As Canada's population ages, geriatric medicine is an increasingly important part of health care.
Over the next 20 years,
Canada's senior population is expected to grow by 68 per cent, according to the Canadian Institute for Health Information (CIHI).
Geriatric medicine at UHN looks at the full picture — medical conditions, mobility, cognition, medications and social supports — while focusing on what matters most to patients.
What is geriatric medicine?
Geriatrics is the branch of medicine focused on health care for older adults. Most experts agree on the goal of geriatric care — supporting healthy aging, independence and quality of life — but differ on how the specialty should be defined.
Some define it primarily by a person's age, while others base it on age-related challenges, such as frailty, memory problems and loss of independence, regardless of reaching a specific age.
For Dr. Richard Norman, geriatrics lead at UHN, the specialty is about much more than age.
"Geriatric medicine to me is about caring for the whole person," he says.
"A lot of medical specialties focus on particular organ systems or diseases, whereas geriatric medicine is holistic, aiming to systematically address the multiple intersecting problems an older adult might experience."
Geriatricians assess how a person's overall health, mobility, cognition, environment and recovery goals connect.
This approach involves collaboration across disciplines, allowing geriatricians to work closely with physicians, physiotherapists, occupational therapists, social workers and caregivers.
When should I seek geriatric care?
While the Ontario government typically considers someone a senior or older adult starting at age 65, Dr. Norman stresses that chronological age doesn't tell the whole story.
"You can be 80 and in amazing health, hiking in the Alps," says Dr. Norman. "Or you can be in your early 60s, experiencing multiple chronic medical conditions, and be quite frail. It's more about the specific needs of the person rather than a single number."
A person admitted to hospital may see a geriatrician as part of their care. People may also choose to seek geriatric care for age-related health issues, such as mobility changes, memory concerns or complex medical issues specific to older adults.
Some older adults who are generally healthy also see geriatricians to support them with maintaining their health as they age.
How is geriatrics different from internal medicine?
At UHN, geriatric care teams work closely alongside internal medicine teams — but with a particular focus on how the patient's cognition, function, mobility and social context intersect with their medical conditions.
This perspective means geriatricians help guide older patients on what comes after hospitalization, including rehabilitation, follow-up care and planning for the future.
"Delivering comprehensive geriatric assessments is one of the best evidence-supported interventions to get people home, keep them at home and avoid things like placement in a nursing home," he adds.
What are some of the most common issues geriatricians help patients navigate?
Dr. Norman highlights five key focuses — the 5 Ms — in geriatrics that act as a framework to help guide care:
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Mind – cognition and memory concerns
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Mobility – recognizing functional decline, falls, decreased fitness
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Medications – reviewing prescriptions and determining what medicine plan is best
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Multi-complexity – considering the intersection of both health and social issues, such as loneliness, isolation, caregiver support network
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Matters most – navigating the patient's recovery goals, values and preferences
What does geriatric care look like at UHN?
Geriatric medicine at UHN spans inpatient care and outpatient clinics across all sites, in addition to community-based programs.
"Our geriatric medicine team is part of an ecosystem at UHN focused on meeting older people wherever they are in the health care system and really addressing their needs," says Dr. Norman.
Some of UHN's specialized geriatric services include:
Geriatric programs and services unique to UHN include:
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Older Adults with Cancer Clinic at the Princess Margaret Cancer Centre
- Pilot program in collaboration with the Lung Transplant program at UHN's Toronto General Hospital focused on the needs of older transplant patients
- Specialized support for aging and older adults living with HIV through the Immunodeficiency Clinic
What can seniors do now to support healthy aging?
Dr. Norman recommends three key actions:
- Regular exercise
- Keeping your mind active and maintaining meaningful connections with other people
- Getting screened for hearing loss
"People are often surprised to know how much hearing plays a role in cognitive function," says Dr. Norman.
Identifying hearing loss early and using hearing aids, if needed, can help protect against developing cognitive impairment, prevent falls and maintain social connections.
"Social isolation and loneliness are increasingly recognized as drivers of many negative health outcomes," he adds.
Above all, Dr. Norman encourages people to seek assessment for themselves or family members when concerns arise.
"We don't just need to accept certain things as part of aging," he says. "There are services purpose-built to support you through these challenges."
