Geriatric Program Research Articles

Comprehensive geriatric assessment-based frailty clinic in a low middle income country: Time to act

Comprehensive Geriatric Assessment (CGA) is a process of care that involves a holistic, multidimensional, interdisciplinary assessment of an older individual and has been demonstrated to be the choice of management for frailty. By 2050, it is expected that 80 % of the aging population will be living in low and low-middle income countries (LMICs). The implementation of geriatric programs is scarce in LMICs. CGA based frailty clinics could help facilitate early screening for impairment in physical and psychological capacities among pre-frail and frail older individuals allowing for suggestions for targeted interventions. Creating a sound healthcare model which addresses issues of older adults living with frailty is the need of the hour, especially in LMICs. Establishing frailty clinics in low-middle income countries could thus help to create a sustainable age-friendly healthcare model for the vulnerable and poor aging population. It is now the time to act.

Problem-Based Learning for Interprofessional Education: A Review of the Concept and Its Application in a Geriatric Team.

The global population is aging, with those aged 65 years or over increasing in number and accounting for a growing share of the population. There are increasing demands for geriatric care which makes the development and delivery of effective geriatric team training a priority. Training in geriatrics is complex because of the multiplicity of medical, psychosocial, and functional issues in elderly individuals which need to be addressed by a multidisciplinary approach using interprofessional education (IPE). Problem-based learning, a student-centered educational model that brings several natural strengths to IPE, is a unique curriculum replacing the traditional lecture-based learning model. This model enhances physician competency after graduation, mainly in psychosocial and teamwork issues that are fundamentally essential for geriatrics. IPE has been shown to have a substantial positive impact on team collaboration, individual development, and healthcare improvement. In this paper, we summarize the current findings from recent studies on training professionals from different healthcare disciplines to deliver care for the elderly in collaborative practice. We also discuss if an interprofessional problem-based geriatric team program in geriatrics is a promising solution to enhance professional collaboration and quality of patient care.

An in-depth examination of geriatric nursing master's programs: A comparative analysis between Iran and Canada

This study was undertaken with the explicit objective of comparing the educational curriculum of the Master's program in Geriatrics in Iran with that of the Alberta Nursing School in Canada. This comparative descriptive study employed George F. Bradley's 4-step method, involving the stages of description and proximity analysis. Data were sourced from internal databases, including Magiran and Scientific Information Database, supplemented by external databases such as Google Scholar, PubMed, and Scopus. The geriatric nursing master's program in Alberta is characterized by a longer duration and a more established history. The delineation of roles for graduates in this context is more specific compared to the situation in Iran. The admission criteria in Alberta are more stringent, emphasizing the quality of candidates through a comprehensive evaluation of general and professional factors. Conversely, the admission process for nursing master's students in Iran considers a broader set of criteria. Furthermore, a substantial disparity exists between the course topics in Iran and the pressing societal and clinical needs. The inadequacy of clinical space and the scarcity of experienced professors emerge as significant challenges within the training program in Iran. The formulation of the curriculum for the geriatric nursing master's program should adhere to a systematic and comprehensive framework that aligns with societal needs. Graduates of the program should possess a well-defined professional position within the healthcare landscape. The educational process should involve the utilization of accomplished professors and a dynamic clinical environment to effectively train students.

Expanding Access to Comprehensive Geriatric Evaluation via Telehealth: Development of Hybrid-Virtual Home Visits

BackgroundIn response to the aging population, the Department of Veterans Affairs (VA) seeks to expand access to evidence-based practices which support community-dwelling older persons such as the Geriatric Resources for Assessment and Care of Elders (GRACE) program. GRACE is a multidisciplinary care model which provides home-based geriatric evaluation and management for older Veterans residing within a 20-mile drive radius from the hospital. We sought to expand the geographic reach of VA-GRACE by developing a hybrid-virtual home visit (TeleGRACE).ObjectivesThe objectives were to: (1) describe challenges encountered and solutions implemented during the iterative, pre-implementation program development process; and (2) illustrate potential successes of the program with two case examples.DesignQuality improvement project with longitudinal qualitative data collection.Program DescriptionThe hybrid-virtual home visit involved a telehealth technician travelling to patients’ homes and connecting virtually to VA-GRACE team members who participated remotely.Approach & ParticipantsWe collected multiple data streams throughout program development: TeleGRACE staff periodic reflections, fieldnotes, and team meeting notes; and VA-GRACE team member interviews.Key ResultsThe five program domains that required attention and problem-solving were: telehealth connectivity and equipment, virtual physical examination, protocols and procedures, staff training, and team integration. For each domain, we describe several challenges and solutions. An example from the virtual physical examination domain: several iterations were required to identify the combination of telehealth stethoscope with dedicated headphones that allowed remote nurse practitioners to hear heart and lung sounds. The two cases illustrate how this hybrid-virtual home visit model provided care for patients who would not otherwise have received timely healthcare services.ConclusionsThese results provide a blueprint to translate an in-person home-based geriatrics program into a hybrid-virtual model and support the feasibility of using hybrid-virtual home visits to expand access to comprehensive geriatric evaluation and ongoing care for high-risk, community-dwelling older persons who reside geographically distant from the primary VA facility.Graphical

