Leading the Way in
‘Geriatricizing’ Health Care for All

The fund honors the legacy and continuing work of Ellen Flaherty, PhD, APRN, AGSF, FAAN, vice president of the Dartmouth Health Geriatric Center of Excellence, associate professor of medicine and community and family medicine at the Geisel School of Medicine, Dartmouth, and associate professor at the Dartmouth Institute for Health Policy and Clinical Practice at Geisel.

The John A. Hartford Foundation, founded nearly a century ago by the owners of A&P grocery store chain, is the leading national philanthropy focused on caring for older adults, and regularly makes grants and awards to organizations focused on creating Age-Friendly Health Systems, supporting family caregivers and improving care for those with serious illnesses and end-of-life care.

But this is no ordinary donation—behind the gift lies a shared passion for helping older adults, and decades of friendship.

The gift came via Terry Fulmer, PhD, RN, FAAN, an internationally recognized expert in geriatric research and practice, who recently stepped down after 10 years at the helm of the foundation. As a celebration of her years of service, the foundation offered to make a gift to the place or person that Fulmer felt was most aligned with The John A. Hartford Foundation’s mission.

For Fulmer, the decision was easy: she chose to honor her fellow age-friendly health care evangelist and longtime friend, Ellen Flaherty. Fulmer calls Flaherty’s work extraordinary and rewarding. “Quality, personalized, loving care—that’s what you’ll see when you see Ellen in practice.”

The two first met in 1988, when Flaherty was a geriatric nurse practitioner at the Jewish Home in New York City and Fulmer was on the nursing faculty at Columbia University. A professional bond quickly formed, growing into a lifelong friendship.

“Terry and I have the same energy level and same commitment level to improving care for older adults,” says Flaherty.

Fulmer and Flaherty are both ardent believers in advancing the Age-Friendly Health Systems movement. A concept that Fulmer first envisioned, it is a model of healthcare that puts the needs and values of older adults as the focus of care. It’s centered on four core principals, known as the “4Ms”—what matters, medication, mentation, and mobility. Fulmer’s observations from years of nursing underscored the need for fundamental change in the approach to better care for older adults. In 2015, she brought the idea with her to

The John A. Hartford Foundation. “Terry is a force around the globe in improving the care of older adults. She has been my career-long mentor,” says Flaherty, who calls this gift “a very emotional honor.”

The Early Connection to Nursing

Flaherty’s passion for nursing and older adults began in her early teens, as a Red Cross volunteer at a nursing home. At the age of 19, she worked a summer job at the Brattleboro Retreat (a mental health facility) as a nurse’s aide. Both experiences heavily influenced her career aspirations. “To me, doing that work really helped define what it takes to care for older adults, and how to support direct care workers,” she recalls.

But there’s also something to the idea that nursing is in her blood—both her mother and sister are in the nursing field—and the bloodline continues: her daughter is also a nurse and her granddaughter is a nursing student.

“We all share this value about caring for others,” says Flaherty.

She earned her nursing undergraduate degree from Molloy University in New York; a nursing master’s degree at Stony Brook University soon after, and her PhD in nursing from New York University in 2004—that last degree coming at the urging of Fulmer. Soon after, Flaherty joined Dartmouth’s medical school in 2009, when she was named co-director of the Dartmouth Centers for Health and Aging. She also served as president of the American Geriatrics Society.

Now, as the vice president of the Dartmouth Health Geriatric Center of Excellence, Flaherty leads a team of about 30, working in primary care, skilled nursing care, research, and more. “We laugh together, we cry together,” she says of the team’s workplace ethos. She believes geriatric care is a team sport, and says her group is often driven by a shared and simple philosophy: ‘How can I help?’

Why a Focus on Older Adult Care Matters

As a specialty, geriatrics is a tough sell for up-and-coming providers, says Flaherty—pay is traditionally low, and the work can be especially difficult, both physically and emotionally.

“That leaves us with a huge responsibility to ‘geriatricize’ everything else,” says Flaherty.

But what does that mean, exactly? Flaherty explains: It’s about adopting the idea that care of older adults’ physical and mental health infiltrates nearly every other area of medical care. As Flaherty likes to say to the next generation of clinicians, “Unless you’re strictly doing pediatrics or obstetrics, geriatrics will be part of your career in healthcare, so pay attention.”

And that’s nowhere more evident than in northern New England, with New Hampshire, Vermont, and Maine regularly taking the top three spots in ranking of oldest state populations by median age. Roughly 21% of the Granite State’s population is 65 or older—a statistic that will be true for the rest of the country by 2050, according to sources like the United Nations’ Population Division and AARP.

“We may never have enough people to specialize in geriatrics, so the question becomes how can we train everybody to provide the very best care to aging adults?”

This gift is one way, says Flaherty. In addition to providing scholarships for providers to attend classes and conferences, it will fund Geriatric Grand Rounds, where invited experts talk about complex medical cases or share insights from their research. These events can pack auditoriums or webinars and serve as the ultimate in professional development, collaboration, and continuing education.

“Grand Rounds is our opportunity to meet the absolute experts in the field, people that folks have looked up to, the people doing the research that we’re studying,” says Flaherty.

Typically, speakers are invited to stay for a day or two, meet the team and spend time with them beyond their formal lecture; another way Dartmouth Health clinicians and Geisel students, regardless of specialty, can be part of the ‘geriatricizing’ movement.