Journal of Public Health, and Canadian Journal of Aging.


My teaching philosophy is essentially governed by the viewpoint that learning is a lifelong process and that the ideal environment for learning is one in which students and instructors believe themselves to be joint partners in a mutual adventure.  This means that the adage ‘you get out what you put in’ is true for all parties. I also agree with award-winning teachers on campus and outside the university who suggest that having a sense of humour is extremely beneficial to the learning process! In a real-life context, my undergraduate and graduate students, and my own two grown children are endless sources of inspiration to me, and provide many meaningful life examples and illustrations for teaching and learning.

My central goal is to keep students motivated, and excited about learning, and to sustain within them an appreciation for geography, broadly conceptualized, and the spatial world in which we live.  To promote and maintain interest, I use a mixture of methods of discussion and group work, seminars, one minute papers, and lab assignments.  Where possible, I embellish text and course reading materials with relevant examples from video clips, books and other literature, the internet, my experience, music, etc.  One additional advantage that I believe I bring into the classroom is that I have worked as a geographer in many diverse environments outside of the university.  Alongside my interest in applied research, I believe that I can offer students a unique learning experience.


Google Scholar

Information help sheet
The Caregiver Journey: Questions to consider when helping your family member enter residential care.

a.  Articles Published in Refereed Journals

(accepted) Kobayashi[DC1] , K.M., Cloutier, D., Khan, M. (2018). Asset-Based Community Development to Promote Healthy Aging in a Rural Context in Western Canada: Notes from the Field, Journal of Community Practice. August and October.
(accepted) Cloutier, D. & Brendle-Moczuk, D. (2019). Health Systems and Health Service Restructuring, International Encyclopedia of Human Geography, Isaac Luginaah and Audrey Kobayashi (Eds). 12 pages, July, 2018; January 2019; March 2019.
Kobayashi, K.M., Kampen, R., Cox, A., Cloutier, D. Cook, H., Taylor, D., Gaspard, G. & Khan, M.M. (2018). Changing roles of care team members within new models of care delivery in residential care facilities: Implications for the delivery of quality of care. International Journal of Aging Research, 2018

Buchan, R., Cloutier, D.S., Friedman, A. (2018). Transformative Incrementalism: Planning for Transformative Change in Local Food Systems. Progress in Planning, July 29th. Role: 2nd author extensive contributions in terms of content and editing.

Saleh, N., Penning, M., Cloutier, D., Mallidou, A., Nuernberger, K., Taylor, D. (2017). Social Engagement and Antipsychotic Use in Addressing the Behavioral and Psychological Symptoms of Dementia in Long-Term Care Facilities, Canadian Journal of Nursing Research, 49, 4: 144-152.

Hainstock, T., Cloutier, D. & Penning, M. (2017). From home to 'home': Mapping the caregiver journey in the transition from home care into residential care. Journal of Aging Studies, Dec 43, 32-39. doi: 10.1016/j.jaging.2017.09.003. Epub 2017 Sep 14.

Cloutier, D. & Penning, M. (2017) 'Janus at the Crossroads: Perspectives on Long-term Care Trajectories for Older Women with Dementia in a Canadian Context.' The Gerontologist, Special Issue: Aging-It’s Personal Issue. 57 (1), 68-81.

Bills Walsh, Kathryn & Cloutier, Denise. (2016)'Just a walk in the park, or is it? A Case Study Analysis of a Seniors Community Park in Oak Bay, British Columbia.' The Northeastern Geographer, Steven Silvern (Ed.). Vol 8, Fall 2016, 22-37. 

Cloutier, Denise, Amy Cox, Ruth Kampen, Karen Kobayashi, Heather Cook, Deanne Taylor & Gina Gaspard. (2016) 'A tale of two sites: Lessons on leadership from the implementation of a long-term care delivery model in Western Canada.' Healthcare4(3); doi: 10.3390/healthcare4010003

Penning, M.J., Cloutier, D.S, Nuernberger, K., MacDonald, S.W.S, Taylor, D. (2016) Long-Term Care Trajectories in Canadian Context: Patterns and Predictors of Publicly Funded Care, The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 00, No. 00, 1-11. doi: 10.1093/geronb/gbw104

Tuokko, H., Rhodes, Ryan, Love, Janet, Cloutier, Denise, Jouk, Alexandra, Shoklitsch, A. (2015) 'Just the facts: changes in older driver attitudes after exposure to educational interventions.' Traffic Injury Prevention 16(6):558-564. doi: 10.1080/15389588.2014.992067

Cloutier, D., Martin-Matthews, A., Byrne, K., Wolse, F. (2015) 'The Space Between: Using a relational space’ framework to explore relationship-building between clients and home support workers in the home space' Journal of Social and Cultural Geography 16(7) 764-782 doi: 10.1080/14649365.2015.1020336

Buchan, R., Cloutier, Denise, Ostry, A. and Friedman, A. (2015) 'Local food system planning: the problem, conceptual issues and policy tools for local government planners.' Canadian Journal of Urban Research 24(1):1-23.

