November 21, 2022

A healthcare initiative to find what matters most to the older adult and their family continues to grow at Community Hospital. Called Age-Friendly Health Systems, Community Hospital is now recognized as an Age-Friendly facility for inpatients as well as in the outpatient infusion center. Last spring, the hospital was also recognized as a Community Spread facility when community pharmacies, eye clinics, funeral homes, nursing homes and dental clinics were invited to learn about the Age-Friendly initiative and what it means in treating older adults.

Guided by an essential set of age-friendly, evidence-based practices using the 4Ms, helps healthcare caregivers focus on the core health issues for older adults, according to Charlotte Marks, BSN, RN, Community Hospital Transition of Care & Patient Educator. “With this initiative, we are educating our staff to focus on what matters, medications, mentation and mobility,” she said.

Asking the patient what matters to them gives them a voice and a choice in their healthcare. “It helps us provide the care our patients want,” she said, “and helps us to connect with the patient.” A patient might be asked, “What matters to you during this hospital stay,” or “What would make tomorrow a really great day for you?” Ensuring what matters to the patient drives the patient’s plan of care, makes them feel truly cared for, and gives them a reason to get better.

Age-Friendly care involves medication optimization, or looking for ways to target and de-prescribe drugs that might be effecting an older person adversely because of their age. She added there are certain medications inappropriate for older people, and some might need lower doses to achieve what matters most to the patient, or does not impede their mobility. “Optimizing medication through targeted de-prescribing is a vital part of managing a patient’s chronic conditions, avoiding adverse effects and improving their lifestyle,” she said.

Mentation involves the patient’s mental activity and process of thinking. Age-Friendly concepts for the patient involve preventing, identifying, treating and managing, dementia, depression and confusion. Ways to focus on the patient’s mentation during their stay might include making sure the patient stays hydrated, orienting the older adult to time, place and situation, making sure they have their personal adaptive equipment such as glasses, hearing aids, dentures and walkers, preventing sleep interruptions, and avoiding high-risk medications, Marks said.

Finally, Age-Friendly focuses on the patient’s mobility. During their stay, a greater focus on safe mobility includes having the patient walk three times a day unless they are bed or chair-bound, being out of bed for meals, receiving physical therapy, avoiding restraints, removing catheters and other tethering devices and avoiding high-risk medications.

Marks explains there is a lot of overlap when using the 4M’s because “everything affects everything in Age-Friendly.” She explained that reviewing and perhaps changing medications could affect the patient’s mobility and mentation. Asking them “what matters in your care?” can influence the patient’s mental state and help them to achieve a mobility goal.

“Age-Friendly concepts help our caregivers as well,” she added. “By helping our patients we can make a difference in their lives, but they truly make more of an impact in ours. It helps us connect with the patient which brings increased satisfaction to both the patient and our staff.”

Age-Friendly Health Systems is an initiative of The John A Hartford Foundation and the Institute for Healthcare Improvement in partnership with the America Hospital Association and the Catholic Health Association of the United States.