Fast Facts

The 4Ms of Age Friendly Healthcare Delivery: Medications - #104

Medications is one of the 4Ms of an Age-Friendly healthcare system.

The 4Ms of Age Friendly Healthcare Delivery: #3: Mobility - #103

Mobility is one of the 4 Ms of an Age-Friendly healthcare system.  This “M” emphasizes mobility.

In 2017, the Institute for Healthcare Improvement (IHI), the John A Hartford Foundation (JAHF), the American Hospital Association (AHA), and the Catholic Health Association (CHA) of the United States addressed the development of age-friendly health systems using a clinical framework to improve the complex care of older adults.

These organizations defined and operationalized age-friendly care following the guidelines of beneficence, evidence-based medicine, and patient/family aligned goals and concerns. The 4M Framework was the result: What Matters Most, Mentation, Mobility, and Medication.  A 5th M is often incorporated to include Multi-Morbidity, which calls attention to the multiple, often inter-related, health problems that many older adults face. This Geriatric Fast Fact focuses on Mobility.

The 4Ms of Age Friendly Healthcare Delivery: #2 - Mentation - #102

Mentation is one of the 4Ms of an Age-Friendly healthcare system.

In 2017, the Institute for Healthcare Improvement (IHI), the John A Hartford Foundation (JAHF), the American Hospital Association (AHA), and the Catholic Health Association (CHA) of the United States addressed the development of age-friendly health systems using a clinical framework to improve the complex care of older adults.

These organizations defined and operationalized age-friendly care following the guidelines of beneficence, evidence-based medicine, and patient/family aligned goals and concerns. The 4M Framework was the result: What Matters Most, Mentation, Mobility, and Medication.  A 5th M is sometimes incorporated to include Multi-Morbidity, which calls attention to the multiple, often inter-related, health problems that many older adults face.

The 4Ms of Age Friendly Healthcare Delivery: #1 - What Matters Most - #101

What Matters Most is one of the 4 Ms of an Age-Friendly healtcare system. This “M” aligns care to what the patient feels is most important in their life. 

QT Prolongation: Risk Factors and Considerations - #100

Review medical conditions and medications that can prolong QT

Telemedicine and Geriatric Care - #99

Older adults may have fewer options for transportation to medical appointments. Telemedicine (telephone or audio-visual communication) can improve patient health, lower healthcare costs, reduce wait times, reach a broader geographic region, and limit unnecessary exposures of patients to infection.

Loneliness of Older Adults - #98

When there is a discrepancy between one’s desired state of social connection and one’s actual relationships, a complex set of feelings termed loneliness occurs.

Caregiver Burden in the Context of Dementia - #97

“Caregiver burden” is a multifaceted concept that encompasses the physical, psychological, social, and financial strain experienced when caring for a loved one over time.1

Alzheimer’s Association Direct Connect Referral - #96

Navigating the diagnosis and progression of Alzheimer’s Disease or another dementia can be overwhelming to patients and their caregivers.

Dementia Detection: Identifying Red flags of Cognitive Decline - #95

Dementia is a growing public health concern with timely diagnosis an important part of high-quality care for older adults.

Social Isolation of Older Adults - #94

Humans are social beings and connections to others are vital to our health and well-being. Social isolation (i.e., the objective absence or paucity of social interactions with others) is a social determinant of health which is related to, but distinct from, the concept of loneliness (i.e., the subjective distressing feeling of being socially isolated).1,2

Age Friendly Healthcare Delivery: The 4Ms - #93

The 4Ms in improving the complex care of older adults are: What Matters Most, Mentation, Mobility, and Medication.

Geriatric Cardiac and Pulmonary Rehabilitation - #92

By assessing comorbidities, frailty and disease status in context of function and care goals, the appropriateness of cardiac or pulmonary rehabilitation for geriatric patients can be determined. 

Tips for Communicating with Older Patients - #91

Good communication with older adults and their caregivers is important to delivering high quality care.

Low Health Care Literacy and the Older Patient - #90

Health literacy refers to an individual’s ability to understand his or her health and effectively navigate the health care system.  

Hip Fracture Management in Advanced Dementia Patients - #89

Determination of appropriate post-fracture management of patients with advanced dementia and hip fracture. 

Guardianship of Adults: Guardian Roles & Responsibilities - #88

Guardianship is the court appointment of legal authority over the person and property of another individual, called the ward. Consultation with an attorney or bioethicist is advised for individual patient cases.

Treatment of Sexually Transmitted Infections in Older Adults - #86

Treatment of sexually transmitted infections in an older adult.

