A Canada-based nursing leader, Esther Sydney, has called for a structured eldercare system in Nigeria, warning that goodwill and family support alone may not adequately protect the country’s growing older population.
Sydney said Nigeria needed trained caregivers, individual care plans, regular quality audits and safer handovers between hospitals, homes and community-care providers.
She noted that migration, urbanisation and changing family structures were making it increasingly difficult for relatives to provide the level of care traditionally expected for older family members.
Sydney, who was appointed Director of Care at Silverleaf by Optima Living in Alberta, Canada, in June 2026, made the recommendations while reflecting on lessons from more than two decades of nursing and healthcare-management practice in Canada and the United States.
She said, “Eldercare needs a system, not only goodwill. What protects older people in the settings where I have worked is structure: assessment before placement, trained caregivers, clear care plans, regular audits, a safe handover between hospital and home, and a way for families to raise concerns.
“Those principles do not depend on expensive facilities. They depend on training and accountability, and they can be adapted to home-based and community care as well as residential homes.”
Sydney identified the period following an older patient’s discharge from hospital as one of the most vulnerable stages in the care process.
According to her, an elderly patient could be considered medically stable and still be unsafe to return home without adequate assessment, medication support or connection to appropriate community services.
“Discharge is not the end of care; it is the most fragile point in it,” she said.
She advocated structured transition procedures that would begin with early screening in emergency departments and continue with proper assessment, placement where necessary, and communication with relatives or professionals receiving the patient.
Sydney said such procedures could reduce avoidable returns to emergency departments and hospital readmissions among older adults.
She explained that her experience coordinating transitions at the Peter Lougheed Centre in Calgary exposed her to the consequences of discharging older patients without adequate plans.
During her more than six years at the centre, Sydney assessed patients in emergency and medical units and determined whether they required placement in long-term care, home-care assistance or support from community organisations.
She said continuity of care should be built into health systems and not left to the individual efforts of nurses or relatives.
Sydney also called for greater investment in the training and retention of nurses and caregivers, describing workforce stability as essential to the quality of eldercare.
She said, “People stay where they are taught well, supported when things go wrong and held to a clear standard. Continuity of staff is continuity of care.”
She advised Nigerian-trained nurses moving to Canada, the United Kingdom and the United States not to consider long-term care merely as a temporary entry point into their profession.
According to her, the sector offers opportunities for nurses to build their assessment, decision-making and leadership skills because they may frequently serve as the most senior clinicians on their units.
“Learn the regulatory framework of the province or state where you practise because compliance is part of patient safety,” she said.
“Add certifications that make you useful, such as infection prevention and control, wound care or diabetic foot care. Ask for mentorship and document what you learn.”
On dementia care, Sydney said restrictions imposed during the COVID-19 pandemic demonstrated that relatives were an important part of the care received by older people.
She explained that many residents living with dementia experienced increased distress, agitation and withdrawal after visits were restricted to control infections.
“That family presence is part of care, not a privilege,” she said.
“Residents living with dementia depend on familiar faces and routines. For staff, the lesson is that behaviour is communication. When a resident is agitated, the question is not only how to calm them, but what they are trying to communicate.”
Sydney also stressed that licensing, inspections and accreditation could protect residents only when care facilities observed required standards consistently.
She said the welfare of residents depended on daily routines, including regular audits of nutrition, wound treatment, palliative care and infection prevention.
“Licensing, inspection and accreditation only protect residents if the home lives by them between inspections, on night shifts and at weekends,” she added.
Sydney trained at John Abbott College in Quebec and obtained a Bachelor of Science in Nursing from the University of British Columbia.
She has worked at the McGill University Health Centre in Montreal, Caressant Care Bourget in Ontario and the Gerald Champion Regional Medical Centre in New Mexico.
She received the Exceptional Merit Award in Nursing and Healthcare Management from Bridge of Excellence in April 2025 for her contributions to nursing leadership, healthcare management, quality standards and risk management.
Sydney has also co-authored several peer-reviewed articles since 2020 on care transitions, long-term care regulation, workforce retention, dementia care, mental health nursing, and support systems for vulnerable people.
