Re-imagining care of older adults

How can we provide equitable health care to people on their journey of aging, while embracing what matters to each person? 

It’s a complex question, that the dedicated teams at St. Joseph’s and across Southwestern Ontario are working to answer today.

With the population of Canadians aged 85 and older expected to triple in the next 25 years, answers need to be found – now more than ever. 

Dr. Sheri-Lynn Kane, geriatrician and Chair, Division of Geriatric Medicine in London, has dedicated her career to caring for older adults. She’s passionate about improving the health care system to be more responsive to this growing group. 

“It’s time for us to stop seeing older adults as the problem and to really embrace the strengths we have across the region and the opportunity to change care and do things differently,” she says.  

As a leader in specialized geriatric care and rehabilitation, an academic health sciences centre in partnership with Western University and a world leader in geriatrics research, St. Joseph’s is the host organization for the Regional Geriatric Program of Southwestern Ontario (RGP SWO). Its mandate is to re-imagine care for older adults living across the region. 

St. Joseph’s brings decades of experience to this role. The organization has been the of the Regional Geriatric Program since 1992, and as a result has provided regional support in some capacity for more than 30 years.  

A tri-directorate model has been created to helm the Regional Geriatric Program – an innovation in itself. 

Dr. Kane is serving as the Medical Director, with Jacobi Elliott, PhD, as Director, Research & Strategy, and Erin Watson as Director of Clinical Programs and RGP Operations. 

Between them they share nearly 60 years of experience and a bottomless passion for the care of older people. 

In the early stages of the re-imagining process, Kane, Elliott and Watson have developed an executive steering committee to oversee the work. 

The Committee has cross-sectoral membership from the region representing a wide range of perspectives– including those from primary and long-term care, rehabilitation, home and community care, mental health and acute care, as well as the community support services sector. 

This group also includes our academic partners from Western University, the University of Windsor, and futures plans to bring on the colleges in the region because of their expertise and roles in educating health care leaders. The leadership trio is also exploring the unique role patient and caregiver partners can have and how best to include them in meaningful ways.

Quality improvement and knowledge translation specialists, who are already working together, round out the team and support the research and evaluation components of the work. 

“We really want this to be a representation of the people who are impacting care across Southwestern Ontario,” says Kane. 

The RGP SWO focuses on five pillars to ensure that people across the region have access to equitable, person-centred care: excellence in clinical care; research and evaluation; education and capacity building; capacity planning and advocacy. 

As the host organization, St. Joseph’s will work with partners within the pillars to promote care synergies between cross-sectoral groups, strive for efficiencies and avoid re-invention in the creation of programs, services and models of care. 

“We want to look more closely at what we can do together, identify the strengths each of the areas in the region offer, consider what we can learn from each other – and begin to apply innovations identified by others to our own areas – always with an evaluation lens,” says Kane. 

Their goals are to build equity in access to care across the region, create innovations around integrated models of care and ensure people receive the right care for them at the right time and in the right place. 

With research and evaluation expertise embedded at St. Joseph’s, the organization will serve as a catalyst for research and evaluation across the region. Part of the mandate will also be to support other researchers, advance quality improvement initiatives, implement and evaluate innovative models of care using a common evaluation framework and partner with regional partners around education. 

The evaluation framework, which will be multi-phased and both individual and system focused, is key to determining success on improving outcomes and improving patient, care provider and caregiver experience.  Provincial Geriatric Leadership Ontario, who unites all of the RGs across Ontario, has developed key indicators to guide the work and track achievements.   

“Re-imagining geriatric care was one of my goals when I took on the role as Chair of Geriatrics,” says Kane, “so I’m very excited about the opportunities that are before us through the RGP SWO.”

“We want to provide equity in care, improve timeliness of care and embrace what matters most to the individual,” she added. “Regardless of what age someone lives to be, we want them to live their own definition of their best quality of life.”

Elliott and Watson echo Kane’s enthusiasm. 

“The work ahead of us provides an opportunity to link research and clinical services to improve patient care and allows us to continuously evaluate the work we are doing. This is the right thing to be doing for older adults,” says Elliott. 

“It’s an exciting time for geriatric care,” says Watson. “This is an equity-deserving population, and they must receive the best care possible. All of the planning and advocacy work will have an impact on what we are and will continue to face in the next decade. It’s just the right thing to do.”

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