Frailty and Long-Term Care 


By: 

Dr. John Muscedere, MD, FRCPC, Scientific Director & CEO, Canadian Frailty Network; Professor, Critical Care Medicine, Queen’s University

Mr. Kashtin Fitzsimons, MSc, Manager, Quality Improvements, Amica Senior Lifestyles

Dr. Ben Robert, MD, Perley and Rideau Veteran's Health Center

Dr. Sharon Kaasalainen, PhD, MSc, BScN, RN, McMaster University

Dr. Suzanne Dupuis-Blanchard, PhD, RN, Université de Moncton

Ms. Karen Chan, MPA, Assistant Deputy Minister, Health and Social Services, Government of Yukon


Frailty is a state of increased vulnerability that results from reduced reserve and loss of function across multiple systems. Over one million older Canadians are living with frailty. To adequately care for the aging population, frailty needs to be part of the conversations among long-term care residents, health care providers, caregivers, scientists, and policymakers

The Canadian Frailty Network (CFN) is devoted to improving care for older Canadians living with frailty and supporting their families and caregivers. The Network has cultivated relationships with strategically aligned organizations and stakeholders across Canada and internationally. CFN improves frailty care by increasing frailty recognition and assessment, by increasing evidence for decision-making, by advancing evidence-based changes to care, by training the next generation of care professionals and scientists, by catalyzing change in Canada’s health and social care systems, and always by engaging with older adults and their families and caregivers.

Throughout the interactive session, participants will gain an understanding of frailty, the operationalization of frailty identification, and the roles of social and palliative care for older adults living with frailty in long-term care. The session will also explore national and international strategies that extend long-term care services to older adults residing at home and create community spaces within long-term care homes.


Master Class outcomes -At the end, participants will be able to:

1. Understand frailty including its assessment and treatment;

2. Be aware of the challenge posed by frailty in the long term;

3. Describe how to improve the quality of life of long-term care residents through social interventions;

4. Discuss how clinicians and decision-makers can integrate palliative care into long-term care; 

5. Understand the benefits of transforming long term care services and spaces to better serve their residents and the surrounding community.

Biographies

Karen Chan is a seasoned executive with experience in non-government organizations (NGO’s), municipal (local) government and provincial public service. The majority of her work experience has been in the human services areas- from children to adults.

Her past experience includes six years in the community, 20 years in the municipal government sector and 17 years with the provincial government.  Karen has held a number of Assistant Deputy Ministers positions over the last ten years in Ontario. Karen joined the Yukon Government the beginning of 2018 as the Assistant Deputy Minister of Continuing Care Division, Health & Social Services, Yukon Government.  In this role, she is responsible for extended care and complex chronic care, special care, long term care, Yukon home care, palliative care and regional therapy programs and continuing care services for citizens of Yukon. Karen has always had a passion for services and supports that impact people. She has perused an integrated and person/client-centred value approach to services and supports in all of her work. Karen has been involved in transformational activities throughout her career.

Working with and engaging with; people, their families, communities, and across sectors, is key to her approach.

John Muscedere was appointed Scientific Director of Canadian Frailty Network, effective August 1, 2013. He has been involved with CFN since its inception, having participated in the Network’s initial proposal for Network of Centres of Excellence funding, as well as serving as Chair of the CFN Knowledge Translation Committee in its first year. He is an intensivist at Kingston General Hospital, and Professor of Critical Care Medicine in the Faculty of Health Sciences at Queen’s University. He is also the Research Director of the Critical Care Program at Queen’s and KGH. Dr. Muscedere is Co-Chair of the Canadian Critical Care Trials Group Knowledge Translation Committee. John is an accomplished critical care researcher whose primary research interests include nosocomial infections, clinical practice guidelines, knowledge translation and critical care outcomes. He has led or participated in the development of many national and international clinical practice guidelines which have guided critical care practice including guidelines for the prevention, diagnosis and treatment of ventilator associated pneumonia, hypothermia post cardiac arrest, calcium channel blocker poisoning and sepsis.  As an intensivist, he has first-hand knowledge of caring for critically ill frail older adults both in academic and community settings. Dr. Muscedere has a keen interest in the design of healthcare systems to optimize patient centered outcomes. He has participated in the redesign of the Ontario provincial critical care system including serving as the regional critical care lead for the South East Local Health Integration Network for 10 years

Kashtin Fitzsimons currently serves as Manager, Quality Improvement at Amica Senior Lifestyles where he has overseen initiatives impacting resident safety and quality of life across thirty-one residences in Ontario, Alberta and British Columbia. With a Masters of Science in Healthcare Quality, Risk and Safety from Queen’s University, Kashtin has applied this background to quality improvement efforts in long-term care, acute care, and community health. Through an ongoing partnership with the Canadian Frailty Network, Kashtin has led Amica’s efforts for quantifying and managing resident frailty present within the organization. To date, this has resulted in a Frailty Index tailored to the health assessment completed for all seniors living in an Amica residence. Looking ahead, Kashtin is excited to partner with researchers and leaders in this field to continuously improve the ageing experience in Canada and abroad.

Sharon Kaasalainen, RN, PhD, is a Professor in the School of Nursing at McMaster University. She joined the School of Nursing in 2002 as an Assistant Professor. She completed a CHSRF Post Doctoral Fellowship at McMaster University and was an Ontario Ministry of Health and Long Term Care Career Scientist. Currently, Dr. Kaasalainen is an Associate Member of the Department of Family Medicine at McMaster University and Honorary Professor at Queens University Belfast. Dr. Kaasalainen’s research program is focused on improving the quality of life for people living and dying in long term care homes with a particular focus on pain management and palliative care. She is currently leading a national team, called “Strengthening a Palliative Approach in Long Term Care (SPA-LTC)” that was initially funded by the Canadian Frailty Network as a Strategic Impact Grant in 2014. Since then she and her team have secured additional funding from CIHR to expand SPA-LTC in four provinces and they are currently leading a randomized control study to evaluate it with plans to scale up the program in six provinces.


Dr. Ben Robert is a family physician providing in-patient care and long-term care for over 30 years.  He is the medical director for The Perley and Rideau Veterans’ Health Centre and is on staff at The Ottawa Hospital.  Dr. Robert attended the University of Ottawa and obtained his Doctorate of Medicine (MD) in 1986. He also achieved specialization in family medicine with a CCFP in 1988 at the University of Ottawa.  Dr. Robert received his Master of Business Administration in 1995. He has additional credentials in Care of the Elderly, as well as Palliative Care.  Dr. Robert has been essential in the development and implementation of a new frailty-informed care program for long-term care residents at Perley Rideau.  

Suzanne Dupuis-Blanchard is a professor at the School of Nursing at the Université de Moncton, is Research Chair in Population Aging CNFS and is Director of the Centre for Aging Research. She holds a Ph.D. in Nursing from the University of Alberta, a Master of Nursing from the University of New Brunswick and a Baccalaureate of Science in Nursing from Université de Moncton. She is the current Chairperson of the National Seniors Council, the past President of the Canadian Association on Gerontology (2014-2018) and past co-chair of the Council on Aging of the New Brunswick government which produced a provincial strategy on ageing. Her program of research focuses on the multiple dimensions of ageing in place, including social frailty, age-friendly communities, and testing innovative service delivery approaches within an Official Language Minority Community (OLMC) context. She has held funding from multiple organizations including CFN, CIHR, SSHRC, PHAC-GNB, and NBHRF. She lives in New Brunswick with her family.


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