Geriatricians in Ontario: What They Do and How to Get a Referral

A geriatrician is a medical specialist in the health of older adults, especially people living with several conditions, many medications, falls, memory changes or frailty. In Ontario you usually need a referral from a family doctor or nurse practitioner, and the visit is covered by OHIP. Geriatric care is organized through 11 Regional Geriatric Programs, and some community geriatric teams accept a call from family directly.

Most families don't know geriatricians exist until a parent's care starts to unravel: a cardiologist, a kidney doctor and a family doctor each adding pills, two falls in a winter, and nobody looking at the whole person.

That's exactly the job a geriatrician does.

What does a geriatrician do?

A geriatrician looks at everything at once. Instead of treating one organ, they look at how your parent's conditions, medications, mobility, mood, memory and home life fit together, and what matters most to your parent.

The centrepiece is the comprehensive geriatric assessment, often done with a team of nurses, therapists, pharmacists and social workers. It usually ends with a plan: medications to stop or change, a falls plan, supports at home, and referrals where needed.

When should an older parent see a geriatrician?

Ask for a referral when the problems are piling up faster than one doctor can untangle them. In the families we work with, the clearest signs are:

• Many medications, prescribed by different doctors, and new symptoms nobody has linked to them.
• Falls, or a fear of falling that's shrinking your parent's life.
• Memory or thinking changes alongside other health problems.
• Weight loss, weakness or exhaustion that's crept up over months.
• Repeated trips to the emergency department or hospital.
• A big decision coming, like whether it's safe to keep living alone.

Our view: a parent on a long list of medications who has started falling should see a geriatrician, full stop. It's the single most common thing we see go unaddressed.

Do you need a referral to see a geriatrician in Ontario?

For a geriatrician's own clinic, yes: specialists see patients on a referral, usually from a family doctor or nurse practitioner. Ask your parent's doctor directly: "Would a geriatric assessment help?"

Some community geriatric programs are more open. In Ontario Health atHome's directory, for example, the GAIN team at Senior Persons Living Connected in Toronto lists family and self-referrals as accepted, and the geriatric program at Durham Community Health Centre in Oshawa says no referral is required. Check each program's page, because rules differ.

No family doctor? Register with Health Care Connect, which finds a family doctor, nurse practitioner or primary care team accepting new patients.

How do you find a geriatrician near you?

Start with the programs, not a name. Three routes, in the order we'd try them:

1. Ask your parent's doctor which geriatric program they refer to. Local doctors know which clinics have the shortest waits.
2. Use Provincial Geriatrics Leadership Ontario's [service map](https://geriatricsontario.ca/find-specialized-and-focused-geriatric-services-near-you/). It shows specialized geriatric services by type across Ontario, from programs that shared data as of May 2021, so confirm details with the program.
3. Search the [CPSO doctor register](https://doctors.cpso.on.ca/). The College of Physicians and Surgeons of Ontario's advanced search lets you choose a specialist in Geriatric Medicine or Geriatric Psychiatry by city or postal code. It doesn't show who is accepting new patients.

Our hospital directories also show which hospitals list geriatric services, for example Hamilton, Kingston and Ottawa. In Toronto, Sunnybrook and Baycrest both list geriatric outpatient programs.

How do you prepare for a geriatric assessment?

Preparation makes the difference between a useful plan and a long, vague appointment.

• Do a "brown bag." Put every pill bottle, inhaler, cream and supplement in a bag and bring it.
• Keep a falls log for a few weeks: when, where, what happened.
• Write down what's changed in daily life: cooking, bathing, bills, driving, sleep, mood.
• Bring hearing aids and glasses, and a family member who sees your parent often.
• Know what your parent wants. Staying home? Driving? Fewer pills? Say it. A good geriatrician builds the plan around it.

Our free health passport gathers medications, conditions and contacts on one page.

What happens after the assessment?

Expect a written plan sent to the family doctor, and sometimes follow-up visits or referrals to therapy, a memory clinic or home care. Medication changes are often the quickest win.

If the plan includes help at home, compare home care options in your parent's city. If it raises the question of moving, our advisors can talk it through with you, free and with no pressure.