A lifeline in the Emergency Room: How the GEM team is transforming senior care at NGH and WHGH
(Pictured left to right: Brittany Kusu, RPN; Jenelle Nelson, RPN; and Michelle Byrne, RPN)
Every second counts in the Emergency Department. For older adults, an Emergency Department visit isn’t just about urgent care—it’s a pivotal moment that can shape their recovery and long-term well-being. The flashing monitors, hurried footsteps, and fast-paced decisions can feel overwhelming, making specialized care essential.
That’s where Registered Practical Nurses (RPNs) Michelle Byrne, Brittany Kusu, and Jenelle Nelson come in.
As the Geriatric Emergency Management (GEM) team at Norfolk General Hospital (NGH) and West Haldimand General Hospital (WHGH), these dedicated nurses are redefining emergency care for seniors. In collaboration with the ED team, they advocate, navigate, and ensure older adults get the right care, in the right place, at the right time.
With the aging population in Haldimand-Norfolk set to nearly double in the next 20 years, this specialized team is more than just a welcome addition to emergency care—it’s an essential one.
“It’s so important that we support our aging population and give them every option to stay in their own homes, where they feel most comfortable,” said Michelle Byrne, RPN. “By working with our valued community partners, we can make sure they get the care and support they need to live safely and independently.”
Meeting a Growing Need
The launch of the GEM program comes at a critical time. Older adults already account for more than a quarter of ED visits at NGH and WHGH—and that number is only increasing.
Between 2016 and 2024, Haldimand-Norfolk saw a 25% rise in the senior population, and projections show an even sharper 41% increase by 2046. As the community ages, the need for specialized geriatric care in emergency settings has never been greater.
“As we see a rise in Haldimand-Norfolk’s aging population, having GEM nurses in the ER is so important,” said Brittany Kusu, RPN. “We take the time to ensure seniors and their families don’t feel overwhelmed or overstimulated by the busy ER environment. We also help guide patients and their families to the right community supports, so they can stay safe at home while maintaining the best possible quality of life. Having a GEM nurse helps build strong relationships with community services in Haldimand-Norfolk, ensuring patients get the right support based on their needs.”
Reducing Risks, Improving Outcomes
For many older adults, an emergency room visit can be more than just a temporary disruption—it can put their long-term independence, health, and well-being at risk. Delirium, dementia, depression, and mobility issues can complicate care, making it harder for seniors to be properly assessed and treated in a fast-paced ED setting.
In fact, according to Provincial Geriatrics Leadership Ontario, older adults are often under-triaged and under-treated in emergency care, despite having higher rates of hospital admission, longer stays, and greater risks of functional decline.
That’s where the GEM team steps in.
“Our team is committed to improving care for our aging population,” said Jenelle Nelson, RPN. “We want to make sure they have the support they need to thrive in their own homes. Whether it’s home care, meals, or community programs, we’re here to help connect them with these resources.”
A Hands-On Approach
Because the GEM team is a relatively new addition, not all patients—or even staff—know about their services yet. Michelle, Brittany, and Jenelle are taking a proactive approach in the emergency departments and providing detailed information about the program
Staff and physicians can refer patients to the GEM program, by identifying seniors who could benefit from their expertise. By working closely with internal and external stakeholders they develop safe discharge plans, connect patients and their families to resources, and reduce unnecessary hospital admissions—all while ensuring older adults receive the compassionate, specialized care they deserve.
A Brighter Future for Senior Care
With the launch of the GEM program in February 2025, NGH and WHGH are taking a major step forward in ensuring seniors receive the right care at the right time.
“The implementation of GEM nurses is a vital step in enhancing the care we provide to our older population, said AnneMarie VanSickle, Director of the Emergency Department at NGH and WHGH “Their expertise in geriatric assessment, early intervention and care coordination not only improves patient outcomes but also helps reduce avoidable admissions and supports safe transitions. By implementing GEM nurses into our emergency departments, we are fostering a more patient-centered approach that recognizes the unique needs of our aging population.”
As the aging population continues to grow, programs like GEM will be essential in shaping the future of emergency care—keeping seniors safer, healthier, and more independent for years to come.
Media Contact:
Aaron Gautreau
Director of Communications & Public Relations
W: 519-426-0130 ext. 2454
