Older Adult Support Across the Continuum of Care

As far back as 2010, when I moderated a conference panel of health and home care specialists, my central question for the panelists within the context of supporting older adults in later life was – what is your vision for a hybrid model of health care? The subtext on this was – how we could best provide health care delivery between home, hospital and care facilities, which includes home care networks, the role of individual caregivers and the integration of technologies.

One of the automatic follow up statements that provoked a lengthy conversation was – we have to determine what appropriate care is and at what level, to meet our numerous diverse needs on the aging continuum. Well nine years later, last Wednesday, June 12, I found myself at that same concept of the aging continuum as I attended the Sinai Health System/University Health Network education day in Toronto, moderated by Dr. Samir Sinha, Director of Geriatrics.

More than once throughout the seven presentations at this event, there was this recognition of the diversity of needs on the aging continuum underlined by observations such as those from Dr. Barry Goldlist, Staff Geriatrician, Sinai Health System and University Health Network: “there are no generalizations about older adults…human diversity increases with age”. And paraphrasing Jerry Hodge, Patient Advisor, Sinai Health System: “there is no elder care 101.”

While myself, and the full house of front line health, social and community care professionals and advocates at the Michener Institute listened to specific topics from hearing loss to frailty, safe medication and addictions, the theme that spoke loudest to me about managing this Continuum of Care was one of self-determination around your own care agenda. This was poignantly stated by Clara McGregor, Staff Litigation Lawyer, Advocacy Centre for the Elderly as she discussed the issue of Consent and Capacity.

As if that uncomfortable and little understood topic is one most people avoid, the panel discussion on Advance Care Planning and Medical Assistance in Dying (MAID) took us quite to the limit of discomfort I’m sure. I couldn’t help but think, if this topic was a great learning moment for the professionals at this event, how uneducated and unprepared the rest of the public is. These things don’t come up at many soirees I attend, yet eventually, we will all face the music.

So for some extremely enlightening, sobering coffee time reading, regards Consent and Capacity and Advance Care Planning, there are two fabulous resources I picked up and want to share. Notably, the Speak Up Ontario information is very well presented and no matter where you live outside Ontario, the issue of identifying your Substitute Decision Maker (SDM) needs to be at the top of your list.

Ontario Health Care Consent Act, 1996

Speak Up Ontario – Advance Care Planning Workbook

As we individually move along this older adult continuum of care,these and other resources are going to be more important, for as Dr. Samir Sinha began the day suggesting, we need to learn how to stay proactive in gathering an ongoing database of information on our own, “Become your own care navigator.”

For Ontario information check out Sinai Health System’s Healthy Ageing and Geriatrics Health Education web page. If you live in another province or another country, it would be worth your while to sleuth out comparable resources.

Bottom line message from this June 12 Sinai Geriatrics education day: Self-determination, knowing who you are and what you value is as important in later life decision-making as it is at any time of life.  

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