Seniors account for 63% of acute inpatient days and 43% of provincial health expenditures in Ontario. Hospitalization can be a pivotal event in a frail senior's life. It can add years and quality to life, or create complications that result in a difficult-to-reverse decline in physical or cognitive function. Without senior friendly processes in place, seniors may also have higher rates of adverse events, surgical complications, and nosocomial infections. Poor outcomes can result, such as increased length of stay, re-admission to hospital, and decreased capacity for independent living.

This toolkit compiles resources developed by the Regional Geriatric Program of Toronto's Network of 29 hospitals and also provides access to the very best of frailty focused resources from our colleagues around the world. The toolkit is organized using a Senior Friendly Hospitals Framework developed and endorsed by the Regional Geriatric Programs of Ontario. This framework has five domains:

Organizational Support – There is leadership and support in place to make senior friendly care an organizational priority. Hospital leadership committed to senior friendly care empowers the development of human resources, policies and procedures, care-giving processes, and physical spaces that are sensitive to the needs of frail patients

Processes of Care – The provision of hospital care is founded on evidence and best practices that acknowledge the physiology, pathology, and social science of aging and frailty. Care is delivered in a manner that ensures continuity within the health care system and in the community, so that the independence of seniors is preserved

Emotional and Behavioural Environment – The hospital delivers care and service in a manner that is free of ageism and respects the unique needs of patients and their caregivers, thereby maximizing satisfaction and the quality of the hospital experience

Ethics in Clinical Care and Research – Care provision and research are conducted in a hospital environment that possesses the resources and capacity to address unique ethical situations as they arise, thereby protecting the autonomy of patients and the interests of the most vulnerable

Physical Environment – The hospital’s structures, spaces, equipment, and facilities provide an environment that minimizes the vulnerabilities of frail patients, thereby promoting safety, independence, and functional well-being