By 2029, there will be almost one million older adults in Ontario living with frailty. This conservative estimate acknowledges that many older people living with complex health conditions such as mental health and addictions concerns, dementia and multiple, interacting medical conditions may not be fully identified in health system data.
Across the province, Specialized Geriatrics Services provide direct clinical care, programmatic support, education and knowledge transfer (via a range approaches designed for health care providers, patients and caregivers), to ensure optimal care for the most vulnerable Ontarians. We work in collaboration with general primary care, hospitals, home care, community service agencies and the long term care sector. We share a focus on ending hallway medicine, and work directly to decrease repeat emergency department visits, hospital re-admissions and prolonged or permanent institutionalization among older people. We do this by providing age and frailty appropriate care and targeted supports to keep seniors safely at home. Our efforts reduce health system costs by providing care specific to the complexity of the population served.
If we are to end hallway medicine, all Ontario Health Teams must demonstrate the necessary policy, clinical and funding focus on older people living with complex and multiple interacting health conditions (including dementia). Each Ontario Health Team must include specific services that focus on this population (see Table 1) and engage the
appropriate clinical leadership necessary to carry out this work.