EXPANDING EDUCATIONAL OPPORTUNITIES IN GERONTOLOGY IN JAPAN

Abstract There are two universities that offer Gerontology curriculum and confer Gerontology degrees in Japan, including J.F. Oberlin University and The University of Tokyo. J.F. Oberlin University started its Master’s program in 2002 and its doctoral program in 2004. The University of Tokyo endowed a Gerontology Research Division in 2006 and started its cross-departmental program in Gerontology in 2008. The endowed Gerontology Research Division was elevated to the Institute of Gerontology (IOG) in 2009. From April 2014 through March 2021, the Gerontology program, known as the Global Leadership Initiative for Age-Friendly Society (GLAFS) at The University of Tokyo, was funded by the Ministry of Education, Culture, Sports, Science and Technology. Today, The University of Tokyo now funds the program which was renamed World-leading Innovative Graduate Study Program in Gerontology: Global Leadership Initiative for Age-Friendly Society (WINGS-GLAFS). This paper first presents a brief history of Gerontology-related events in Japan, including foundational education proposals of The Science Council of Japan, then introduces Japan’s leading Gerontology education programs offered by J.F. Oberlin University and The University of Tokyo in detail. Finally, it presents other gerontology related activities including the Gerontology Literacy Test started by the IOG in 2013.

HOW GERONTOLOGY PROGRAMS ARE MEETING CHALLENGES IN HIGHER EDUCATION

Abstract Population aging means that gerontology education is increasingly relevant for all students, yet trends in higher education create existential challenges for many gerontology programs, who may not attract robust number of applicants or majors. In this symposium, educators from five different gerontology programs will share their programs’ particular challenges as well as a wide variety of strategies they have used to meet these challenges. The first presentation will show how recent losses at Ithaca College, including the Aging Studies major and independent department status, also come with opportunities for collaboration with health science and public health programs. The second presentation will describe the University of North Carolina at Wilmington’s approach of combining undergraduate and graduate programs to attract and retain students after being placed on a “low-productivity list” in the not-too-distant past. The third presentation will share how a new Occupational Endorsement Certificate at the University of Alaska Anchorage took the place of the deactivated gerontology minor. Colleagues from the University of Massachusetts Boston will describe their efforts to enhance diversity and grow program enrollment across undergraduate and graduate programs. Finally, the fifth presentation will describe how increased demand for general education courses as well as funding dependent on undergraduate major enrollment created challenges at the University of South Florida. This is a Directors of Aging Centers Interest Group Sponsored Symposium.

TEACHING IN THE TUNDRA: LESSONS LEARNED AT THE UNIVERSITY OF ALASKA ANCHORAGE

Abstract UAA is an open-enrollment, public university of about 12,000 students. The gerontology minor was formed in 2005 as a result of the Geriatric Education Center (GEC). However, the loss of the GEC and most gerontology faculty, coupled with low student enrollment in the minor, led to its deactivation in 2014. Since then, several new faculty have been hired with an interest in gerontology. The Gerontology Faculty Workgroup, instituted by the GEC, remains active and the university now has 4 new courses on aging, including a geriatric Interprofessional Education (IPE) course. This forward momentum in recent years has led to the development of a new Occupational Endorsement Certificate program in gerontology. Training the future workforce and working professionals, the new program is poised to be more sustainable than a minor. In this presentation, we share details of past challenges and current successes within the College of Health.

