From Oct. 18 to 20, Dr. Eoghan O’Shea attended the 47th annual educational meeting of the Canadian Association of Gerontology on behalf of the CMA, where the focus was on mobilizing research, policies and practices related to aging. The following post is a summary of his key learnings from the conference.

Physical obstacles to and facilitators of full participation, safety and security in society

Nearly two million Canadians use some kind of mobility device (wheelchairs, walkers, canes, scooters, etc.). Individuals and elderly people who rely on mobility aids are more likely to experience anxiety or isolation, because of barriers and challenges associated with physical environments — they may encounter greater difficulty getting around or feeling safe to do so without risking injury.

The barriers are not only physical but societal and attitudinal as well. Seemingly small obstacles can have a large impact on seniors with mobility impairments: traffic lights, curbs, ramps (or lack thereof), washrooms, slopes and poorly placed signage are all examples of potential barriers in the community. As Dr. W. Ben Mortenson and Dr. William Miller shared in their presentation, even small details such as the type of flooring (carpeted versus concrete, hardwood or laminate) could have significant effects on someone’s independence, safety or risk for injury.[1]

Improving hospital care for seniors

Dr. Roger Wong, a geriatrician practicing in the Vancouver area, discussed three things that converge when a frail senior is admitted to hospital: the issue that led to the hospital admission (which is usually quite minor) is then compounded by geriatric syndromes and other complex diseases or conditions.

Dr. Wong stressed the importance of hospitals being person-centred and senior-friendly. Creating environments like this requires collaborative work from a team of professionals that should include physiotherapists, occupational therapists and social workers.[2]

Dr. Wong has a TED Talk, “How to keep your elderly parents safe and in their home longer” in which he discusses how the use of technology — cellphone apps to ensure doors are locked, social media as a means to socialize with family and friends across great distances — can enable seniors to safely stay in their own homes longer than they might otherwise be able to do and can also combat isolation and loneliness.

Improving outcomes for frail seniors through better identification and evidence
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The Canadian Frailty Network, with the support of the Government of Canada through the Networks of Centres of Excellence, sponsored a panel discussion chaired by Dr. John Muscedere that explored strategies to properly identify and treat frailty in seniors living in the community.

When caring for frail seniors, and even dealing with the concept and diagnosis of frailty, consistency is the most important thing. Presenters emphasized the need for consistency in how frailty is defined and identified and how research is used. It is thought that too many frailty scoring systems exist; the tendency to label someone as frail without proper objective scoring evidence stalls progress in frailty research.

Primary care providers would benefit from electronic medical record (EMR) templates to assist them in having the most up-to-date information on their patients. Once frail seniors are properly identified, they will benefit from having well-implemented support, including having access to assistance from care providers beyond their primary care physician, such as a health coach.[3]

Mobility, inactivity and fallingamong older adults

The Vancouver Falls Prevention Clinic evaluates individuals over the age of 70 with a history of at least one fall; clinic staff members perform physical, cognitive and geriatric assessments. By offering a wide range of support to their patients — including providing referrals, recommending medication changes, ordering tests, problem-solving remediable issues and assisting with exercise and lifestyle changes— they motivate their patients by encouraging accountability and fostering confidence.

Foreign-born Canadian seniors are less likely to become involved in organized sports or join clubs than seniors who were born here, but most still achieve a target of 7,000 steps through activities such as gardening, cycling, housework and walking for errands or leisure.

Dr. Teresa Liu-Ambrose chaired a discussion about Choose to Move, a BC-based program in which seniors work with an activity coach to develop personalized physical activity plans customized to their individual needs, goals, interests and ability levels. Participants benefit from motivational group meetings and one-on-one consultations and check-ins.[4]

[1] Mortenson WB, Miller W. Barriers and facilitators of mobility and social participation among ageing mobility assistive device users. Presentation at the 47th Annual Canadian Association on Gerontology Conference, 2018 Oct 18–20, Vancouver, BC.

[2] Wong, Roger. Improving Hospital Care for Seniors – System, Best Practice, Innovation. Presentation at the 47th Annual Canadian Association on Gerontology Conference, 2018 Oct 18–20, Vancouver, BC.

[3] Muscedere J. Improving evidence for decision making by adapting common data elements and core outcome measures in frailty studies. Panel discussion at the 47th Annual Canadian Association on Gerontology Conference, 2018 Oct 18–20,Vancouver, BC.

[4] Liu-Ambrose T. Mobility, inactivity and falls among older adults. Discussion at the 47th Annual Canadian Association on Gerontology Conference, 2018 Oct 18–20, Vancouver, BC.