Age-Friendly Health Systems

Addressing the unique care needs of older adults.

Age-friendly health care is an urgent need. There are more than 46 million Americans age 65 and over, and that number is projected to double to more than 98 million by 2060.

Many older adults have more than one chronic disease and take multiple medications. Many individuals in this population of people live with uncertainty as they transition from living independently to reliance on others.

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) in partnership with the American Hospital Association and the Catholic Health Association of the United States (CHA). The goal of the initiative is to rapidly spread the 4Ms Framework to 20 percent of US hospitals and medical practices by 2020.

It is part of the AHA’s commitment to improving the health of people at every life stage and in communities across the country.

The “4Ms” Framework

  • What Matters: Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.
  • Medications: If medications are necessary, use age-friendly medications that do not interfere with What Matters, Mentation or Mobility.
  • Mentation: Prevent, identify, treat and manage depression, dementia and delirium across settings of care.
  • Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

An Age-Friendly Health System is one in which every older adult’s care:

  • Is guided by an essential set of evidence-based practices (the 4Ms);
  • Causes no harms; and
  • Is consistent with What Matters to the older adult and their family.

Additional information and resources about the Age Friendly Health Systems Initiative and 4Ms Framework can be found at Institute for Healthcare Improvement.

the AHA Action Community

The first AHA Age-Friendly Health Systems Action Community is concluding in April 2020. An Age-Friendly Health System Action Community tests the 4Ms Framework in hospital and ambulatory settings, sharing learnings in a 7-month virtual community.


The benefits of the Action Community include:

  • Redeploying and prioritizing existing hospital/health system resources.
  • Supporting your health organization’s mission, vision and values.
  • Putting your organization ahead of the curve in preparing for the impending market shift.
  • Be recognized as an “Age-Friendly Health System Participant.”

To find out more about the Age-Friendly Health Systems Action Community, download a one-page flyer. Stay tuned for more information about our next Action Community. Email for additional information or to ask questions.

On-demand Replay

Learn about AHA Action Community

The AHA hosted webinars with Christiana Care Health System and Providence St. Joseph Health to discuss the importance and impact of the 4Ms Framework and how to become an Age-Friendly Health System.

Pioneer health systems

Five pioneer U.S. health systems tested and implemented the 4Ms Framework in order to become an Age-Friendly Health System. Read their stories: to learn how they have successfully implemented the 4Ms at their organizations leading to reductions in patient length of stay and readmissions, improvement in patient family engagement and patient satisfaction, positive return on investments and improvement in patient safety.




Success Story: Implementing the 4Ms at Christiana Care

Nurses and other key stakeholders at Christiana Care embraced the 4Ms Framework, which became part of strategic planning efforts.


Health Systems Recognized for Age-Friendly Care

The Institute for Healthcare Improvement, a project partner, has recognized 162 health systems and health care practices for providing age-friendly care.


Building an Age-Friendly Health Care System

Published in AHA Trustee Insights and geared to hospital and health system board members, information about the Age-Friendly movement and how to become involved.

Issue brief

Creating Age-Friendly Health Systems

What it means to be an Age-Friendly Health System, why care for older adults is so complex, and the components of an Age-Friendly Health System. Includes early results from the health systems that piloted this initiative.


Putting the 4Ms into Practice

Learn more about the 4Ms Framework and how to use it in practice to become an Age-Friendly Health System in the Guide to Using the 4Ms in the Care of Older Adults.


Making Care Better and Friendlier for Older Adults

Personal story about caring for aging parents shared by Marie Cleary-Fishman, vice president of clinical quality at the AHA Center for Health Innovation.

4Ms Framework for an Age-Friendly Health System

Rush Center for Excellence in Aging highlights using the 4Ms to create an Age-Friendly Health System.

What Is an Age-Friendly Health System?

Mary Tinetti, M.D., chief of geriatrics at Yale School of Medicine and Yale–New Haven Hospital, describes what it means to be an Age-Friendly Health System and how to provide the best care possible to older adults.


The John A. Hartford Foundation
The Institute for Healthcare Improvement (IHI)
Catholic health ministry of the United States

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