Older adults and clinical experts discuss the future of Aging in Ontario
at the February Summit
By: Provincial Geriatrics Leadership Ontario
When living with complex health conditions like dementia, frailty and mental health conditions, older adults frequently require the support of specially trained health and social care professionals. From specialist physicians, such as geriatricians, geriatric psychiatrists and care of the elderly primary care physicians, to specialized interprofessional teams, including nurses, rehabilitation professionals, mental health professionals, pharmacists and others, Ontario is fortunate to have a range of expert options.
An annual inventory of these services, prepared by Provincial Geriatrics Leadership Ontario (PGLO) identified 1600+ expert health professionals who assess, treat and provide ongoing support to older adults living with complex health conditions. While not everyone requires specialized support, for older people who live with multiple health conditions and who are experiencing problems with memory, mental health, medications, mobility, falls and other important matters, these services can make the difference between remaining in the community or being prematurely institutionalized. Specialized clinical services are also important supports to primary care providers as they care for increasing numbers of older adults. PGLO has estimated that more than 1.1 million older Ontarians may be living with frailty by 2040. This population will require programs and services that are designed specifically to holistically meet their unique and often multifaceted needs.
Fortunately, there are already many excellent programs to build on to address rising demand. These programs link physicians and others specializing in the care of older adults with complex health conditions, and draw from specialized training and provincial and national standards to guide practice, such as a framework for rehabilitative care for older adults living with frailty or clinical guidelines to address anxiety in older adults.
Specialized clinical services are proving their value. Two recent evaluation studies found that Geriatric Emergency Management (GEM) Teams, a program example that includes registered nurses and other health professionals, reduce hospital admissions and the length of hospital stays. GEM programs also saved roughly $4 for every dollar spent (Seniors Care Network, 2024, Regional Geriatric Program of Eastern Ontario, 2023). Outside the hospital setting, interprofessional community-focused geriatrics and seniors' mental health teams, sometimes called outreach or outpatient teams, support thousands of very complex patients each year, often reducing the use of hospital or long-term care services. In 2023/2024, these teams supported more than 50,000 older adults living with highly complex health conditions in the community (Kay & Morrison, 2024). These are only two of the nearly 30 different types of programs and services found across the province.
Other innovative programs were also highlighted at a recent Aging Care in Ontario Summit, co-hosted by PGLO and Behavioural Supports Ontario, which brought together more than 100 clinicians and older adults to share ideas about the future of aging care in Ontario.
Remarkably, despite system pressures, health and social care professionals are stepping up to meet the demand for care specifically focused on the needs of older adults. In 2023-2024, 480 providers reflecting 35 different health professional roles from 96 organizations participated in the Provincial Common Orientation to the Care of Older Adults, an eleven-week workforce training series. Combining online content and 11 weekly 90-minute sessions facilitated by expert interprofessional geriatric assessors, learners discuss and apply content to their clinical practice. Topics are addressed through 23 interactive modules covering content ranging from normal aging, ageism and communication to screening, assessment, care planning and intervention across geriatric syndromes. Since April 2024, 300 more health professionals have already registered for training.
“It is encouraging to see the enthusiasm for older adult care growing. At the same time, there is a need to grow specialized programs and services along with clinician enthusiasm," says Dr. Kelly Kay, a PhD and Executive Director of PGLO. “We must move quickly to provide needed support to our primary care colleagues and to ensure all older adults have equitable access to clinical supports specific to their needs so older adults can live where they choose to. To do this, we need to design and implement programs guided by the best available evidence and experience," said Kay.
To support health system planners and organizations implementing programs for older adults, PGLO completed a review of the evidence to identify design elements for integrated care for older adults living with complex and chronic health conditions and an accompanying tool kit, including an implementation rubric.
Funding for PGLO is provided by the Ministry of Health.