Lynn Guerriero is president and CEO of Niagara Health and Dr. Samuel Thrall is a geriatrician at Niagara Health. This column appeared in the St. Catharines Standard, Niagara Falls Review and Welland Tribune.
When we think about healthcare, many of us instinctively turn to hospitals as the first and best option. However, not all medical concerns require hospital admission, and for older adults, hospitalization can pose significant risks. At Niagara Health, we’re committed to ensuring patients receive the right care in the right place, while helping them avoid the complications that can arise from unnecessary hospital stays.
Over the last year, Niagara Health cared for an average of 70 patients per month who did not require hospitalization, each staying an average of 14 days. Often these patients are brought to the hospital because their caregivers and families are no longer able to cope with their care needs or because they need a reprieve from the responsibilities of being a caregiver. Of these, 32% became alternate level of care (ALC) patients, remaining in hospital because appropriate community supports were unavailable. This issue is not unique to Niagara, across Ontario there are more than 5,000 ALC patients in hospital beds, with nearly half waiting for placement in long-term care facilities.
This has ripple effects across the healthcare system. Hospital beds occupied by patients who do not need acute care can delay access for those in urgent need, such as individuals in the Emergency Department (ED) or awaiting surgery. That’s why Niagara Health is working collaboratively with regional healthcare, community and social service partners to ensure patients who do not require hospital-level care are connected to the appropriate supports.
This situation strains hospital resources and places these patients at unnecessary risk, especially older people. Research shows that 50% of older adults experience functional decline during extended hospitalizations, underscoring the importance of avoiding unnecessary admissions. Prolonged stays can lead to hospital-acquired complications, including infections, falls and deconditioning from reduced mobility. For individuals with frailty or cognitive impairment, these risks are even greater.
Recognizing this, Niagara Health has made the care of older adults a priority. Our geriatric specialists take a person-centered, integrated approach that aligns with the provincial Senior-Friendly Care Framework, delivering specialized inpatient and outpatient services across our sites and in the community.
One focus is the prevention and management of delirium, a sudden state of confusion affecting up to 64% of older patients. Delirium is preventable, and Niagara Health integrates early assessments and interventions to reduce its incidence. Simple measures like ensuring hydration, nutrition, mental engagement and using assistive devices like glasses or hearing aids are key.
Falls, the leading cause of injury among older adults, are another critical focus. Niagara Health’s Falls Prevention Program evaluates risk factors, such as poor mobility, disorientation and medication side effects. By educating patients and families, reducing hazards and implementing safety measures, the program reduces fall-related injuries.
The Geriatric Assessment Program (GAP) extends Niagara Health’s commitment to older adults through specialized inpatient and outpatient care at all sites. This team of nurses, nurse practitioners and physicians develop personalized care plans to help older adults live safely and independently for as long as possible.
By preventing avoidable admissions, supporting patient transitions and strengthening community resources, we’re working toward a sustainable healthcare system.
As Niagara’s population ages, the demand for older adult services continues to grow. Half of Niagara Health’s patients are 65 or older, and the region has the third-largest percentage of Canadians aged 85 and above—a demographic expected to double in 25 years.
This issue is urgent as we face our annual surge in respiratory illnesses, increasing ED demand. Niagara Health remains committed to connecting patients with appropriate resources, ensuring safe discharges and reducing risks of extended stays.
For patients and families, it’s important to understand that hospitalization is not always the safest or most effective option. That said, we want to be absolutely clear: if you are experiencing a medical emergency or require urgent care, the hospital and ED are here for you. We recognize that navigating care decisions can be challenging, and we are here to support families in understanding the options available. We have a list of supports available in the community on our Going Home page on our website under the Patients & Visitors tab. When hospital care is not medically necessary, alternative care settings often provide a better environment for recovery and maintaining independence.
