Even as a nurse, married to a physician, I found helping my aging parents navigate the health care labyrinth to be a daunting and eye-opening experience. My mom’s 11-year battle with Alzheimer’s ended on Sept. 11, 2017, leaving her 24/7 caregiver, my father, alone and searching for purpose. I am thankful my family has some knowledge and resources to provide support to my father but realize just how many older adults have to maneuver through these complexities on their own.
Older adults have complex and unique health needs, which can make their medical care more challenging. For example, following my dad’s open heart surgery in 2014, he was determined to continue to be the full-time caregiver for my mom. That was an impossibility with his own recovery needs, which complicated his transitions between care settings—moving from the hospital to a rehab facility and then home. Knowing that goal and value in addition to the role our family could and would play was key to care planning and successful transition for my dad.
To address these kinds of challenges for our families and to improve health care for all older adults, a team of us at the AHA’s Health Research & Educational Trust (HRET) joined the Age-Friendly Health Systems initiative to design a new model of care focused on what we refer to as the “4 Ms”: what matters to patients, medications, mentation and mobility.
The John A. Hartford Foundation, which has worked to enhance the health and well-being of older people for more than 35 years, is providing support and leadership. In addition, by partnering with the Institute for Healthcare Improvement and the Catholic Health Association of the United States on this social movement, AHA aims to replicate these change approaches to 1,000 care settings, including hospitals, ambulatory care, long-term care and post-acute care, by 2020.
Kicking off this work are care teams from five U.S. health systems, piloting the 4M model in multiple care settings. They have enthusiastically tested interventions for the past year and are excited about the results they are seeing. Based on these findings, an initial change package was developed and will be tested this fall in communities representing acute inpatient and ambulatory settings.
Marie Cleary-Fishman is vice president, clinical quality, of the Health Research & Educational Trust.