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ACE a common-sense approach to eldercare

Troy Media by Donna Thomson 13 July 2017

Dr. Samir Sinha is Canada’s guru on aging. We should listen carefully to his ideas because 42 per cent of all hospital patients in our country are over 65 and they account for 60 per cent of all hospital days. Senior patients consume 60 per cent of acute-care budgets and almost half of all health-care spending.

Sinha is the head of geriatrics at Toronto’s Mount Sinai and University Health Network Hospitals and a frequent contributor on issues related to aging on CBC’s The National Politics of Health Care Panel.

Sinha is the creator of a unique approach to hospitalization for seniors – one that’s proven to heal older people more quickly, and put them on a safe and healthy fast track back home. The approach, called Acute Care for Elders (ACE), is being rapidly adopted by hospitals across Canada and beyond.

Enabling people to age at home by returning older patients to their own homes more quickly with fewer complications is the ultimate goal of ACE. Many older patients will be discharged quickly after treatment, but for those admitted, the differences between a traditional hospital ward and an ACE unit are striking. ACE units are designed to care for frail older adults and that eases the burden of care for families.

Uncluttered hallways offer non-slip, low-glare floors and handrails, as well as occasional padded chairs for resting. These design features encourage patients to maintain strength and mobility by keeping active. Large clocks and information boards help keep people oriented. Low beds and easy-access bathrooms promote mobility and reduce the risk of falls.

Quality sleep is a key element of the ACE approach. The Queensway-Carleton Hospital ACE unit in Ottawa has elaborated on the model by creating an overnight HUSH time (Help Us Support Healing). Lights are dimmed and staff phones are set to vibrate. Natural care is supported by flexible visiting hours and family members are welcome to stay overnight.

Most importantly, families are recognized as valued members of the treatment team. Nurses invite calls to check in on a loved one any time of the day or night. This care has led to patient satisfactions rates consistently as high as 99 to 100 per cent over the past year, especially with more older patients able to return home.

Dr. Samir Sinha

Over the next 20 years, the population of Canadians over 65 will double and the number of over 85 will quadruple. The current hospital treatment model makes the frail elderly sicker and more dependent. There’s an urgent need for innovative approaches that lead to better outcomes in primary care for seniors. ACE is designed to treat elderly patients in a way that identifies and respects their abilities and limitations, speeds healing and promotes safe discharges home – all good outcomes for the whole family.

I asked Sinha what he thought would accelerate the growth of ACE units and the broader approach across Canada.

“Transforming our care for older adults and their families begins within our medical and nursing schools,” he said. “Right now in Canada, a rotation in pediatrics is required in our training, but geriatrics remains an option. Given our demographics of aging, I believe every graduating physician and nurse should have experience in geriatrics. That would help change the focus of health care to better serve those who actually use it the most and are amongst the most vulnerable patients in the system.”

Dr. Samir Sinha’s approach to eldercare makes sense for older adults and for natural caregivers. We can all get behind it by asking for an ACE unit and approach in every Canadian hospital.

Donna Thomson is a caregiver, author and activist. She wrote The Four Walls of My Freedom: Lessons I’ve Learned From a Life of Caregiving (2014) and blogs at The Caregivers’ Living Room ( She is a board director of the Kids Brain Health Network and advises from a family perspective on numerous health research projects. She also teaches families how to advocate for care at The Advocacy School and The Caregiver Network. She writes Caring Connections with Vickie Cammack.