The Growing Demand for Age-Friendly Care in the United States

For the first time in human history, there are now more people living over the age of 64 than under the age of 5. [1] Major contributors to this are advancements in medical technologies, public health efforts and elevated standards of living and hygiene.

The Looming Problem for an Aging Population

Despite all these advancements, the medical system in the United States remains overwhelmed, understaffed, and outdated (in mindset and healthcare) when trying to handle such a massive influx in the needs of older adult populations. With around 7,000 Geriatricians in the United States, the American Geriatrics Society predicts we will need to nearly double this amount by 2030 - just 7 years away - to meet the growing demand.

According to the World Health Organization, ageism is the most widely acceptable prejudice in the world. It is often not taken as seriously as other forms of discrimination. This is prevalent in some countries more than others, but it can affect older adults’ mental health, lead to social isolation, financial insecurity, decreased quality of life and, for our focus, prejudice in healthcare.

Studies have shown, when doctors are given identical case studies, with the same symptoms and same likelihood of recovery, they are far less likely to recommend treatments for older patients than their younger counterparts. [2] We can, should, and will, do better.

How Age-Friendly Health Systems Provides a Solution

There has never been a more critical need for Age-Friendly Care in all of human history. Research shows that providing older populations with specific, age-friendly care has long reaching benefits including reducing the number of emergency department visits, hospitalizations and readmissions, a reduction in medication-related problems, increased mobility, and early detection of memory issues and depression.

Age-Friendly Care strives to follow an essential set of evidence-based practices that cause no harm and align with what matters most to the older adult and their family and caregivers. 

Age-Friendly Health Systems is an initiative of the John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and Catholic Health Association of the United States. Their initial goal was to spread the 4Ms Framework to 20% of US hospitals by 2020. This initiative exceeded that goal with over 2,800 recognized Age-Friendly Health System participants. [3]

Our healthcare system needs to work at taking a fresh approach that respects older peoples’ autonomy and decisions to live a happy and fulfilled life according to their own terms.

The guiding principles to providing Age-Friendly Care is structured around the 4Ms Framework:

• What Matters to older people with respect to their goals and preferences when getting treatment, end-of-life care and across settings of care.
• Medications that should be avoided or scaled back as necessary
• An emphasis on Mentation to prevent, identify, treat, and manage dementia, depression, and delirium
• Mobility to ensure older adults can maintain safe mobility, function, and independence

The synergy of these principles ensures the person is treated as a whole, treating the patient with the disease, rather than solely treating the disease. More importantly, it is also about respecting what the patient wants.

The general population along with caregivers can view the 4Ms Framework as a guide to be better equipped to assist the growing aging population.

Never has there been a more critical need for education and training on the importance of providing Age-Friendly Care and the 4Ms. Healthcare providers, aging populations, caregivers, and their family members should all be included in what this means.  

How CHAP is Supporting Age-Friendly Health Systems in the Home

The United Nations has coined 2021-2030 as the decade of healthy ageing. [4] This is a critical juncture in history where globally governments, society, international agencies, professionals, academia, the media and private sector need to come together to improve the lives of older people.

CHAP is committed to creating a certification program to bring Age-Friendly Care and the 4Ms Framework to the home health care setting. This certification would allow for agencies with the Age-Friendly Care Certification to manage care for individuals leaving an Age-Friendly Care Hospital. Agencies can extend their care to provide for these individuals in their home which allows for more freedom and autonomy for the individual.

What You Can Do to Support an Age-Friendly Movement

To adequately provide for the large demand in Age-Friendly Care, we need to work at educating aging populations and their families on their rights and freedoms of care along with training and certifying health care providers and caregivers on the 4Ms Framework. We need to work together to bring awareness to aging populations, to look at our assumptions and preconceptions about older people and to do better.