There are many organizations and foundations advocating to improve health care for our aging populations.
One of the ongoing challenges is organizing care into a framework that allows the care receiver to be an advocate for themselves.
One example for improving health care for our elders is a framework supported by the John A. Hartford Foundation. This framework for creating age-friendly health systems is called the 4Ms. It is intended for practitioners to organize and engage older adults in their care by addressing the key concepts that are impacting their lives. It is also an opportunity for older adults and their caregivers to become better advocates for their own care.
The 4Ms are “What Matters,” “Medication,” “Mentation” and “Mobility.”
Asking the question “what matters most to you?” can create real conversations with elders and their caregivers about their goals and thoughts about their current health status. It can be a springboard for creating a plan that supports realistic patient-centered goals that the participant will embrace.
ADVERTISEMENT
Discuss current medications with the mindset of reducing harm, and if medications are necessary, using age-friendly medicine that doesn’t interfere with each other.
Mentation is preventing, identifying, treating and managing depression, delirium and dementia across care settings, starting with using appropriate screens. There are other strategies, besides medication, for addressing mentation issues. Alternatives should be part of the discussion with the health care provider.
Mobility means ensuring that older adults move safely every day to maintain function and the ability to do what matters to them.
These 4Ms are interdependent; for example, some medications can affect safe mobility and/or mentation, which will likely impact the big “M,” which is being able to do what matters most.
While we can’t make a health care system adapt a patient-friendly system, as a self-advocate or advocate for someone else, you can begin to shape how you receive care.
Prior to the next health care visit, reflect on why you are going in and what it is that is most important to you to address. Have your list of medications and supplements that you are taking. If you’re not sure why you are taking a certain medication, circle or highlight it so you can ask your provider about it. If you feel you are having symptoms from medications, write those symptoms down and ask if they could be side effects.
Independence will be impacted by changes in mentation and mobility, and this should be part of the overall discussion.
Last, but not least, you are paying for the care you receive and you have the right to advocate for yourself and to receive optimal care.
