Age-friendly care: What it is and how reporters should cover it

You may have heard of age-friendly care. Several panelists discussed this concept at Health Journalism 2024 in June. But how is it measured? And why does it matter? Here are some things reporters should know when covering this topic.

More than 54 million Americans are 65 or older. This number is projected to skyrocket to about 95 million by 2060. Many older people have more than one chronic condition and take multiple medications. While most want to live independently, many families are uncertain about achieving independence while ensuring loved ones receive the best care possible for their needs and goals. That's where age-friendly care comes in.

Age-friendly care, an initiative of The Institute for Health Care Improvement and The John A. Hartford Foundation, is modeled on the evidence-based 4Ms framework. (The foundation supports AHCJ's aging beat topic, but has no input on editorial decisions or content)

Talking about what matters is crucial for aligning goals of care and what kind of life a person may want as they age, noted Jamie A. Swanson, D.O., a geriatrician at Jefferson Health in Abington, Penn.

Why do we need age-friendly care?

• Medicine often approaches care one condition at a time. Clinical treatment goals may not always align with what an individual patient wants, according to Jennifer Wall, DNP, former chief quality officer at Hebrew Senior Life in Boston. Age-friendly care also keeps patient priorities at the forefront, ensuring patients receive the care they need and want.
• Different specialists may not always coordinate care and might miss something. Symptoms from other conditions may even overlap, but sometimes the dots aren't connected. Age-friendly care also takes a more holistic approach based on evidence-based, patient-centered goals of care.
• Multiple medications could cause dangerous interactions and side effects, affecting cognitive status, increased risk of falls, and other serious side effects. Age-friendly care focuses on managing medications to minimize these risks.
• Finally, cognitive decline or dementia may change how a person is cared for - and the role families play in their care. Age-friendly care includes understanding mental and behavioral health status, including the difference between delirium and dementia.

Over 4,000 health systems and hospitals have adopted this framework.

Patient-centered approaches can help reduce readmissions, decrease length of stay, lower costs and improve outcomes for older people, according to the American Hospital Association.

• Age-friendly care can be integrated into primary care practices, emergency departments, entire health systems, and communities, including the U.S. Department of Veteran Affairs.
• The 4Ms framework and other crucial components of age-friendly care are routinely field-tested, honed, and improved in hospitals and other care settings via the Age-Friendly Health Systems Action Community.
• Length of stay has decreased, outcomes improved, patient and staff satisfaction has increased, and many workforce challenges have been addressed, American Hospital Association President and CEO Rick Pollack said in 2023.
• In June 2024, The Accreditation Commission for Health Care (ACHC) approved two new specialty credentials: the Distinction in Age-Friendly Care for Home Health and Hospice and the Distinction in Outcomes for Home Health. These designations will be given to ACHC-accredited organizations that have excelled in providing high-quality, patient-centered, age-friendly care.
• Community Health Accreditation Partner (CHAP) also provides an age-friendly designation for home care companies and has a collection of at-home resources and standards.

Story ideas

• Contact your local hospital or health system. Find out if they are part of the age-friendly initiative. If not, why? If so, ask about outcomes, length of stay, patient satisfaction, and other key metrics before and after the adoption of this framework.
• Does your local hospital have a separate geriatric emergency department? How are falls or health examinations handled? Are teams looking at risk factors like home safety, outside support or community programs?
• If no age-friendly health systems exist in your area, how are doctors, nurses, social workers, and case managers trained to account for the 4Ms?
• Are other local facilities such as rehabilitation centers, skilled nursing facilities, home care companies or senior life communities practicing the 4Ms? Have they seen a difference in outcomes or quality of care?
• What is your county, city or state doing to foster more age-friendly health care and services? What more could they be doing?