Skinner, M.W., Cloutier, D., Andrews, G. (2014) ‘Geographies of Ageing: Progress and possibilities after two decades of change’ Progress in Human Geography 1-24, DOI: 10.1177/030913251458444

Mazzei, F., Gillan, R., Cloutier, D. (2014) ‘Exploring the Influence of Environment on the Spatial Behavior of Older Adults in a Purpose-Built Acute Care Dementia Unit’ American Journal of Alzheimer Disease and Other Dementias 29(4), 311-319. (On-line publication 2013)

Tuokko, H., Rhodes, R., Love, J., Cloutier-Fisher, D., Jouk, A. & Schoklitsch, A. (2012) ‘Change in Beliefs about Older Drivers through Applied Theatre’ Educational Gerontology 39(1), 45-56. doi:10.1080/03601277.2012.660868

Stajduhar, K.I., Funk, L., Roberts, D., McLeod, B., Cloutier-Fisher, D., Wilkinson, C., and Purkis, M.E. (2011) ‘Home care nurses’ decisions about the need for and amount of service at the end of life’ Journal of Advanced Nursing 67(2), 276-286

Funk, L., Stajduhar, K.I., Cloutier-Fisher, D. (2011) ‘Exploring family caregiver’s rationales for non-use of formal health care services when caring for a dying family member’ Home Healthcare Management and Practice 23(5), 318-328. DOI: 10.1177/1084822310384920.

Cloutier-Fisher, D., Kobayashi, K., and Smith, A.P. (2011) ‘The subjective dimension of social isolation: a qualitative investigation of older adults’ experiences in small social support networks’ J. of Aging Studies 25(4), 407-414

Seemann, M., Onur, T., Cloutier-Fisher, D. (2011) ‘Earthquake Shaking Probabilities for Communities on Vancouver Island, British Columbia, Canada’ Natural Hazards. 58(3), 1253-1273

Allan, D., Funk, L.M., Reid, R.C., Cloutier-Fisher, D. (2011) ‘Exploring the Influence of Income and Geography on Access to Services for Older Adults in British Columbia: a Multivariate Analysis using the Canadian Community Health Survey (Cycle 3.1)’ Canadian Journal on Aging 30(1), 1-14

Stajduhar, K., Funk, L., Wolse, F., Crooks, V., Roberts, D., Williams, A., Cloutier-Fisher, D.,  McLeod, B. (2011) ‘Core Aspects of “Empowering” Caregivers as Articulated by Leaders in Home Health Care: Palliative and Chronic Illness Contexts’ Canadian Journal of Nursing Research 43(3) 78-94

Househ, M.S., Kushniruk, A.W., Maclure, M., Carleton, B., Cloutier-Fisher, D. (2011) ‘Strengths and Weaknesses of using Conferencing Technologies to Support Drug Policy Knowledge Exchange’ Studies in Health Technology Information 164, 405-409.

Househ, M., Kushniruk, A.W., Maclure, M., Carleton, B., Cloutier-Fisher, D. (2011) ‘Virtual Knowledge Production within a Physician Educational Outreach Program’ Knowledge Management and E-Learning: An International Journal 3(1), 24-34

Purkis, M.E., Borycki, E., Kuziemsky, C., Black, F., Cloutier-Fisher, D., Fox, Lee Ann, Mackenzie, P., Syme, A., Tschanz, C. (2011) ‘Extending the team component of the Latimer ethical decision-making model for palliative care’ Journal of Healthcare Leadership 3, 1-12

Stajduhar, K.I., Funk, L.M., Roberts, D., Cloutier-Fisher, D., McLeod, B., Wilkinson, C., & Purkis, M.E. (2011) ‘Articulating the role of relationships in access to home care nursing at the end of life’ Qualitative Health Research 21(1), 117-131

Househ, M. Kushniruk, A.W., Maclure, M.M., Carleton, B., Cloutier-Fisher, D. (2011) ‘The Use of Conferencing Technologies to Support Drug Policy Group Knowledge Exchange Processes: An Action Case Approach’ International Journal of Medical Informatics Vol 80(4), 251-261

Setton, E.L., Keller, P., Cloutier-Fisher, D., Hystad, P. (2010) ‘Gender-based differences in estimates of commuters’ exposure to traffic-related air pollution – a simulation study’ Professional Geographer Vol 62(1) February, 66-83.

