Integrating Age-Friendly Concepts to Improve Care for Older Adults: Adopting the 4M Technique

As nurses, we recognize where healthcare disparities for older adults exist and are conscientious towards achieving quality health outcomes based on the needs and preferences of older adults. Research demonstrates that creating an age-friendly healthcare system (AFHS) helps improve assessment and creates personalized care planning directed as to what matters for older adults - thus improving the quality of care and directing that care to the needs of the individual and their caregivers (Institute for Healthcare Improvement, 2020). Age-friendly care is about routinely and proactively assessing the personal goals and preferences of older adults and their caregivers, as well as routinely addressing their most common health needs in an effort to improve care, prevent avoidable care interventions and focus all care on the goals and wishes of our clients (Fulmer, Mate, and Berman, 2018). ADOPTING The number of older adults, aged 65 and older, will nearly double by the year 2060 (Age-Friendly Health Systems | Center | AHA, 2021). And as ethnic and socioeconomic disparities increase over time they add to the greater risk of poor health and disease (De Biasi et al). Geriatric patients have multiple chronic health issues adding to the complexity of their care - including chronic and mental health problems. It is established that, our current healthcare model is not prepared to handle an influx of geriatric patients with complex medical and social care needs. Additionally, healthcare models are not integrated to a point that care can be provided in a personalized and tailored manner to keep up with this increasingly diversified population. Despite national efforts to prioritize older adult healthcare, programs are under-resourced and siloed (De Biasi et al., 2020). Overall, there is a lack of consistency in how each system approaches quality care and how they personalize their care delivered (Headley, 2019). To address these challenges the John A. Hartford Foundation (JAHF) and Institute for Healthcare Improvement (IHI) have partnered up with American Hospital Association (AHA) to improve care for older adults and their caregivers (Age-Friendly Health Systems | Center | AHA, 2021). The 4M's - What Matters, Medication, Mentation, and Mobility are a framework to guide this care. The 4M framework is a collection of evidence-based interventions that provides a shift in thinking how to organize care from assessment to evaluation (Institute for Healthcare Improvement, 2020).