JGH opens Wellness in Aging Centre to enhance care for the elderly

New Centre is nearly triple the size of the previous geriatric facility

On the 40^th anniversary of the launch of the original JGH geriatric clinic, a newly renovated space—nearly triple the size of the previous facility—has been opened to meet the needs of the growing number of elderly patients.

The ribbon was cut on June 30 at a dedication ceremony for the Susan & Aron Lieberman Family Wellness in Aging Geriatric Centre, made possible through the generosity of the Liebermans’ children and their spouses—Ben and Nadine Lieberman, Marty and Renée Lieberman, Helene and David Donath, and Lorne and Chaya Lieberman.

Marty Lieberman spoke at the dedication ceremony as his family’s representative.

The project was also undertaken with support from the Aron and Susan Lieberman Foundation and the JGH Foundation.

Like the previous clinic, the new space is located on the ground floor of Pavilion E, just inside the Légaré entrance. However, the main door to the Centre is now in the short hallway that connects Pavilion E with the lobby of Pavilion K.

“We are humbled and honoured by today’s event,” Marty Lieberman told those who had gathered to dedicate the Centre. “We now have a unique opportunity to give back to this world-class institution.”

Speaking for members of his family, Mr. Lieberman said the donation was their way of living up to “the philosophy of ‘What can I do for our fellow people who are more vulnerable than us?’ Our aim is to help the elderly who are vulnerable, raise their spirits and help them live a longer and healthier life.”

Dr. Ruby Friedman, Associate Director of Geriatric Medicine, noted that the new Centre will maintain the approach that his Division pioneered in the early 1980s, “recognizing that people are more than the sum of their diseases and their declining capabilities. Multi-disciplinary evaluation and care are necessary to address these complex issues.

Dr. Ruby Friedman, Associate Director of Geriatric Medicine

“This model of assessment is actually now widespread and routine in medicine, but it started with the so-called ‘geriatric model’ 40 years ago.”

Dr. Lawrence Rosenberg, President and CEO of CIUSSS West-Central Montreal, expressed his gratitude for the “timely and tangible recognition and demonstration on the part of the Lieberman family to draw continuing attention to the needs of the geriatric population.”

“There cannot be enough words to say thank you for something that this hospital needed and the people of Quebec needed,” added Harvey Levenson, Chair of the Board of Directors of the JGH Foundation.

In an email after the ceremony, Dr. José Morais, Director of the Division of Geriatric Medicine at the JGH and at the MUHC, extended his thanks to the Lieberman family “for their insightful decision and support.

“The opening of the Lieberman Family Wellness in Aging Geriatric Centre marks a new era for this specialized service to better serve the community. It’s the latest chapter in a 40-year history of providing excellent care to older people and their families.”

“A bigger centre was certainly needed, and this one is much more welcoming, much more efficient and so airy,” says Riva Hecht, who has been bringing her 91-year-old husband, Thomas, to the JGH since the 1990s for regular care due to his Alzheimer’s disease.

“It’s so much easier on me and on him, too, because mobility can be a problem,” says Mrs. Hecht. “The care has always been excellent, and now it also feels warmer, with the big TV and the poppies on the wall in the reception area. It was badly needed and we’re very fortunate to have such a facility.”

Additional space is among many special features

According to Rita Di Girolamo, Nurse Clinician and Coordinator in Geriatrics, a key improvement in the Centre is the additional space, which has allowed the number of examination rooms to jump from four to 10.

As a result, more patients can be seen quickly and simultaneously not only by a geriatrician, but by a variety of healthcare professionals who can provide a rapid assessment. This substantially cuts waiting times and makes scheduling more efficient.

Among the other notable features of the Centre:

• The overall design accentuates brightness, airiness and colour, which are intended to have a calming and reassuring effect on patients and families.
• Greater care has been taken to ensure privacy at all times, not just during examinations, but in preliminary sessions where a nurse checks the patient’s vital signs and gathers other basic information.
• To help patients properly orient themselves, the main corridor is illuminated not just by ceiling fixtures, but vertical lighting strips on the walls.
• Each of the two nursing evaluation rooms contains a scale that can weigh a patient who is seated in a wheelchair.
• Space has been set aside for research, which was not easily conducted in the previous facilities.
• To help in creating a reassuring environment, a small nook has been added in the reception area, where patients and their companions can make a complimentary cup of herbal tea.
• Included in the reception area—whose spaciousness facilitates compliance with measures for infection prevention and control—are several chairs with higher seats for those who have mobility problems.

Attention to “the small matters”

Especially significant is that the new Centre gives staff a greater ability to deal promptly with what Dr. Friedman calls “the small matters that, if left unattended, can become very serious matters.”

The main corridor of the new Wellness in Aging Centre is brightly illuminated not just by ceiling fixtures, but vertical lighting strips on the walls.

For example, he says, it may not seem terribly important that an elderly person has begun to walk slightly less than usual. However, if this tendency continues, it can eventually lead to a substantial loss of mobility and an increased risk of falling, unless a proper geriatric evaluation is conducted.

