Huron-Perth Boomers Fall 2020

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HEALTH & WELLNESS Learning more about Geriatrics A Q+A with Dr. Alexandrea Peel on the importance of specialized Medical Doctors for older adults Q: Can you explain your job in laymen’s terms? What exactly does a Geriatrician do? A: Geriatrician is an internal medicine doctor with additional sub-specialty training in caring for older adults with complex health care needs and assisting their caregivers with their care. Many older persons and their family doctors find that care can get fragmented and confusing when they are accessing multiple specialists and community agencies for different aspects of their care. A Geriatrician tries to look at the person as a whole, to create the best recommendations for their medical care based on the unique situation and preferences of the older adult and their caregiver. Dr. Alexandrea Peel, MD, FRCPC You need a referral from your family doctor or nurse practitioner to see a Geriatrician (just like any other specialist). Geriatricians try hard to bring the care closer to your home when required, so they will usually offer home visits, virtual visits, and visits to long-term care or retirement homes. 22 • HURONPERTHBOOMERS.COM
HEALTH & WELLNESS Examples of common reasons to see a Geriatrician include multiple interacting health problems, multiple hospitalizations or emergency visits, multiple medication side effects, falls, memory problems, or trouble managing at home. Q: You grew up on a farm near Wingham, and your husband is from the Lucknow area. Why did you choose to return to the community where you grew up to practice medicine and raise a family? A: Growing up in our rural farming community, I have a unique knowledge of the health care needs and challenges faced by my friends, neighbours and relatives as they age. Being a Geriatrician, I need to understand my patients’ context to provide care, so moving home to practice was a natural fit for me. Despite the large proportion of persons over age 65, I was aware of how limited our access to specialized medical services designed to assess, diagnose, treat, and rehabilitate older adults and support their caregivers. I hoped that by moving back, I could provide care to frail community members, but also catalyze development of a health system that is supportive of older adults’ care needs. In addition to being a Geriatrician, I am also the mother of two little boys (aged 3 and 1) and my spouse also works locally The (Bruce Grotto Power). Our families are a tremendous support to us and we feel lucky to live in such a beautiful part of Ontario and rejoin our community. Q: What inspired you to become a Geriatrician, and why did you choose to practice this specialty in a rural setting? A: I had many important experiences that shaped my career pathway. I have always had a special connection to my grandparents. Their experiences with the health care system became the lens for my interaction with my patients and families. As a high school and university student, I was lucky enough to find health care jobs through the Gateway Healthkick summer jobs program. Many of these jobs were with older adults. I found many Geriatrician mentors during my medical school and internal medicine training. I was drawn to the more holistic approach in geriatric medicine where you balance best practice with the unique care preferences of older adults and their families. Q: What is your definition of ‘rural?’ Do the small towns of Bruce, Grey, Huron, and Perth counties qualify, or is it only the outlying areas (the farming community)? A: Where a Geriatrician works is determined in many cases by two factors — available salaried positions, and by location of provincially funded specialized geriatric service teams (nurses, nurse practitioners, physiotherapists, occupational therapists, social workers, pharmacists etc., whose positions are funded by the Ministry of Health). In our region and many others, salaried positions for Geriatricians are only available in urban areas and team funding/expertise is largely directed to urban areas. Many health regions in Ontario are starting to challenge this model by distributing Geriatricians and teams throughout their region, to bring care closer to home for frail people. Because of these challenges, most Geriatricians are not able to start a solo practice in a rural area, and the majority are based in tertiary (London) or secondary care hospitals. I have several colleagues who work in remote centers like Thunder Bay and Sudbury, but those are considered remote urban areas rather than rural. In our regional there are 10 Geriatricians based in London and one based in Wingham. In our region “urban” is often defined as having a population over 10,000 people and other areas are defined as rural. Q: What are some of the unique challenges older people face in rural environments in comparison to urban environments? A: There are several. Home care delivery in rural areas is an impending health crisis in our area. Some rural areas have no, or few, nurses or personal support workers available to provide care in the home. Existing workers must drive long distances in sometimes poor weather to provide care to their clients. In addition, there is a shortage of affordable housing with FALL 2020 • 23
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Huron-Perth Boomers Fall 2020

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