National Initiative for the Care of the ElderlyInitiative nationale pour le soin des personnes âgées
Anthony P. Lombardo, MA, PhD(c)Network Manager
Long Term Care Association of ManitobaOctober 2008
NICE: Context & Background Unprecedented growth in number and proportion
of elderly in Canada 2005, 4.2 million seniors, 13.2% of population1
2036, 9.8 million seniors; 24.5% of population1
Increasingly multicultural older population2
Shortage of professionals and students specializing in the care of the elderly
Gaps in interdisciplinary care of the elderly Gaps in evidence-based care of the elderly
1. Martin Turcotte and Grant Schellenberg, A Portrait of Seniors in Canada: 2006, Ottawa, ON: Statistics Canada, 2007, p. 12.
2. Ibid., p. 23; A. Bélanger and É. Caron Malenfant, Population Projections of Visible Minority Groups, Canada, Provinces and Regions: 2001 – 2017, Ottawa, ON: Statistics Canada, 2005.
How many Geriatricians? 189 geriatricians in Canada – CMA
2003 1.25 geriatricians per 10,000 for elderly 2000/01 only 7 physicians entered post-
graduate training for all of Canada 512 – 607 required geriatricians
How Many Nurses?
There are 251,675 nurses in Canada 26,619 work in geriatric care (10 percent) 75.9 percent work in long term care 11 percent in hospitals Ave. age 47.8 years 48.6 percent are eligible for retirement - Canadian Nurses Association, 2006
How Many Social Workers?
Who knows? 4 to 5 percent of registered members in
gerontology Two MSW degrees in gerontology in
Canada As of last year, graduate about 15
students a year
NICE: A short history… Funded through Networks of Centres of
Excellence – New Initiative Grant One of only 5 “New Initiative” networks funded Incorporated non-profit, 2006 Housed at Institute for Life Course and Aging,
University of Toronto One of only 3 networks awarded International
Partnership Initiative grant (2007) Over 200 members
Diverse disciplines and professions
NICE: Network Goals Networking and Knowledge Transfer Disseminate evidence-based research across
university – community continuum Foster interdisciplinary teams in the care of the
elderly Improve geriatric and gerontological curricula
and enrolment Address training shortages in the care of the elderly
Effect positive policy changes
NICE Structure
Central Committees Knowledge Identification Program Development
Researcher Training Curriculum Development Professional Development
Communications Advisory Committees
Business Advisory Seniors Advisory
New Committees Policy, Planning and
Protocol ICCE Advisory
Theme Teams Caregiving Dementia Elder Abuse End-of-Life Mental Health
Committee Progress
Researcher TrainingNICE Student Mentorship Program
Curriculum DevelopmentCore competencies and accreditation
Knowledge IdentificationWeb resources on evidence-based practice
and teaching tools
NICE “Theme Teams” Action towards interdisciplinary care: Forging
unique links Interdisciplinary teams
Medicine, nursing, social work, and others Bridging research and practice
Interdisciplinary environments for students Seniors’ involvement in the teams Develop user-friendly tools using evidence-
based research, translate into practice
Theme Team Tools Caregiving Theme Team “Respect All” Poster
Designed for staff in long-term care facilities
Placed on facility walls for easy visibility
Suggestions are based upon research evidence
Distributed through Canadian Gerontological Nursing Association
Format & use are being evaluated
Theme Team Tools Caregiving Theme Team “Caring Calendar”
Designed for family members Formatted with consideration of
behaviour changes One evidence-based support
strategy per month Distributed through Alzheimer
Canada Format & use are being
evaluated
Theme Team Tools Elder Abuse Theme Team Elder Abuse Suspicion Index
(EASI) Developed by Dr. Mark Yaffe,
McGill University Tool to screen for potential
cases of elder abuse Adapting for use with
different health practitioners Adapting for use in different
countries (Israel, England)
Theme Team Tools Elder Abuse Theme Team Developed by Drs. Myrna Reis
and Daphne Nahmiash Caregiver Abuse Screen
(CASE) and Indicators of Abuse Screen (IOA)
CASE: Screen caregivers for potential signs of abuse
IOA: Training practitioners to recognize the signs of potential elder abuse
Theme Team Tools Elder Abuse Theme Team In Hand (En Main) Developed by Dr. Marie
Beaulieu, University of Sherbrooke (Quebec)
A framework to guide health care professionals in decision-making around suspected/confirmed cases of elder abuse
Original devised in French, being translated/adapted for use with English audiences
Theme Team Tools End-of-Life Theme Team “What to Expect” Brochure
Includes sections that describe Physical Changes Pain Control and Opiate Use Advance Care Planning and
Substitute Health Care Decision-making
Written for friends and family members of the dying person in a respectful and matter-of-fact tone
Could also comfort the dying Will be placed in palliative care
facilities across the country
Theme Team Tools
End-of-Life Theme Team “Capacity & Consent” Tool Quick reference tool to help
health practitioners in understanding law and respecting seniors’ rights
First tool geared to Ontario Additional tools in development
for other provinces and territories
Theme Team Tools Mental Health Theme
Team Depression Assessment
Screen Based on guidelines of
the Canadian Coalition for Seniors Mental Health
Tool for family physicians to increase screening of older patients for symptoms of depression
Tools in Process
Dementia Theme Team Assessment and
diagnosis tool for family practitioners
Based on Guidelines of the Registered Nurses’ Association of Ontario
International Collaboration for the Care of the Elderly (ICCE) Only NCE-NI to be awarded additional funding through
International Partnership Initiative of NCE and International Development and Research Centre (IDRC)
New partnerships with researchers and organizations in: Australia China England Germany India Israel Scotland South Africa Switzerland
ICCE: Context and Goals Global aging
Economy of scale in world-wide knowledge on the care of the elderly
Canada’s growing older population Collaborate with countries with longer histories of meeting the
challenges of an aging population Canada’s growing ethnically-diverse older population
Collaborate with countries with experience in the cultural issues of aging
Critical shortage of geriatric/gerontological professionals Forum for interdisciplinary collaboration and training
ICCE: Partner Responsibilities
Tool DevelopmentMake tools sensitive/relevant to home regions
Knowledge TransferParticipate in NICE eventsCoordinate and conduct KT events in home
region Student Involvement
Research Funding Received
Homeless to Home: A Knowledge ExchangeHomelessness Partnering Initiative, HRSDC
Older Women and Domestic AbuseStatus of Women Canada
Research Funding Under Review Recruiting Students into the Field of Aging
Health Human Resources Strategy, Health Canada Intergenerational Outreach to Improve
Recruitment New Horizons for Seniors Community Participation
and Leadership, HRSDC Improving Older Women’s Financial Literacy
Status of Women Canada Palliative Care for Older Adults in Institutional
Settings CIHR: Knowledge Synthesis
NICE Knowledge Transfer
Website www.nicenet.ca
NICENews Available online
Workshops and Symposia Annual NICE Knowledge Exchange
June 5 – 6, 2008: Toronto, Ontario www.niceke.ca
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