CREATING INTERNET-BASED DISTANCE LEARNING IN GERONTOLOGY

Abstract Dr. Schneider was Associate Director and then Deputy Director of the National Institute on Aging from 1980 through 1986. Dr. Schneider helped to create the Geriatric Leadership Academic Award. This award funded geriatric positions in many medical schools including Harvard, Johns Hopkins, Duke the University of California at Los Angeles, and the University of Tennessee. These awards led the creation of Geriatric Divisions at numerous American medical schools. After he became Dean of the Leonard Davis School of Gerontology, Dr. Edward Schneider with Maria Henke created the nation’s first Internet based Master’s Degree program in Gerontology. This program has graduated over 1000 students since then.

PLANNING FOR OLD AGE BY GRADUATES OF A MASTER’S GERONTOLOGY PROGRAM IN ISRAEL

Abstract The master’s programs in gerontology in Israel were founded in 1999 in response to the challenges brought by extended life courses and the accompanying accelerated growth of welfare and health services for the aged. Since its beginning, thousands of students graduated from the programs and occupy central positions in the gerontological field. However, no empirical data exists on the extent of the involvement by graduates in employment in the field of aging. The current study aims to provide a first-time assessment of the experiences of graduates in Israel following their studies, as well as examine the level of preparedness to old age among graduates, since their work and study of older adults might make their own future old age more salient. We collected data using online surveys from 197 graduates of the gerontology programs. Participants were asked about their work experience in the gerontology field and about the extent to which they prepare for old age. The findings showed that most graduates (80%) currently work in the field of aging, and are overall pleased with the jobs. However, most of the graduated (68%) also reported difficulties in finding employment. Logistic regressions showed that those who currently work in aging and who graduated before less years were also less likely to make preparations for needing nursing care in old age and talking with relatives about their death. Thus, working and studying about aging could be related to being less likely to make preparations for old age.

FORETHOUGHT OR AFTERTHOUGHT? THE FUTURE OF GERONTOLOGICAL EDUCATION

Abstract The increasing population of older adults would suggest a comparable increase in the demand for gerontological education. The current workforce shortage and number of Gerontology programs that are struggling and/or closing, however, suggest this is not necessarily the case. Bass and Ferraro (2000) reported over 1,000 gerontology/aging or related programs in operation. Today, there are 537 programs in gerontology and/or aging including 31 Associate degrees; 185 Minors; 79 Undergraduate and 92 Graduate Certificates; 43 Majors; 57 Masters; and 16 doctoral programs (University of Nebraska Omaha, 2023). Many interrelated factors have been suggested to account for the decline. From an economic point of view, these factors are thought to include: decreasing enrollments in and revenue generation from gerontology programs; demographic shifts away from traditional age college students; and decreasing interest and value of higher education overall. From a pedagogical point of view, this might reflect a return to individual courses and programs ensconced in more traditional disciplinary approaches (e.g., family studies, psychology, and sociology). Pervasive ageism has also been thought to be an underlying societal factor. While none of these factors are easily remedied, understanding their impact is an important first step. GSA programming such as Ageism First Aid and Reframing Aging Initiative are taking the next Herculean step in tackling societal ageism. This presentation focuses on reframing the value of gerontological education to students, employers, and policymakers– moving it from an afterthought to a prioritized strategy for addressing the mounting demand for aging services and service providers.

THE IMPACT OF COVID-19: IDENTIFYING WELLNESS STRATEGIES FOR ACADEMIC GERONTOLOGY AND NURSING FACULTY AND STAFF

Abstract The continually evolving nature of the COVID-19 pandemic has presented challenges for individuals working in all sectors of the population, and academia is no exception. The nursing workforce is aging: the average age of a nurse is 52; 55% of the RN workforce is age 50 or older, and the average age of an employed nursing faculty is 46 years old. To date, little is known about the impact of the pandemic on individuals working in gerontology or nursing academia. The purpose of this study was to determine the impact of the COVID-19 pandemic on faculty and staff in a College of Nursing (CON) with a Gerontology program and identify practical strategies to promote health and wellness. A mixed-method survey was administered to faculty (n=140) and staff (n=139) in a College of Nursing in the Intermountain West. Quantitative and qualitative data were collected through a convenience sample. The researchers asked respondents to rate their experiences working from home, including the effects on work-related factors and social-lifestyle factors. Descriptive statistics were used to analyze the data. A total of 139 respondents completed the survey (faculty, n=86; staff, n=53). Respondents identified areas that were better and worse with regard to both work-related and social-lifestyle factors. Further, practical strategies to promote health and wellness were also identified. Finally, themes regarding support from leadership were recognized. This presentation will discuss these three results. These findings highlight the pandemic impact on aging nursing faculty and staff and introduce valuable strategies for promoting health and wellness.