Setton, E., Marshall, J., Brauer, M., Hystad, P., Keller, P., Cloutier-Fisher, D. (2010) ‘The Impact of Mobility on Exposure to Traffic-Related Air Pollution and Health Effect Estimates’ Journal of Exposure Science and Environmental Epidemiology June 30 (doi: 10.1038/jhes.2010.14).

Househ, M., Kushnirik, A., Carleton, B., Cloutier-Fisher, D. (2009) ‘A literature review on distance knowledge exchange in healthcare groups: what can we learn from the ICT literature?’ Journal of Medical Systems, Springer Science, DOI: 10.1007/s/10916-009-9401-7

Kuziemsky, C., Borycki, E., Purkis, M.E., Black, F., Boyle, M., Cloutier-Fisher, D., Fox, L., Mackenzie, P., Syme, A., Tschanz, C., Wainwright, W., Wong, H. (2009) ‘An interdisciplinary team communication framework and its application to healthcare ‘e-teams’ systems design’ BMC Medical Informatics and Decisionmaking 9:43, doi: 10.1186/1472-6947-9-43

Househ, M., Kushnirik, A., Maclure M., Carleton, B., Cloutier-Fisher, D. (2009) ‘Barriers and Opportunities for Knowledge Exchange in Drug Policy Formulation’ Electronic Health Care, 1(4), 78-81

Blake, A. and Cloutier-Fisher, D. (2009) ‘Backyard Bounty: Exploring the benefits and challenges of backyard garden sharing projects’ Local Environment, 14(9), 797-807

Househ, M., Kushnirik, A., Maclure, M., Carleton, B. and Cloutier-Fisher, D. (2009) ‘A Case Study Examining the Impacts of Conferencing Technologies in Distributed Healthcare Groups’ Healthcare Quarterly 1(4), 78-81

Kobayashi, K., Cloutier-Fisher, D. and Roth, M. (2009) ‘Making Meaningful Connections: A Profile of Social Isolation and Health among Older Adults in Small Town and Small City, British Columbia’ Journal of Aging and Health 21(2) 374-397

Cloutier-Fisher, D. and Kobayashi, K. (2009) ‘Examining social isolation by gender and geography: conceptual and operational challenges using population health data in Canada’ Gender, Place and Culture 16(2), 181-199 

Cloutier-Fisher, D. and Harvey, J. (2009) ‘Home beyond the house: experiences of place in an evolving retirement community’ Journal of Environmental Psychology 29(2), 246-255

Setton, E., Keller, M., Peter, C., Cloutier-Fisher, D., and Hystad, P.W. (2008) ‘Spatial variations in estimated chronic exposure to traffic-related air pollution in working populations - A simulation’ International Journal of Health Geographics 39(7), doi: 10.1186/1476-072X-7-39

Lau, F., Cloutier-Fisher, D., Kuziemsky, C., Black, F., Downing, M., Borycki, E., Ho, F. (2007) ‘A Systematic Review of Prognostic Tools for Estimating Survival Time in Palliative Care’ Journal of Palliative Care’  23(2), 93-128 

Cloutier-Fisher, D., Penning, M., Zheng, C., Druyts, E., (2006) ‘The Devil is in the Details: Trends in Avoidable Hospitalization Rates by Geography in British Columbia’ BMC Health Services Research 104(6) doi: 10.1186/1472-6963-6-104 (URL:

Allan, D. & Cloutier-Fisher, D. (2006) ‘Health Service Utilization among Older Adults in British Columbia: Making Sense of Geography’ Canadian Journal on Aging 25(2), 219-232 

Cloutier-Fisher, D. & Skinner, M. (2006) ‘Leveling the playing field? Exploring the implications of managed competition for voluntary sector providers of long-term care in small town Ontario’ Health and Place 12, 97-109

Cloutier-Fisher, D. (2005) Different strokes: need for help among stroke-affected persons in British Columbia’ Canadian Journal of Public Health 96(3), 221-225.

Mackenzie, P. & Cloutier-Fisher, D. (2004) ‘Home Sweet Home: Experiences of Place for Retirement Migrants to Small-town British Columbia’ Rural Social Work 9, 129-136

Murphy, B.L. & Cloutier-Fisher, D. (2002) ‘Balancing act: graduate school and motherhood’ Great Lakes Geographer 9(1), 37-47

Freeman, T.R., Stewart, M., Birtwhistle, R. & Cloutier-Fisher, D. (2001) ‘Health diaries for monitoring events following immunization’ Canadian Journal of Public Health 91(6), 426-430

Cloutier-Fisher, D. & Joseph, A.E. (2000) ‘Long-term care restructuring in rural Ontario: retrieving community service user and provider narratives’ Social Science and Medicine 50, 1037-1045

