Huron-Perth Boomers Fall 2020

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
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