CIHR Institute of Aging Strategic Plan 2023-2028
Reframing Aging – Empowering Older Adults

Strategic Direction B: Adapt Health and Care Systems to Better Address the Needs of Older Adults

Older adults require evidence-informed health care and services that are age-appropriate, culturally safe, accessible and grounded in equity.

Research Priorities

Equitable health and care systems

  • Support older adults to live well through integrated health and care systems
  • Embed support in primary care and community-based services
  • Increase equitable digital solutions and technology for older adults
  • Support for health and wellbeing of caregivers and a supported healthcare workforce

Pandemic recovery and future health emergencies

  • Support older adults to re-establish social connections and community
  • Support for mental health and increasing rates of cognitive impairment and dementia
  • Address delayed care and loss of social/physical fitness among older adults

Priority 1: Equitable health and care systems

Canada’s health care systems are experiencing significant pressure as they respond to the increased needs and types of services required by older adults with chronic and medically complex conditions, and the pandemic has only intensified these pressures. Hospitals, for example, are designed to serve younger persons with acute medical needs, however vulnerable older adults are disproportionately relying on hospital services when they often would be better served by a model of care that involves an ongoing relationship with a person-centered, integrated care teamFootnote 9.

An integrated and continuing care approach would provide more impactful health care for older adults to sustain healthy aging, support the management of chronic conditions as health declines and produce comprehensive and accessible care across health and social servicesFootnote 10. This is an important step in health system transformation, and should link the physical, mental and social health needs of older persons to primary care and to specialized geriatric care services, as required. Care models need to ensure equity in delivery and access, including across rural and urban locations, tailored to the ethnocultural, gender, language and economic diversity of the Canadian population and sensitive to bias associated with ageism, stigma and racism to ensure cultural safety. This offers an unprecedented opportunity for applying a learning health systems approach towards innovation in systems and continuous improvement, with research evidence informing health care delivery and health care needs informing research programsFootnote 11.

There have been significant advances in digital technologies and the availability and access to electronic health care resources in recent years, particularly during the COVID-19 pandemic. Many older adults have embraced digital technologies and resources to receive health care and mental health support, access services for health promotion and monitoring and to reduce social isolation by connecting with family and friends. There are opportunities for transformative growth of digital approaches and technology to support older adults in healthy aging and health care delivery, but barriers also need to be considered and resolved. A digital divide poses serious equity issues for some older adults, with social and economic factors influencing availability of technology and access to internet, poor digital literacy and lack of caregiver support to assist with digital accessFootnote 12.


Adapting health and care systems to meet the specific needs of older adults emerged as an urgent area for research in our consultations with researchers, older adults and our broader community. This includes adaptations to health systems and health system navigation, alternative care models, and equitable digital solutions for health services for both prevention and care delivery and to enhance social communication. Support for older adults in the health care system is deeply connected to the health and wellbeing of caregivers, including those employed in the health care workforce and family and friends that act as caregivers. Research that involves evaluation and implementation of programs and strategies to effectively support and train health care workers and caregivers in addressing and advocating for the physical and mental health needs of older adults is needed. This is particularly critical for older individuals that may not be able to express their own needs adequately due to difficulty with communication or cognitive impairment.

Priority 2: Pandemic recovery and future health emergencies

The COVID-19 pandemic has had a devastating impact on health care, the health care workforce and the community, with many persons not having their basic needs met during this time. Older adults, in particular, have been severely impacted, largely due to increased vulnerability to serious disease following infection with the virus. A large proportion of deaths associated with COVID-19 have been in this age group. As we move into an endemic stage and recovery period of the pandemic that will be long lasting and undoubtedly cover the years of this Strategic Plan, new challenges for older adults will arise with predicted increases in cognitive impairment related to SARS-CoV2 infection and the impact of isolation on mental health.


We will promote research and activities that help to re-establish social connections and community engagement of older adults with a focus on optimizing physical and mental health care. This commitment is connected to addressing health care that has been delayed during the pandemic years, as well as the loss of social and physical fitness for many older adults under pandemic restrictions. These new stages of the pandemic will require ongoing changes and a need for a resilient and adaptable health care system to be prepared for and deal with the next crisis or health emergency. There is an urgent need to change the continuing care system, both community- and facility-based, to overcome and prevent future occurrences of the shortfalls that were evident during the first waves of the pandemic.

Success and Impact

Within the timeframe of this Strategic Plan, research will contribute to:

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