You may have heard the buzz about age-friendly care. But what is it, and how do you integrate it into your work with older adults?

Age-friendly care exists to help older adults get care that aligns with their unique health priorities and addresses their needs. It is based on what research shows are the most important elements of care to address with older adults, the 4Ms: what Matters, Medication, Mentation and Mobility.¹

What Matters Most anchors age-friendly care, guiding decisions regarding medications, mentation, and mobility. These are a person’s unique health priorities derived from their core values.

How does age-friendly care benefit older adults?

Health care should be aligned with the values and priorities of patients. This is especially true in the care of older adults, a population with diverse needs who vary in their health priorities. And evidence about the best treatment options is often lacking, particularly for the majority of older adults who experience multiple chronic diseases and conditions. By addressing a person’s unique needs and priorities, age-friendly care can help guide decision-making in the face of uncertainty and difficult tradeoffs.  

“Age-friendly care is what all older adults deserve and should demand because it aligns health care decision-making with what matters most to them,” according to Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. “For an older person with many complex conditions, identifying health priorities and what matters most can be challenging, but there are evidence-based tools to help.”

Age-friendly tools for health professionals caring for older adults

Understanding what matters most to an older adult regarding their health is the first step in offering age-friendly care. Evidence-based resources exist to help you identify and address their health priorities in a systematic, measurable way.

Health priorities are the health and life goals each older adult most desires within the context of their care preferences, or what they are willing and able to do to achieve those health goals.

Many tools and supports are available to improve access to age-friendly care. 

Health Professional Toolkit:

• Features a self-directed priorities identification website
• Includes printable guides on identifying patient’s health priorities, including tips and scripts
• In-depth resources on how to provide priorities-aligned care and decision-making
• Tips for inviting patients to this approach
• Strategies and troubleshooting for aligning care with each older adult’s health priorities
• Templates for documenting patient’s health priorities
• Billing codes and return-on-investment calculator

Simplified Tools:

• Identify health priorities with patients
• Align care around those priorities
• Pocket card for quick reference

Additional resources to prepare yourself in patient priorities-aligned identification and decision-making:

• Self-directed training with the American College of Physicians: Decision-Making for Patients with Multiple Chronic Conditions: Patient Priorities Care
• Interprofessional online training series: Practice Patient Priorities Care through discussion and case-based coaching
• Continuing education program with the American Association of Nurse Practitioners: Advancing Patient Priorities Care: Deepening Understanding and Practical Applications
• Opportunities to collaboratively learn about the 4Ms of age-friendly care

Once you understand what matters most to a person, decision-making becomes much more focused. Every decision made with the older adult and their health care team regarding medications, mentation, and mobility should consider whether an intervention interferes or supports what matters most to the person.

Resources for older adults and care partners

It is important to regularly talk with older adults about their health care in the context of what matters most to them. Their top priority can change over time, and their care may need to be changed accordingly.

These resources, which you can share with older adults and care partners, are designed to help older adults identify their specific, actionable, and realistic health priorities and what treatments or symptoms are most bothering them or getting in the way of meeting their goals.

My Health Priorities:

• Helps older adults identify their health goals, priorities, and care preferences online at their own pace
• Receive a printable health priorities summary to share with health care team and family
• Care partners are encouraged to work through the site with their loved one to facilitate discussion
• Available in Spanish

Tips for talking with your health care team:

• Helps older adults share their priorities with their care team
• Offers questions older adults can ask their care team
• Suggests phrasing for talking about their health priorities, concerns, and goals

My Health Checklist:

• Helps older adults talk about all 4Ms with their health care team

Age-friendly care, starting with understanding what matters most, helps older adults be active partners in their health care decisions. It improves communications among patients, health care professionals, and care partners by ensuring everyone is focused on the same outcomes.

If you would like to collaboratively learn about the 4Ms of age-friendly care, the Institute for Healthcare Improvement facilitates action communities and offers an online course with coaching.

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States. Patient Priorities Care and My Health Priorities are funded by The John A. Hartford Foundation.

Sources

1. Kedar S. Mate, et al. Creating Age-Friendly Health Systems—A vision for better care of older adults. Healthcare. March 2018. Found on the internet at https://www.sciencedirect.com/science/article/abs/pii/S221307641730012X