Gray, R.E., Chart, P., Carroll, J.C., Fitch, M.I. & Cloutier-Fisher, D.  (1999) ‘Family physician's perspectives on ovarian cancer’ Cancer Prevention and Control 3(1), 61-67

Gully, P., Cloutier-Fisher, D. Pless, R.  Herbert, C. (1995) ‘Management of sexually transmitted diseases by family physicians: a descriptive study’ Canadian Family Physician 41, 1890-1896

Freeman, T., Cuff, W., Duclos, P., Stewart, M., Morris, B., & Cloutier-Fisher, D. (1994) ‘A comparison of local reactions to two formulations of DPT vaccine’ Canada Communicable Disease Report 20-15, 129-132.

Joseph, A.E. & Cloutier, D. S. (1991) ‘Elderly migration and its implications for service provision in rural communities: An Ontario perspective’ Journal of Rural Studies 7(4), 433-444

Joseph, A.E., & Cloutier, D. S. (1990) A framework for modeling the consumption of health services by the rural elderly’ Social Science and Medicine 30(1), 45-52

b.  Books, Chapters, Monographs

(accepted) Martin Matthews, A. & Cloutier, D. S. (2017) 'Household Spaces of Aging: when care comes home.' Geographical Gerontology: Concepts and Approaches, M. Skinner, M. Cutchin, G. Andrews (Eds.). Routledge: UK.

Cloutier, D. Penning, M., Nuernberger, K., Hainstock, T., Funk, L.M., Taylor, D. and Kelly, R. (2016) 'Long-term care service delivery challenges for ageing in place in rural communities: A health region case study of home and residential care.' Chapter 7, Ageing Resource Communities: New Frontiers of Rural Population Change, Community Development, and Voluntarism. Mark Skinner, Neil Hanlon (Eds). Publishers: Routledge: London. doi: 10.4324/9781315728209

Cloutier, Denise. (2013) (Book Review). Pathways through the Transitions of Care for Older Adults, Annual Review of Gerontology and Geriatrics, P. Dilworth-Anderson and M.H. Palmer, Vol 31, Springer Publishing Co: New York. Canadian Journal on Aging 32 (1), 106-108. doi: 10.1017/s0714980813000044

Househ, M., Kushniruk, A., Maclure, M. Carleton, B., Cloutier-Fisher, D. (2012) ‘Developing Virtual Communities to Support Drug Policy Knowledge Exchange: The Canadian Experience’ E-Health Communities and Online Self-Help Groups: Applications and Usage. IGI GLOBAL Publishing Group, Hershey, Pennsylvania

Virtue, N., McKee, B., Foster, L.T., Blake, A., Cloutier-Fisher, D., Keller, C.P., Ostry, A. (2010) ‘The Geography of Women’s Wellness and Well-being across British Columbia’ A Supplement to the British Columbia Atlas of Wellness, Department of Geography, University of Victoria

Cloutier-Fisher, D., Foster, L., David Hultsch, D. (Editors) (2009) ‘Vulnerability and Resilience among Older Adults in BC’ Western Geographical Series, Victoria

Cloutier-Fisher, D., Foster, L., David Hultsch, D. (Editors) (2009) ‘Chapter 1, Introduction’ in Vulnerability and Resilience among Older Adults in BC, Western Geographical Series, Victoria

Foster, L., T., Miller, G., McKee, B., and Cloutier-Fisher, D. (2009) ‘Chapter 16, Vulnerabilities and Resiliencies of Seniors in BC: A wellness Approach’ Vulnerability and Resilience among Older Adults in BC, Western Geographical Series, Victoria

Cloutier-Fisher, D. and Kusch, K, (2009) ‘Chapter 12, Breaking Barriers and Breaking Bread: Evaluating a Congregate Dining Program as a Means of Reducing Social Isolation and Promoting Friendships among Vulnerable Older Women in a Life Enhancement Skills Group’ Vulnerability and Resilience among Older Adults in BC, Western Geographical Series, Victoria

Joseph, A.E. & Cloutier-Fisher, D. (2005) ‘Ageing in rural communities: vulnerable people in vulnerable places. In G. Andrews & Phillips, D. R. (Eds.)’ Ageing and Place: Perspectives, Policy and Practice 133-146, Routledge Studies in Human Geography, London

Fowler, J. Cloutier-Fisher, D., Foster, L., Keller, C.P., McKee, B., Virtue, N., Tuk, T., Armour, R. (2005) ‘British Columbia Atlas of Mortality, 1989-2002’ (On-line atlas containing static and interactive and downloadable maps.)  URL:

Faces of UVic Research video

In this video, Denise talks about her research as a health geographer where she examines how our geography influences our health and well-being.