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Specialized program helps older adults live their best lives

Posted Jun 27th, 2023

We are Niagara Health is a series of stories that celebrates the incredible people working and volunteering in our organization and how they make a difference in the lives of patients and coworkers every day.

A group of people stand outside, some arm in arm, smiling for the camera

From left: Geriatric Assessment Program team members Registered Practical Nurse Alea Read, Ward Clerk Vanessa Shannon, Geriatric Assessment Program (GAP) Case Manager Suzie Forgeron, Clinical Nurse Specialist Julie Rubel, Registered Nurse Lydia Knack, Registered Nurse Stephanie Ralph, Geriatrics Head of Service Dr. Ziyaad Al-Khateeb, and Ward Clerk Chantal Young.

About half of all patients admitted to hospital in Niagara are 65 or older.

The region is also home to the third largest percentage of Canadian adults over the age of 85 – a population predicted to double in the next 25 years.

With that in mind, Niagara Health has made care of older persons a strategic priority and positioned itself as a leader in geriatric care in the process with its Care for Older Persons Strategy.

“At this stage, we’re hoping to move ahead of other hospital systems in terms of our approach to care for older persons, financial investment, time and strategic plan,” says Lori MacCulloch, Niagara Health’s Director of Complex Care and Geriatrics. “Really, when you think about it, a significant part of what we do all the time is caring for older adults. I’m really proud of this organization for saying, ‘We recognize this is happening and we’re supporting this by making care for older persons a priority.’”

The Care for Older Persons Strategy is an integrated, person-centred model of care that aligns with the Senior-Friendly Care Framework and delivers specialized inpatient and outpatient services across and beyond Niagara Health.

Many teams, programs and individuals are working to establish age-friendly care and specialized services that are accessible to all older adults. By the time the strategy is fully implemented over the next few years, “every (hospital) door will be the right door” for someone 65 and older to walk through and receive standardized care by Niagara Health physicians and staff.

The Geriatric Assessment Program (GAP) is one of those services providing compassionate care to Niagara’s older adults. GAP offers both inpatient and outpatient programming at all Niagara Health hospitals.

These are just a few of the dedicated team members who meet with patients and their families to create comprehensive care plans, and provide counselling and support to help Niagara’s older adults live safely and independently as long as possible.

Dr. Ziyaad Al-Khateeb, Head of Service, Geriatrics

Suzie Forgeron, Geriatric Assessment Program (GAP) Case Manager

Stefanie Irish, Interim Clinical Manager of Regional Geriatrics and Clinical Manager of Inpatient Medicine, Telemetry and Stroke at the Niagara Falls hospital

Stephanie Ralph, Registered Nurse, Bachelor of Science, Inpatient Geriatric Assessment Program

Julie Rubel, Clinical Nurse Specialist, Geriatrics

Vanessa Shannon, Ward Clerk  

A man with an olive complexion and short-cropped beard smiles for the cameraDr. Ziyaad Al-Khateeb, Head of Service, Geriatrics

Why did you become a geriatrician?

I chose geriatric medicine because of its holistic and team-based approach to patient-centred care. The opportunity to make a meaningful impact to the ever-growing aging population fit perfectly with my admiration for older adults as a student. 

What brought you to Niagara Health to practise medicine?

When I was nearing my graduation, I wanted to practise in an underserved community. Niagara has one of the largest proportions of older adults in Ontario. The team I met here shared my passion for a comprehensive, multi-disciplinary approach to patient care so the choice was easy.


A woman with short, ash-blonde hair smiles for the cameraSuzie Forgeron, Geriatric Assessment Program (GAP) Case Manager

Why did you want to work with older adults?

After more than 35 years in nursing and helping my own aging parent, I wanted to provide the same support for other older adults. I already had experience with GAP and knew this was the job where I could be empathetic and compassionate to the extraordinary needs of some of our patients.

What makes older adult care at Niagara Health’s GAP so special and important?

We recognize the full lives and amazing experiences our patients have had and use this to build our plan of care. Our program recognizes the vulnerability of some older adults and strives to work with them, their families and outside resources to provide compassionate, supportive care to allow them to maintain as much independence as possible in a safe and supported environment.

What should someone know coming to GAP for the first time?

GAP is an inclusive program. We will do our best to support patient and family. We want our patients to live independently for as long as possible. We want our patients to be safe, always. Our patient’s goals are our goals.


A portrait of a woman with long brown hair smiling for the cameraStefanie Irish, Interim Clinical Manager of Regional Geriatrics and Clinical Manager of Inpatient Medicine, Telemetry and Stroke at the Niagara Falls hospital

What makes Niagara Health’s Geriatric Assessment Program stand out? 

