Trustees Can Help Lead the Way to Age-Friendly Health Systems
The greatest success story of the 20th century is longevity. This is especially true in the United States, where average life expectancy at birth rose by more than 30 years between 1900 and 2013.
Our amazing progress in extending lifespans has tracked with a corresponding plunge in America’s birth rate, fundamentally reshaping our nation’s demographics. There are more than 57 million Americans age 65 or over, and that number is projected to climb to about 89 million by 2060.
We face a conundrum: while we revere longevity, we don't display the same level of enthusiasm for actually taking care of older people. America today is a graying society, and 42 million family caregivers of older adults in this country ask, what do I do now? That question urgently needs an answer, or at least plans and policies that lead us in a new direction.
Since 1982, The John A. Hartford Foundation has been a leader in transforming how the care of older adults is delivered. The Foundation has awarded more than $724 million in grants to enhance the health and well-being of older people and today we are the largest foundation solely dedicated to improving the care of older adults in this country. I am enormously proud of that commitment.
Working in close partnership with the American Hospital Association, the Institute for Healthcare Improvement and the Catholic Health Association of the United States, the Foundation has strongly supported the creation and spread of the idea of age-friendly health systems, a vanguard in the effort to ensure older adults receive safe, evidence-based care focused on what matters to them.
The concept of an age-friendly health system rests upon the “4Ms” framework of what Matters — aligning care with each older adult’s specific health outcome goals and care preferences; Medications — using age-friendly medications that do not interfere with other goals; Mentation — preventing, identifying, treating and managing depression, dementia and delirium across settings of care; and Mobility — ensuring that older adults move safely every day to maintain function.
The 4Ms care model addresses not only physical health, but also conditions such as disability, elder mistreatment, loneliness and social isolation, which can impact overall health. The Surgeon General released a warning advisory about the isolation and loneliness last year.
This work aligns with many of the goals of the AHA’s Patient Safety Initiative, a collaborative, data-driven effort that aims to continuously transform and improve the landscape of patient safety for older adults and patients of all ages.
Our aim is to have every care provider become an age-friendly health system. With our partners, the Foundation set a goal of spreading this approach through a thousand sites of care, and today we're at almost 4,000, so that's very exciting. And the reason that the age-friendly idea has spread so quickly not only around the country, but the world as well, is because we're talking about human function.
It doesn’t matter in what part of the country you live, your socioeconomic status or your family makeup. We all want care for our older loved ones that is dignified, compassionate and effective — the same things we want for ourselves when the time comes.
This movement continues to gather steam and now it’s up to all of us to keep the momentum going. Leadership is key to propelling this work, and hospital and health system trustees have a vital role to play, which I know well from my own trusteeship on the board of a health system in upstate New York.
As advisors, we can support the top-down spread of the age-friendly ethos within our organizations and help lead them through the steps that can earn recognition with accreditation and certification.
As trustees, I urge everyone to check the age-friendly status of your organization. If you haven’t already, have your hospital or health system consider joining the tuition-free AHA Action Community, underwritten by our Foundation, that provides access to webinars, coaching and a rich array of learning tools. The next one starts this September.
The changing health needs of our society is not a forecast. The change is already here, and it is up to all of us to transform our approach to health care in ways that recognize this reality and support all of us with age-friendly care as we get older.
Terry Fulmer, PhD, RN, is president of The John A. Hartford Foundation and a trustee of Basset Medical Center.