WORKING TOGETHER TO PROVIDE GERIATRIC CARE: INTERDISCIPLINARY TEAM CREATION AND EVALUATION IN CANADA

Abstract Prince Edward Island is Canada’s smallest province (pop. 160,000) and has one of the oldest populations in Canada. While there is a robust and growing geriatrics program through provincial healthcare, it consists exclusively of medical providers (i.e., geriatricians and nurse practitioners). An opportunity for formal interprofessional collaboration presented itself when the University of Prince Edward Island began a Doctor of Psychology (PsyD) program in 2019. Soon thereafter, we established an interdisciplinary team between the PsyD and the provincial geriatrics programs. The goals of the team included: 1) enhancing care for older adults on the island, 2) providing training for PsyD students, and 3) increasing interprofessional collaboration and learning. In an evaluation of the first year of the collaboration, we collected data on the types of referrals and characteristics of the patients referred (e.g., number of medications), and asked all providers on the team (N=4 geriatricians, N=9 nurse practitioners, and N=4 psychology student clinicians) to answer open ended questions on the highlights and challenges of establishing the team, the organization of formal team meetings, and provision of patient care. Of the 74 patients seen by psychology, reasons included cognitive or psychodiagnostic assessment (N=22, 30%), psychotherapy (N=20, 27%), caregiver support (N= 25, 34%), or multiple services (i.e., both assessment and intervention; n=7, 10%). Additional patient characteristics will be shared, as well as themes from provider survey responses. Our program has implications for other areas in rural North America, particularly training opportunities built into our team functioning.

THREE DECADES OF RESEARCH GUIDING POLICY AND POLICY GUIDING RESEARCH IN AGING AT THE UNIVERSITY OF SOUTH FLORIDA

Abstract The Florida Legislature created the Florida Policy Exchange Center on Aging more than 30 years ago to conduct independent research and policy analyses on critical topics in aging. Housed at the University of South Florida (USF), the center brought together students and faculty to examine public policies that directly affect the health and well-being of older adults (e.g., the role of Medicaid funding in home- and community-based care and the effects of nurse staffing levels in nursing homes). As new policy questions emerge, the foundational work of the policy center continues to guide undergraduate and graduate education at the USF School of Aging Studies. This presentation describes the multiple opportunities to incorporate policy instruction into an interdisciplinary gerontology program. These opportunities depend on having faculty who maintain ties with the organizations that provide direct care and services to the public and who connect the policy lessons they learn through these relationships to their teaching and research. Another key element is access to health services data needed to answer critical policy questions. The goal of such an approach is to enable gerontology students to engage in policy analysis and development and to understand the essential links between research, public policy, and practice that improves the lives of older adults.

UNDERGRAD AND GRAD COMBINED PROGRAMS: FACILITATING RECRUITMENT THROUGH NEW PATHWAYS

Abstract The University of North Carolina Wilmington was reclassified as an R2 institution in 2018. As such, additional focus has been placed on graduate programs and the generation of research. More recently, UNCW’s Chancellor Volety followed recommendations from faculty, staff, and students to seek to endorse the Age Friendly University principles. These two accomplishments create ideal conditions for growing the gerontology program, which had been on the low productivity list and considered for dissolution (as has happened with many programs around the country). To facilitate recruitment into the MS in Applied Gerontology, new pathways known as “4 + 1” or “combined programs” were created. By allowing qualified undergraduate students to take a portion of their coursework at the graduate level, students explore their interest in gerontology, become invested in gerontology education, and meet undergrad and graduate requirements simultaneously. Students are then able to complete their MS in Applied Gerontology in as little as one more year. Such programming has created a steady stream of students into the graduate program, which is no longer on the low productivity list. While this approach has many strengths, challenges exist that must be acknowledged. Marketing the program to a now very broad prospective student base requires finesse. For example, marketing that would appeal to an exercise science student may not be what speaks to a psychology student. These challenges also translate to the classroom. Although gerontology is an interdisciplinary field, career goals for students now vary even more widely as do their expectations and academic needs.