Diagnosis of Sexually Transmitted Infections in Older Adults - #85

Diagnosis of sexually transmitted infections in an older adult.

Conversations Surrounding STI Prevention - #84

While sexually transmitted infections (STIs) are on the rise among older adults, medical providers may associate this problem with younger populations, missing prevention and treatment opportunities.

Suspected Influenza in Older Adults - #83

Older adults with influenza may present with nonspecific symptoms and/or exacerbations of co-morbid illnesses.

Improving Care for Older Patients with Depression - #82

Depression in older adults, even major depression, is treatable. 

Environmental Causes of Falls - #81

Identifying and decreasing environmental risk factors for falls.

Care Transitions: Skilled Nursing Facility to Emergency Department - #80

The challenges and potential dangers of and improvements of SNF transitions of care.

Assessment of Dementia Patients in the Emergency Department - #72

Assessing delirium in dementia patients in the emergency room

Senior Housing Options - #70

Outlining the different options for senior living and which option is appropriate based on the older adult. 

Performance Improvement in the Nursing Home - #69

Create awareness amongst providers about the role and value in conducting Performance Improvement (PI) programs in the nursing home. 

Deprescribing Medications in Elderly Patients - #68

Identifying inapproproate medications in elderly patients

Surgical Management of Breast Cancer in the Elderly Patient - #67

Determine appropriate surgical management for elderly breast cancer patients.

Obesity in the Older Adult - #66

Dealing with obesity in the older population in an out-patient setting.

Preventing Hypoglycemia in the Older Adult with Diabetes - #65

Managing diabetes in older adults in an outpatient setting.

Preoperative Geriatric Assessment - #64

Establish capacity for consent and the patient’s understanding of the need of surgery.

Acute Management of Behavior Changes in Hospitalized Patients with Dementia - #63

Identify the specific difficult behavior and apply best practice management strategies.

Power of Attorney for Health Care - #62

Define, compare, and contrast power of attorney for health care, surrogate decision maker, and guardian.

Advance Directives - #61

Define advance directives and the components that are commonly incorporated.

Medical Decision-making Capacity Assessment - #60

Determine an older adult’s ability to make medical decisions in a hospital or clinic setting.

Tips for Leading Difficult Family Meetings - #59

Outline standard approaches for planning, leading, and concluding difficult family meetings with strategies for navigating conflict.

Assessment of an Older Emergency Department Patient – 10 Key Points - #58

Master geriatric-specific diagnostic considerations in the assessment of an older adult in the emergency department.

Assessment of Older Adults with Abdominal Pain in the Emergency Department: 10 Key Points - #57

Develop a comprehensive approach to the timely evaluation of older adults with abdominal pain in the ED.

Osteoporosis Treatment - #56

Primary and secondary options for therapy of osteoporosis.

Osteoporosis Screening and Diagnosis - #55

Screening for osteoporosis aims to identify patients at increased risk of fragility fractures who may benefit from an intervention to mitigate that risk.

Acute Ischemic Stroke - #54

Non-contrast CT is the initial diagnostic test to evaluate for acute ischemia and rule out hemorrhage.

Inappropriate Sexual Behavior (ISB) and the Dementia Patient. - #53

Identify and define inappropriate sexual behavior (ISB) in the context of a patient with dementia.

Perioperative nerve injury prevention - #52

Identify causes of anesthesia related nerve injury.

Radiation Therapy in the Management of High Risk Nonmetastatic Prostate Cancer in the Geriatric Population - #51

Describes the role of radiation therapy in the management of high risk non-metastatic prostate cancer.

 

Introduction to Quality Improvement - #50

Understand key concepts in healthcare quality improvement in any setting.

Radiation Therapy in the Management of Low and Intermediate Risk Prostate Cancer in the Geriatric Population - #49

Understand the course of treatment for patients with low and intermediate risk prostate cancer.

Radiation Therapy in the Management of Early Stage Breast Cancer in the Geriatric Population - #48

Assess magnitude of benefit for radiation after breast conserving surgery.

Introduction to Patient Safety - #47

Understand key concepts in patient safety in any care setting.

Assessment and Prevention of Delirium in ICU - #46

Adult ICU patients should be routinely monitored for delirium.

Frailty in the ICU - #45

Frailty assessment of patients at time of ICU admission may be useful in identification of vulnerable elderly patients.

When do I get an echo on my asymptomatic patient with severe aortic stenosis? - #44

This Fast Fact reviews the pathophysiology of severe asymptomatic aortic stenosis and helps determine when to order a Transthoracic Echocardiogram (TTE) for  diagnostic evaluation.

