Our ageing population is a year older,
but are we a year wiser?

The baby boom generation that arose in 1946 unleashed a wave of student protests in the 1960s, bought homes and started families in the 1970s and 1980s, and then started turning 65 in 2011. Just a few years ago, one of the largest generations that Canada has ever seen started leaving the workforce to enter retirement, and in 2015, for the first time in Canada, Statistics Canada reported that there were more Canadians over 65 than there were under 15, sparking numerous articles and discussions about a “grey tsunami” that will raise costs and put more stress on our health care system.

Describing the rapid changes in Canada’s demography as a “tsunami” is in fact a misrepresentation. Tsunamis are sudden and intense, however, we have known that our population was ageing faster than ever for quite a while; and, unlike a tsunami, our ageing population should not be considered a disaster that will wreak havoc on our civilization. Rather, I think of the fact that our life expectancy has almost doubled over the last century as a triumph, not a tragedy.

The greatest concern for our health care system isn’t that people are getting older – which has been happening for millennia – but rather that our traditional health and social care systems are unprepared to manage the evolving needs of a rapidly ageing population. One way we could prepare to meet the needs of our ageing population would be to train more geriatricians to better treat the growing numbers of older Canadians with complex and unique needs. Graduates of Canadian medical schools today are far more likely to provide care to older patients than infants and toddlers in their medical careers, but unfortunately geriatrics, by and large, is not part of their core training, while pediatrics is.  This perhaps helps to explain why only 250 of Canada’s 75,000 physicians are geriatricians, while there are at least 10 times as many pediatricians.

In 2010, to meet the growing needs of our ageing population, Mount Sinai Hospital made a significant commitment and became the first acute care academic health sciences centre to make geriatrics a core strategic priority. By adopting the Acute Care for Elders (ACE) Strategy, Mount Sinai uniquely positioned itself as a leader in providing specialized and comprehensive care for older adults. Now that Mount Sinai Hospital is integrated into the larger Sinai Health System, this innovative approach to the care of older adults is rapidly spreading across all Sinai sites, including Circle of Care and Bridgepoint Active Healthcare that are already leaders in the provision of geriatric care.

Across all three Sinai Health System sites, our Healthy Ageing and Geriatrics Program provides comprehensive care to older adults and their families, evaluates the effectiveness of various models of care to improve patient and system outcomes, trains physicians and other health professionals in the most current and relevant practices of geriatrics, and advocates for best practices and policies that will improve the care of our ageing population.

Our program is innovating in the care of older adults with our award-winning ACE Strategy, which is an innovative, interprofessional approach that links together inpatient, outpatient, emergency and community models of care in a continuum of care to support the independence and function of older adults. Under this strategy, the hospital continues to develop, implement and link together a series of evidence-informed models of care and best practices to create a more integrated experience for older patients, their families, and caregivers across the continuum of care. We also continue to work with our home, community, and primary care partners to implement evidence-informed but customized interventions within and across the entire continuum of care.