Context and History

Canada must be prepared to meet the needs of an aging population, and the National Initiative for the Care of the Elderly (NICE) is playing a central role in ensuring that happens.

NICE is an international knowledge transfer network of researchers, practitioners, students and seniors dedicated to improving the care of older adults on a global scale. NICE was proposed because (1) there is a gap between evidence and practice in care for older adults ^[3]; (2) there is an ominous shortage of practitioners (e.g., doctors, nurses and social workers) who can provide specialized care for older adults ^[4-15] and (3) there is likewise a dire shortage of students and researchers who specialize in the field of aging, combined with inadequate education in geriatrics and gerontology ^{[10-12, 16, 17]}.

NICE, with an innovative model to maximize minimal human and economic resources, has made important strides in addressing these goals, as addressed in this keynote. NICE was established in 2005 through a “New Initiative” grant of the Government of Canada’s Networks of Centres of Excellence program.  We were incorporated as a Canadian non-profit organization in 2006, and we are governed by a 16 member Board of Directors.

NICE has three overarching goals: (1) disseminating evidence-based research into practice through the development of simple, user-friendly, interdisciplinary tools; (2) addressing the shortage of professionals in gerontology and geriatrics by attracting new students to the field, and enhancing the training current students receive; and (3) advance policy and research in the care of the elderly.

In 2007, NICE was awarded an International Partnership Initiative grant from the Networks of Centres of Excellence and the International Development Research Centre (Canada). This grant established the international arm of NICE, the International Collaboration for the Care of the Elderly (ICCE), which has extended the work of NICE through partnerships with researchers and practitioners in nine countries: Australia, China, England, Germany, India, Israel, Scotland, South Africa, and Switzerland. Our international partners work with our national partners and undertake knowledge transfer activities in the field of aging in their home regions, facilitating a mutually-beneficial exchange of knowledge on a global scale.

At present, NICE has over 600 members, comprised of seniors, researchers, practitioners, and students from a diverse spectrum of fields, including medicine, nursing, social work, rehabilitation science, social science, law, law enforcement and policy. We have a large group of seniors who work hand-in-hand with the teams and on the various committees. We also have over 100 student members, nationally and internationally. All member groups, including seniors, have direct representation on the Board of Directors of NICE.

Achieving our Goals: Moving Research into Practice to Improve Care

NICE is the only national organization dedicated to interdisciplinary approaches in transferring knowledge in the field of aging. The rationale for the NICE model is premised on research that clearly indicates an interdisciplinary, team-based approach built on evidence is the most cost-effective form of care for older adults ^{[18, 19]}.

A unique feature of NICE is the work of our “Theme Teams.” We have five Teams in areas of priority identified by our membership:

1. Caregiving;
2. Dementia Care;
3. Elder Abuse;
4. End-of-Life Issues; and
5. Mental Health.

Our Teams are unique because they facilitate team-based, interdisciplinary collaboration for the creation of knowledge transfer tools

The Caregiving Theme Team

Produces annual editions of its popular “Caring Calendar,” which offers supportive advice to families and individuals caring for older adults.  The Team has also developed a “Respect All” poster, which provides quick pointers that long-term care staff members should remember when providing care to older adults. This Team is also launching a new project to aid personal support workers in long-term care institutions, as well as a tool aimed at grandparents who become the primary caregivers for their grandchildren.

The Dementia Theme Team

Is presently developing a tool on the assessment of dementia and delirium, based on guidelines developed by the Registered Nurses Association of Ontario.

The Elder Abuse Theme Team

Is developing numerous tools, including the “Elder Abuse Suspicion Index (EASI),” for helping health care practitioners detect suspected cases of elder abuse, originally developed by Dr. Mark Yaffe at McGill University. Team members are also working with Dr. Marie Beaulieu of the University of Sherbrooke on adapting and disseminating a tool she developed, “En-Main (In-Hand)” to aid social workers in ethical decision-making in suspected cases of elder abuse. The Team has adapted two tools developed by Drs. Daphne Nahmiash and Myrna Reis, the “Caregiver Abuse Screen (CASE)” and the “Indicators of Abuse (IOA)” screen, also for detecting cases of elder abuse by caregivers. Finally, the Team is also adapting a tool for law enforcement personnel to help them recognize and investigate suspected cases of elder abuse.

