TORONTO — The study of geriatrics has undergone monumental changes in the past couple of decades, says Dr. Michael Gordon, medical program director of palliative care at Baycrest.

“Society and the media have changed their views remarkably. [Whereas] geriatrics [used to be] marginalized, it is now in the centre of the health care system.”

Although there are only 220 geriatricians in Canada, geriatrics is a growing field, he said. “Geriatrics was first recognized in 1981 – it was a latecomer [in the field of medicine.]

“Not as many doctors want to look after older people, and geriatrics is on the bottom of the economic ladder of remuneration. The good news, though, is that in the last four years, more people have applied than ever before.”

Gordon, whose father is 98, was speaking at Baycrest as part of its speaker series Aging, Innovation and the Mind. Guest host of the evening was CTV News anchor Sandi Rinaldo, who has a 97-year-old father.

The “phenomenal” change is partly due to the fact that years ago, seniors couldn’t survive conditions that they can now live with for decades, said Gordon, who writes a monthly column on geriatrics for The CJN.

“Conditions such as heart failure had a short prognosis, and [then people lived with it] for a few miserable years. With proper intervention, they can now live with it for decades,” he said.

“There are still conditions in which the control is not where we want it, but the terrain has changed. We can do more than watch,” he added.

Adult children of aging parents – there are more than nine million Canadians between the ages of 40 and 59 whose parents need care – should be aware that as we get older, everything takes more time. “If you are [walking] with a person who is slow, slow your own pace,” Gordon advised.

There are natural losses such as hearing, vision, gait and mobility, he said. “Hearing doesn’t just mean sound. It could also mean differentiating words, and that can be fixed as simply as facing the person and speaking one thought at at time.”

Technology is now “phenomenal,” but hearing aids don’t always work. “We can only work with what we have left. Sometimes we can hear sounds, but our interpretation is impaired.”

Gordon said that memory loss affects everyone, but alone, it means nothing.

“Dementia, [though], is an umbrella term, and it includes many conditions, among which is Alzheimer’s,” he said.

“The good news is that the risk factors for Alzheimer’s are the same as the risk factors for heart disease, such as high blood pressure and lipids, and diabetes.”

The more changes you can make, the better, he said. “Controlling blood pressure is critical. There are great medications available, and you can limit the amount of salt you eat.

“Diabetes and high cholesterol are related to obesity and diet, and if diet alone doesn’t control them, again, there are medications.”

People who use their brain a lot seem to have some protection against cognitive decline, he said. “It is good for your mind for it to be engaged and active. Socialization also has a protective affect. At Baycrest, we promote social programs because we know it is good for people.”

In his work, he said, he tries to help spouses or children figure out how to get their loved ones to do what’s reasonable to protect themselves.

“Caregivers have to make sure they have a discussion about ‘what they would do, if,’” Gordon said.

“It’s not an easy talk, but if something happens to someone else close, you could ask, ‘What if that happens to ‘us?’ You could also talk about a [relevant] newspaper article. Many older people welcome the discussion rather than fear it. The hardest part is how to deal with disagreements on care.”

Try to give older people the best information and advice, Gordon said, “but they have to feel in as much control as possible.”

Years ago, he said, seniors lived “in a nursing home or not. Now, though, the spectrum has changed, and there are options that didn’t exist before. You have to navigate what’s available depending on your financial situation and get to know the system before you’re in a crisis.”

It’s very important for caregivers to find a balance in their own lives. “If you don’t protect yourself, you will burn out. You have to come to terms with what you can reasonably do for yourself and for them,” he said. “When you are unable to help them, then you will really feel guilty.”

When you’re with your parents, he advised, “listen to their stories again and again. They are an important part of their lives, and [the stories] often bring up good memories.”