Providing Compassion and Care Throughout All Ages

Brantford Community Healthcare System (BCHS) is committed to providing excellent medical care and understanding the needs of patients of all ages.

BCHS’ geriatrics team offers comprehensive assessments and consultation services, delivered with compassion. Aiming to empower older adults and their caregivers to make informed decisions, ensuring client-centered care, and reintegrating geriatric patients back into the community in collaboration with community partners.

"I love listening to their life stories and learning more about their experiences and passions. I feel honoured when they share with me their goals or concerns, knowing I can help advocate for them."

Dr. Mihaela Nicula is a valuable member of this committed team. With June being Senior’s Month, BCHS not only celebrate the contributions of seniors to the community but also recognize the individuals who provide care for them. BCHS sat down with Dr. Nicula, a Geriatrician at Brantford General Hospital, to learn more about her journey in geriatrics and her aspirations for the future of senior care and caregiving.

Can you tell us a bit about your journey—how did you end up working in geriatrics?

During my internal medicine residency, I found geriatrics a fascinating sub-specialty because it deals not only with medical complexity, but also with psychosocial issues, ethical decisions and involves interprofessional collaboration.

Was there a particular moment or experience that inspired you to focus on caring for older adults?

Geriatrics was my first rotation during residency training, and it left a lasting impression on me. My attending physician at that time, Dr. Karen Frutel, was an incredible role model. I witnessed her joy in working with her team and in her interactions with patients and their caregivers.

What kinds of medical or emotional challenges do you most often help seniors navigate?

Working as part of an interprofessional team, we provide comprehensive geriatric assessments for older adults experiencing recent cognitive changes, functional decline, mobility issues, or falls. Many of our patients have multiple chronic conditions and take several medications, which we review and adjust based on their current care goals and level of frailty. We also support patients in managing the emotional adjustments that come with difficult life transitions. The team will collaborate with other disciplines for more specific assessments and management of mental health issues, along with psychosocial factors affecting their health.

What do you enjoy most about working with older adults?

I love listening to their life stories and learning more about their experiences and passions. I feel honoured when they share with me their goals or concerns, knowing I can help advocate for them.

Are there any particular patient stories or relationships that have stayed with you over the years?

So many. One of the patient stories that has stayed with me was an 88-year-old woman who lived with moderate stages of Alzheimer’s dementia, cared for at home by her devoted daughter. At a certain point, she had a prolonged and complicated admission to the hospital, requiring additional low-intensity inpatient rehabilitation before she could return home. This admission led to further decline cognitively, and mobility challenges increased her needs of care.

What struck me most was the incredible bond between mother and daughter—their resilience and determination to find joy despite the challenges of dementia. Months later, during a follow-up visit in the geriatric clinic, they shared with me photos from their recent cruise to Antarctica. The photos showed my patient beaming with joy, sitting in her wheelchair surrounded by penguins.

In what ways is caring for seniors especially rewarding or meaningful to you?

Many of the patients our team supports have trouble expressing their needs due to their cognitive impairment, neurological conditions, mental health issues or sensory impairments such as visual or hearing loss. It’s very rewarding to build connections with these individuals, understand their unique needs, deliver the care they deserve, and empower other members of their care circle.

What aspects of practicing geriatric medicine are you most proud of?

Building capacity for geriatric services.

What are some of the biggest challenges in this field, and how do you manage them?

In my opinion, one of the biggest challenges, is the lack of integration between primary care and specialized geriatric services. Another key issue is ensuring smooth transitions of care for frail older adults between acute care and community settings. Solutions such as shared accountability agreements, the use of a common electronic medical record (EMR) system and strengthened case management can help address these gaps and improve outcomes for vulnerable seniors in the community.

What advice would you give to families who are struggling to care for aging loved ones? How can family members best support?

There are many free resources available to support caregivers. The Regional Geriatric Program (RGPc) and Provincial Geriatrics Leadership Ontario both offer excellent tools and information. It’s important for caregivers to not only access proper education, but also build a strong support network and learn self-care strategies to maintain their own well-being.

What changes would you like to see in how society approaches aging and elder care?

I hope to see our communities become more senior-friendly—with greater access to recreational activities and spaces that support physical health. It’s also essential that we continue to advocate for more affordable and accessible housing options for older adults.