HEALTH SYSTEM LEADERSHIP PERSPECTIVES AND PRIORITIES ON CARE FOR OLDER ADULTS

Abstract Innovative care models for older adults such as non-institutional and home-based care have the potential to improve quality and efficiency of healthcare, but adoption of these models requires resources from health systems. Health systems leaders can influence the relative priority of geriatric care and associated resource allocation. This influence is especially important for areas with limited resources such as in rural areas. We interviewed recently retired health system leaders about their experience and how priorities in health systems can be aligned to improve the quality and reach of geriatric care. We conducted qualitative interviews with 10 participants (40% female) using a snowball sampling strategy of geographically diverse, retired hospital, regional, and national leaders in the Veteran Healthcare system, the largest single-payer system in the US. Participants described how they managed myriad competing health system priorities by weighing and devoting attention and time to tackle the crises of the day, the numerous national mandates and directives, and the goals for the local hospital or system, as seen from their own perspectives. Alignment with performance metrics provides strong impetus for some health system leaders to determine their priorities. Incentives to encourage health systems leaders to prioritize and allocate resources aimed at long-term improvements in care could be important. Additionally, building relationships and maintaining trust amongst partners across facilities and offices is critical to initiating and growing geriatrics programs. This work highlights that influence must work on multiple levels to effect change in prioritization of care for older adults.

INCREASED SUPPORT FOR OLDER VETERANS AND THEIR CAREGIVERS USING TELEHEALTH SERVICES

Abstract Five million Veterans live in rural areas in the U.S., and about half of those live in the South. Rural Veterans are more likely to be older and have a disability compared with non-rural Veterans. In Texas, Veterans comprise seven percent of the adult population with a median age of 50 years, of those 17% live in rural areas where access to care is a concern for many Veterans and their families. Technology-based services could help close this gap. The GRECC Connect program is one way to reach rural Veterans and their caregivers. GRECC Connect is a multi-disciplinary virtual geriatrics program that provides support for providers to help manage older, rural Veterans through telemedicine. Patient Tele- consultations follow the Age-Friendly Geriatrics 5 M’s framework (Medications, Mentation, Mobility, Multi-complexity, and what Matters most). As a demonstration project at the San Antonio GRECC, we partnered with the Geriatric Extended Care Services (GEC), and the Dementia Caregiver Program (DCP) to educate and support caregivers. We also partnered with the education department to conduct clinic outreach. In Fiscal year 2022, we served 72 Veterans, 66 of those had a caregiver, and the majority (51/66, 77%) were enrolled in the DCP. In Q4 (17/17, 100%) of caregivers were enrolled in the DCP. In addition, Veterans were referred to 248 additional services including palliative care and saved 5,934 miles. The GRECC Connect program decreases barriers experienced by older rural Veterans including transportation, assistance to navigate VA system and access to specialty geriatric and palliative care.

PERSPECTIVES OF GERIATRIC FELLOWS TOWARD SCHOLARLY ACTIVITY

Abstract Previous research conducted nearly two decades ago found that almost half of geriatricians published during their fellowships. About 17% of these geriatricians also indicated a need for further training in scholarly activity. However, it is unclear what barriers and facilitators to participating in scholarly activity geriatric fellows currently face. Our objective was to assess perceived barriers, facilitators, and attitudes toward scholarly activity among current geriatric fellows in ACGME-accredited programs. We conducted a survey of current geriatric fellows from September 2022 to November 2022. An online survey was emailed to geriatric fellows and geriatric program coordinators, when geriatric fellow emails were not publicly available, to assess fellows’ perceived barriers, facilitators, and attitudes toward scholarly activity. We used descriptive statistics to assess geriatric fellows’ perceptions of scholarly activity. Our sample (n=36) was mostly women (61.1%). The most common scholarly activities fellows planned to participate in during fellowship included quality improvement projects (80.6%), case report/series (44.4%), or original research studies (44.4%). The most common perceived major barriers reported were the short duration of fellowship (69.4%) and lack of training to conduct scholarly activity (58.3%). Lastly, about 44.4% of fellows reported being extremely or very enthusiastic and 50% reported being somewhat enthusiastic about participating in research during their fellowship. Most fellows reported plans for at least one type of scholarly activity and reported at least being somewhat enthusiastic about participating in research, however, barriers were identified. A follow-up email survey will be distributed at the completion of fellowship to assess changes in fellow perspectives.