Driving Cessation - #43

Resources available for facilitating driving cessation.

Driving Evaluation Tools - #42

Learn the basic medical requirements for safe driving and the components of clinical evaluation.

Long Term Care Services - #41

Identify and define the options for geriatric living and associated levels of care.

Treating Insomnia - #40

Identify and define treatment strategies for geriatric insomnia patients.

Etiologies of Anemia - #39

Identify and define various etiologies of anemia in older adults.

Evaluating Insomnia - #38

Learn underlying basic science and practical clinical management of insomnia evaluation.

Chemotherapy toxicity - #37

Review toxic affects of chemo therapy on geriatric patients.

Should your patient have that oncology intervention? - #36

Diagnostic testing and treatment are determined based on ability to improve disease process or quality of life/goals of care.

Recognizing and Identifying Elder Abuse & Neglect - #35

Approximately 11.4% of adults over the age of 60 years will experience some form of mistreatment.

Normal Pressure Hydrocephalus - #34

An approach to diagnoses of geriatric patients who have suspected NPH.

Peri-operative Management of Do-Not-Resuscitate Orders in the State of Wisconsin - #33

A summary of the risk factors, incidence, and survival associated with intraoperative cardiac arrest.

Assessing and Managing Low Vision - #32

How to manage patients once it is determined they have low vision.

Basic Assessment of Tinnitus - #31

Initial diagnosis of tinnitus by history and physical exam.

Fluoroscopy - #30

Learn necessary positioning and mobility requirements for geriatric patients undergoing a fluoroscopic study.

Systemic Effects of Ocular Medications I. Glaucoma and Pupillary Dilation - #29

Review systemic effects of ocular medications for glaucoma and pupillary dilation.

Systemic Effects of Ocular Medications II. Age-related Macular Degeneration - #28

Review systemic effects of ocular medications for age related macular degeneration.

Ocular Effects of Systemic Medications - #27

Identify and manage ophthalmic complications of systemic medications.

Should your Patient have that Cardiac Intervention? - #26

Use geriatric assessment tools to determine appropriateness of invasive cardiac interventions.

Home Care Services - #25

Review available home care services and Medicare requirements.

Interpreting Echocardiographic Changes - #24

Learn practical interpretations of echocardiographic changes.

Antiplatelet Therapy in Coronary Disease - #23

Review antiplatelet therapy in coronary artery disease.

Home Safety Evaluation: Can I send this patient home? - #22

How will a home safety evaluation benefit your geriatric patient?

Non-Vertigo Dizziness - #21

Learn a systems-based approach to evaluation non-vertigo dizziness.

Cardiac Causes of Syncope - #20

Review cardiac causes of syncope.

Vertigo and Complaints of Dizziness - #19

Differentiate peripheral and central causes of dizziness.

Cerumen Impaction Management - #18

Practical dosing information for ceruminolytic agents.

Medications in Geriatric Otolaryngology - #17

Review use and side affects of common medications for otolaryngologic diseases.

Falls Risk Factors & Interventions - #16

Identify fall risk factors and common interventions that decrease fall risk.

Fall Etiology and Assessment - #15

Learn to assess multiple factors causing falls.

Assessing Delirium - #14

Identify and assess delirium.

Hypertension - #13

Determine blood pressure goals in older adults and possible medications.

Caution: Perioperative Surgery Medications - #12

Perioperative medication that may increase delirium risk.

Diagnosing Dementia in Acutely Ill - #11

Factors that may be clues to underlying dementia in acutely delirius patients. 

Anticoagulation in the Geriatric Surgical Patient - #10

Review perioperative anticoagulation management of geriatric patients.

Managing Pain in Elderly Rib Fracture Patients (>65 years) - #9

Review an algorithm for pain management of rib fractures.

Laboratory Evaluation of Kidney Function - #8

Review key renal function lab values in a geriatric patient.

Pharmacologic Aspects of Renal Drug Clearance - #7

Review pharmacologic aspects of renal drug clearance.

Initiating Renal Replacement Therapy (RRT) - #6

Consider quality of life assessment in initiating renal replacement therapy.

Etiology of Acute Kidney Injury (AKI) in Hospitalized Patients - #5

Review etiolgies of acute kidney injury in hospitalized patients.

Assessing Gait - #4

Learn practical gait assessment for geriatric patients.

Stroke Impairment & Complications Rehabilitation - #3

Review frequent impairment and complications of acute stroke.

Assessing Post-Stroke Depression - #2

Learn to assess post-stroke depression (PSD).

Assessment of Fall Risk Etiology - #1

Review assessments to consider in evaluating "falls".