Our program consists of registered nurses (RNs), registered practical nurses (RPNs), occupational therapists, a nurse practitioner and physicians who all have specialized knowledge of the care needs of our older adult population. Our RNs and RPNs are often the first point of contact with our patients and their care providers. They ensure our patients receive quality care and efficient service from our renowned geriatricians in our outpatient clinics and on our inpatient units across all five hospitals. We have three unique clinics that all serve to enhance the quality of life for our older adults: our MD clinics, nurse practitioner clinics and our RN followup clinics. Our inpatient team, outpatient team and our Behavioural Supports Ontario clinical leads allow us to provide holistic care to our patients in hospital and in the community.

Favourite part of coming to work?

My favorite part of coming to work is working with this team. The support that every staff member provides each other is unlike any other. Their passion for care of older adults is evident every day. Each person takes the time to provide an extraordinary patient experience to every patient and their families.

How will the new hospital aid in providing older adults the best care possible?

The new South Niagara hospital will allow us to care for older adults with added space for consultations and clinic visits, effectively reducing wait times. Our ambulatory care setting will be more accessible with a thoughtful design that is easy to navigate and provides comfortable spaces for our patients and their families.


A woman with dark hair smiles for the camera.Stephanie Ralph, Registered Nurse, Inpatient Geriatric Assessment Program

Why did you become a nurse?

I took the long road to becoming a nurse, but I am so glad I did. Originally, I completed my science degree with a goal to teach high school. After completing this program, I knew I needed to change career paths and focus my love of helping and caring for people on healthcare. My mom, a registered nurse, provided a lot of inspiration and guidance, leading to my nursing focus.

What compelled you to focus your work on older adults?

As soon as I began nursing school, I was drawn to caring for older adults. I am passionate about providing patient-centred care to vulnerable populations and prioritizing the time it takes to understand who each patient is as a person. Older adults bring with them so much experience and have contributed so much to society, it is inspiring to listen to their stories and to give back to them.

What should everyone know about our Geriatric Assessment Program?

Everyone should know how important comprehensive geriatric assessment is. We provide holistic care to each of our patients to guide them through their unique aging process. The patients we serve, who have dementia or other neurocognitive disorders, require specialized care to help navigate the disease process. As a program, we aim to provide the highest level of care to support our patients and caregivers.


A woman with shoulder-length blonde hair smiles for the cameraJulie Rubel, Clinical Nurse Specialist, Geriatrics

What drew you to older adult care?

I was drawn to care of older persons after an impactful high school co-op placement at a local retirement home. The opportunity to share in the lives and witness the life stories of older persons is a tremendous gift. After nearly two decades in nursing practice, I remain committed to this specialty because of its complexity and focus on collaboration, both with teams and with patients and their families.   

Best part of the job?

The best part of working in Geriatrics at Niagara Health is working with teams and programs across all sites. Using an expanded knowledge base, our team can help interprofessional staff better understand the unique needs of older persons and incorporate established and emerging evidence into practice. In my 13 years with our program, I’ve seen real change in our approach towards care of older persons and I am encouraged for our future.

Tip for maintaining wellness in aging?

Most importantly, I would recommend we stay active. Being active is not just physical -- though this is very important, too -- but also remaining engaged in the broader community. For instance, people can join a book club, volunteer at a local service club, or just meet friends for coffee. Engaging our minds and bodies throughout life is key to healthy aging and is attainable in different forms for all.


A woman with shoulder length dark blonde hair smiles for the cameraVanessa Shannon, Ward Clerk  

What is your favourite part of working with older adults?

Simply put, they are “my people.” I’ve worked with seniors most of my career and have connected with them on a special level since I was a child. My mother has been a nurse in long-term care for decades and this is where my passion for helping seniors started. I would visit the residents when she was working and sit and talk with them. I’ve always loved connecting with older adults because they have such life experience and wisdom. 

What drew you to working in healthcare?

I’ve always loved helping others and it runs in the family. My late father was a family physician and my mother and sister are nurses. By working in medical administration, it’s a perfect combination of using my skills in business while assisting our patient experience. It’s truly rewarding to work for an outstanding program such as Geriatric Assessment. We’ve touched so many lives in the community and I hear nothing but positive feedback regarding our program. 

What should everyone know about our Geriatric Assessment team?

We truly care. I work with a team of tremendous individuals. They are some of the brightest and most compassionate professionals I have ever encountered. Our physicians, nurses, nurse practitioner and administrative staff all work together to ensure our patients and their families are looked after to the best of our abilities. We work in unison to provide the highest level of care and support to our senior population and their loved ones.


Niagara Health System