The End-of-Life Theme Team

Has produced a comprehensive brochure covering the best practices on what to expect towards the end of a person’s life. The Team has also produced a tool on “Capacity and Consent,” to help health care practitioners understand the legal rights of older people with respect to capacity and consent. The first edition of the tool was written for legislation in Ontario and versions for all Canadian provinces and territories are presently in development.

The Mental Health Theme Team

Has produced two tools for the detection, diagnosis, and provision of primary care for the treatment of depression among older adults, based on the Guidelines of the Canadian Coalition for Seniors’ Mental Health.

In addition to knowledge transfer through the creation and dissemination of evidence-based tools, NICE also hosts knowledge transfer events. The cornerstone event is the Annual NICE Knowledge Exchange, which brings together our members for keynotes and interactive workshops in topics related to knowledge transfer, along with guest speakers and meetings of our Theme Teams and Committees, special panel sessions, a student poster competition, and formal and informal social and networking opportunities. At our third Exchange in 2008, NICE partnered with the Canadian Institutes for Health Research – Institute of Aging, to welcome fifty of their students who were attending the Institute’s “Summer Program in Aging.” We also partnered with the Seniors Health Research Transfer Network (SHRTN), to share events with their Annual Assembly and foster collaboration between the two networks. Eighty-five students attended the conference, many of which participated in the first annual NICE Student Poster Competition.

NICE also offers a website and a newsletter, as a method of exchange current and relevant information in the field of aging.

Achieving our Goals: Improving Education and Recruiting Students to the Field of Aging

The Researcher Training Sub-Committee provides unique training opportunities for students interested in the field of aging. Students work on NICE Theme Teams and Committees as volunteers or on placement through the NICE Student Mentorship Program. Students are actively engaged in meaningful work in the network, including literature reviews, knowledge transfer, policy statements, and conference presentations.

Students are invited to our annual conference, the Annual NICE Knowledge Exchange, where they benefit from training in knowledge translation, student poster competitions, and formal and informal networking opportunities with national and international researchers, practitioners, seniors and fellow students.

The Researcher Training Sub-Committee is also developing two programs for outreach to high school and undergraduate students to recruit them to specializing in studies and/or careers in the field of aging.

The Curriculum Development Sub-Committee has developed a framework of core interdisciplinary competencies for medicine, nursing, and social work (a first for Canada), which will be used to develop training recommendations to be integrated into existing gerontology/geriatrics programs, or indeed to create new ones. At the Exchange this year, this sub-committee sponsored a special panel session on introducing geriatrics/gerontology into curricula into these disciplines.

Achieving our Goals: Advancing Policy and Research

NICE members have been involved in national education for improving care for older adults. NICE representatives have presented at the Special Senate Committee on Aging, the Standing Committee on Veterans Affairs, the Boards of CIHR’s Institute on Aging, Canadian Network for the Prevention of Elder Abuse, Canadian Association of Gerontology; the National Council on Aging; and the Conservative Women’s Caucus. Our members have been vocal in the media on issues related to older adults, and were featured on CBC television and radio, the Globe and Mail, the Toronto Star, and Reader’s Digest, among others.

Our members continue to make extensive contributions to the field of aging through books, journal articles, and conference presentations, demonstrating their dedication to conducting and disseminating quality research.

NICE has itself received close to $1.2 million in research funding through the Canadian Institutes of Health Research (CIHR); Human Resources and Social Development Canada (HRSDC); International Development Research Centre (Canada); Networks of Centres of Excellence ; and Status of Women Canada (SWC), for projects related to knowledge transfer and research in aging in collaboration with NICE.

NICE has research applications under review with CIHR; Health Canada; HRSDC; Social Sciences and Humanities Research Council of Canada ; and SWC, totaling close to $1 million, to further expand NICE-related activities and bring together researchers and practitioners who previously would not have worked together.

NICE has also leveraged support for a number of research projects related to improving care for older adults, including advance care planning, falls prevention, elder abuse prevention, assisted conversation for stroke victims, research education for nurses and improving quality of life in palliative care, representing over $1 million in research funding.

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