This focus on the elderly, whom the JGH has been treating for decades in disproportionately large numbers, has made the hospital a leader in geriatric medicine and research. In fact, the mission statement of the JGH recognizes care for the elderly as a priority.

The roots of this expertise can be traced back to the heavy influx of Jewish immigrants into Mon­treal after World War II. As more and more of these individuals reached their senior years in the 1970s and ’80s, the hospital experienced a major surge in the number of older patients seeking treatment and support. This led to numerous upgrades in geriatric services at the JGH long before most other local hospitals needed to do so.

Today the number of older patients is continuing to rise, due in large part to a demographic shift across North America, as many of those in the populous baby-boom generation head into their 60s and 70s.

As well, Ms. Di Girolamo notes that the JGH now sees a significant number of elderly patients from beyond the Montreal area, including some from as far away as Mont Tremblant. “We have quite a reputation,” she says, “so people are willing to travel a long distance to be assessed here.”

A new phase in a 40-year evolution

The launch of the new Centre is the latest phase in an evolution that began in 1978, when Dr. Mark Clarfield became founding Director of the hospital’s long-term geriatric ward. This was soon followed by an acute-care ward, two chronic-care wards and a Geriatrics Assessment Unit that were all merged into the JGH Division of Geriatrics in 1981.

A nursing evaluation room, with a scale that can weigh a patient in a wheelchair.

Dr. Clarfield, who is now Professor Emeritus and head of the Centre for Global Health at Ben-Gurion University of the Negev in Be’er  Sheva, Israel, says in an email that one of his most pressing concerns—and most gratifying successes—in the early years was the recruitment of young, talented staff.

Alongside these physicians, nurses and multidisciplinary professionals, he embarked on expanding the array of services, establishing links to the community, making the Division a teaching destination for McGill University students, setting up a residency program, and conducting research into aging.

Working closely with Dr. Clarfield was Dr. Rubin Becker, who is currently JGH Chief of Internal Medicine and who, over the years, has continued to encourage many medical residents to train in geriatric medicine.

It was Dr. Becker who served as founding Director of the Geriatric Assessment Unit and of the newly created Division of Geriatrics in the early 1980s. He notes that the COVID‑19 pandemic has been especially problematic for the elderly, but in general, their care “has improved dramatically over the past four decades. We still have a great deal more to do, and I trust that the new Centre will help move us forward.”

Dr. Howard Bergman, who was Director of Geriatric Medicine at the JGH and at McGill from 1993 to 2009, attributes the success of the Division to its ability to build on the combined strengths of internal medicine (focusing on specialized geriatric medicine) and family medicine (seeing to the needs of the elderly).

Dr. Bergman—currently a JGH physician in Geriatric Medicine and in the memory clinic, as well as Professor of Family Medicine, Medicine and Oncology at the Institute for Health and Social Policy at McGill—says the new Geriatric Centre “provides the facilities to ensure the growth, sustainability and excellence of care for older persons in the hospital and the community. It is also a setting for state-of-the-art teaching of students and trainees from all disciplines.”

In the mobility clinic, gait and balance are assessed by having the patient walk along a special carpet whose many embedded sensors track the patient’s movements and relay the data to a computer for analysis.

Dr. Clarfield  adds that the legacy of the Division’s early years is evident in the new Centre—specifically, “offering humane, evidenced-based diagnosis and therapy to frail older persons, making every effort to involve and support family members, encouraging a team approach to care of the elderly, and maintaining a strong presence and academic profile for geriatrics at the JGH and McGill.”

Another key player in the development of the Centre was Myer Bick, who retired in 2018 as President and CEO of the JGH Foundation. According to Dr. Friedman, Mr. Bick played a crucial role in establishing the link that brought together the Lieberman family and Geriatrics.

While concern for the needs of the elderly is at the heart of the donation by the Liebermans, there is also a personal connection to Dr. Friedman and his wife, Adele Goldstein.

Dr. Friedman’s parents were well acquainted with Susan and Aron, with both couples having originally lived in Poland, survived the Holocaust, immigrated to Montreal and settled within three blocks of each other.

“The Lieberman children, who all live in Montreal, are contemporaries of me and my wife,” Dr. Friedman adds. “We’ve been to all of their weddings, their bar mitzvahs, their bat mitzvahs and the weddings of their children.

“That’s why the ‘arranged marriage’ between the Lieberman family and Geriatrics seems so natural: They’re the right people with the right values at the right time in the right place. The members of their family—the parents, children and next generation alike—have always had great respect for the Jewish tradition of honouring one’s mother and father, and of caring for the elderly.”

Dr. Friedman is hoping the new Centre will motivate more medical students and healthcare trainees in numerous other fields to consider a career in geriatrics, which tends to attract fewer people than many of the other specialties. This is considered a necessity, given the world-wide shortage of all types of professionals in geriatrics.

“The motivation that they need is right here,” he says, gesturing at the new Centre. “All they have to do is look around to see how dedicated we are to making funds, space and professional expertise in a field that will touch all of our lives someday.

“The members of our staff—physicians, nurses, allied health professionals, administrators, receptionists and the rest of us—are ready to greet our patients and their families by setting the mood with a big smile and a nice cup of herbal tea.”