Sentinels of the Social geriatric program: implementation in rural areas of network for the identification of seniors at rick secondary to loss of autonomy or cognitve deficits

AbstractBackgroundIn a large rural area, isolated seniors rarely consult health services and often come to emergency rooms after severe deterioration. The implantation of “sentinels” in their environment could make it possible to identify them early.MethodThe AGE Foundation, a charitable organization, in collaboration with the public health services of the Granit region (22,000 p/2731 Km2) in the province of Quebec developed care trajectories, identified caregaps and environments requiring sentinels. The project include the analysis of the implantation and the identified casesResultIn 2022, the nurse “navigator” trains 80 sentinels in the use of tracking tools such as AD‐Plus. The sentinels are home care workers and non‐professionals (hairdresser, grocer, municipal agents, etc.) well established in 16 communities. In 9 months they have raised more and more alerts, from 2 to 25 per month for a total of 129. The alerts concerned seniors with an average age of 79, 56 were between 80 and 89 years old and 18 over 90 years old. The majority, 66%, are women. But more importantly, 73% had no follow‐up in the health system before. They required an average of 20 days of targeted interventions, the vast majority of which took place at home.ConclusionMany seniors suffer from loneliness. At the beginning of loss of independence or cognitive impairment, do not consult health services. The “Sentinels” and the Navigator present an effective tracking model.

The Landscape of Geriatric Fellow Scholarly Activity Participation: Findings From a National Survey of Program Directors.

Introduction As the US population continues to age, there is a critical need for geriatricians to be trained and engaged in research to inform high-quality care for older adults. Our objective was to understand the extent, type, barriers, and facilitators of research training and the attitudes towardresearch training and scholarly activity among Accreditation Council for Graduate Medical Education (ACGME)-accredited US geriatric fellowship programs. Methods We conducted a cross-sectional survey of geriatric fellowship program directors from September to November 2022. Surveys assessing program characteristics, requirements for scholarly activity, director demographics, and director attitudes toward scholarly activity were distributed via email. We used descriptive statistics to assess fellowship scholarly activity requirements, facilitators, and perceived barriers. Results The survey response rate was 35.3% (41/116 programs). Most programs (82.9%) required participation in scholarly activity and provided protected time (73.2%). Definitions of scholarly activities greatly differed among programs. The most common scholarly activity requirements included participation in a scholarly project (70.7%) or local presentation (46.3%). The short duration of fellowship was the most common major barrier, reported by 70.7% of directors. Lastly, 34.1% of directors indicated satisfaction with the quality of research training provided, while 65.9% of directors reported satisfaction with the opportunities provided to participate in scholarly activities. Conclusions Overall, program requirements, facilitators, and perceived barriers to scholarly activity were heterogeneous among US geriatric program directors. Additionally, only about one-third of directors were satisfied with the research training provided. Our future work will compare the attitudes and reported barriers/facilitators ofprogram directorand fellow participantstowardparticipation in scholarly activity.

Survey and Interview Findings of an Environmental Scan of Perioperative Geriatric Models of Care in Canada.

Best practice recommendations support the implementation of perioperative geriatric care models that tailor to the specific needs of older adults undergoing surgery. The objective of this study was to describe the current proactive perioperative geriatric programs and pathways in Canadian hospitals. A survey of geriatricians, surgeons, and anesthesiologists practicing in Canada combined with phone interviews of a subset of participants were used to determine characteristics of perioperative geriatric pathways or programs including eligibility, team composition, and intervention elements. Analysis of 132 survey respondents and 24 interviews showed 47% (40 out of 85) of hospitals described had elements of a perioperative geriatrics program and 20% had two or more elements. Eleven themes emerged including: how perioperative geriatric care programs built geriatric competencies in other health-care providers; geriatric assessment identified risks not captured in standard perioperative risk assessment; perceived value for patients and the health-care team; delirium prevention was addressed; most programs were reactive; most programs were informal; virtual care may be used to meet demand; successful implementation required system buy-in with collaboration across subspecialties; mechanisms to drive improvement were accountability and data evaluation; few clinicians with geriatric expertise; and other priorities limited program implementation. There were few hospitals in Canada with perioperative geriatric care models and even fewer with elements spanning the entire perioperative pathway. Strengths, weaknesses, opportunities, and threats to inform the implementation and sustainability of perioperative geriatric care in the Canadian context were identified in this national environmental scan.