Asante and Providence embrace ‘Age-Friendly Health Care System’
Over the years, I’ve accompanied many clients to medical appointments, the emergency room and visited them in the hospital. One thing that is noticeable is that these systems were not really designed to address the unique needs of many older adults, and especially those with dementia.
Here’s the good news, though. Both Asante and Providence are incorporating something called an “Age-Friendly Health Care System” into their approach to addressing this population.
In Oregon, the over-65 population is expected to double in the next 30 years. About 23% of Jackson County residents are already over 65, for a total of almost 51,000 people. This will certainly impact the medical services across all areas of care.
To be better prepared, the health care systems are following guidelines called “The Age-Friendly 4-M Framework.” This is a reliable set of evidence-based interventions for medical providers treating the older population. This is not a specific program, but a shift in the care that this person would receive across all areas of the health system. The areas being addressed are mobility, mentation, medication and what matters.
Each area has its specific goals and focus.
For medication, it’s to minimize high risk medications in older adults. As the patient, it’s a good idea to make sure each visit to a medical provider includes a current list and a review of your meds. It’s possible that one doctor is not aware of what another one has prescribed for you. Some medications should not be used with those who have dementia, for example.
For mentation, or thinking activity, the goal is to prevent, identify, treat and manage dementia, depression and delirium across all care settings. It’s also very important that the family and care providers, as well as their doctors, know how to best communicate with someone who has this diagnosis. Training for families is easily accessed through the Alzheimer Association’s website (alz.org).
Mobility goals are designed to ensure older adults can maintain function and move about with ease and safety every day. Clearly, this includes fall-risk management. To address this, it’s suggested to patients to use online exercise programs, if going to a gym is not possible. Also, look into the STEADI program (www.cdc.gov/steadi/index.html), which is on the CDC website and has two wonderful 2-page brochures to read: “Stay Independent” and “Family and Caregivers: Protect Your Loved One from Falling.”
According to these guidelines, what matters to the person is the fourth factor, and of prime importance as well. This means that each medical provider is encouraged to know and align the medical care with each person’s specific goals and preferences. The areas to consider here are the patient’s thoughts on longevity, cognitive abilities, and their sense of independence. Knowing and understanding these will have a direct influence on which types of treatments the person is willing to pursue. Here’s where it’s important for you as the patient to express your own choices, so that treatment options can be adjusted to meet your personal goals. What matters to you, matters!
The focus is now on training medical providers to be more in touch with and have a better understanding of their patients’ care needs, based on these four areas. It’s also up to each person to be sure that their medical provider is taking the time to fully grasp what their goals truly are. This might mean being a bit more outspoken about your choices as you’re aging. What fit for your care needs up until now might have changed.
It’s also a good idea to take someone along with you to all medical appointments who can take notes and act as your advocate. This 4-M focus is a positive change to our local health care settings, and we can expect better outcomes for all patients through this approach.
Ellen Waldman is a certified aging life care professional. Submit questions about aging and Ashland-area aging resources and column suggestions to her through her website, www.SeniorOptionsAshland.com.