Defining the Age Friendly Standard
The age friendly standard is not a singular, mandated law but rather a guiding principle and framework used by health systems, communities, and governments worldwide. Its primary objective is to make health services, public spaces, and social environments more accessible, supportive, and inclusive for an aging population. The two most prominent frameworks defining this standard are the Age-Friendly Health Systems initiative and the WHO's Age-Friendly Cities framework.
The 4Ms Framework in Healthcare
The Age-Friendly Health Systems initiative, led by the Institute for Healthcare Improvement (IHI) and The John A. Hartford Foundation, utilizes the 4Ms Framework to deliver high-quality, evidence-based care specifically for older adults. When health systems reliably provide the 4Ms, they ensure that every older adult receives the best care possible, is not harmed by care, and is highly satisfied with their care experience.
What are the 4Ms?
- What Matters: Aligning care with the older adult's health goals and care preferences, including end-of-life care.
- Medication: Reviewing medications to identify and, where possible, reduce or eliminate medications that are harmful or inappropriate for older adults.
- Mentation: Preventing, identifying, and managing dementia, depression, and delirium across all care settings.
- Mobility: Ensuring older adults move safely every day to maintain function and prevent falls.
The WHO Age-Friendly Cities Framework
Developed by the World Health Organization, this framework focuses on the social and physical environment of communities. It proposes eight interconnected domains that cities and communities can address to become more age-friendly. By focusing on these domains, communities can identify and address barriers to the well-being and participation of older people, promoting a sense of inclusion and belonging.
The Eight Domains of the WHO Framework:
- Outdoor Spaces and Buildings
- Transportation
- Housing
- Social Participation
- Respect and Social Inclusion
- Civic Participation and Employment
- Communication and Information
- Community Support and Health Services
The Importance and Benefits of Adopting Age-Friendly Standards
Adopting age friendly standards brings a multitude of benefits for older adults, healthcare providers, and communities as a whole. For older adults, it leads to better health outcomes, increased independence, and a higher quality of life. For healthcare providers, it creates a more efficient and effective care model, which can lead to reduced readmission rates and lower healthcare costs. For communities, it fosters social cohesion, economic participation, and creates more livable and inclusive spaces for everyone, regardless of age.
Economic and Social Benefits
- Increased Independence: By improving mobility and access to services, older adults can live independently for longer, reducing the burden on formal care systems.
- Reduced Healthcare Costs: Proactive management of geriatric syndromes, appropriate medication use, and fall prevention can significantly reduce hospital stays and readmissions.
- Enhanced Community Engagement: Better transportation and accessible public spaces allow older adults to remain socially active, reducing loneliness and isolation.
- Boosted Local Economies: Older adults with greater mobility and engagement contribute more actively to the local economy, both as consumers and potential volunteers or employees.
Comparison of Major Age-Friendly Frameworks
| Feature | Age-Friendly Health Systems (4Ms) | WHO Age-Friendly Cities |
|---|---|---|
| Primary Focus | The health and medical care delivered to older adults in clinical settings. | The broader physical and social environment of a community. |
| Key Components | What Matters, Medication, Mentation, and Mobility. | Outdoor Spaces, Transportation, Housing, Social Participation, Respect and Inclusion, Civic Engagement, Communication, and Health Services. |
| Goal | To ensure all older adults receive evidence-based, high-quality care that causes no harm and aligns with their personal goals. | To adapt urban structures and services to be accessible and inclusive for older adults, enabling their participation. |
| Implementation | By hospitals, clinics, and health systems. | By city planners, public services, and community organizations. |
| Measure of Success | Improved health outcomes, reduced harm, and higher patient satisfaction scores. | Increased social participation, better accessibility, and higher quality of life for older residents. |
How to Implement Age-Friendly Standards
Implementation involves a multi-faceted approach, requiring collaboration across different sectors. For health systems, it requires a commitment from leadership to adopt and embed the 4Ms framework into daily workflows. For communities, it means engaging with older residents to understand their needs and priorities, then developing policies and projects that address the WHO's eight domains.
Practical Implementation Steps
- Assess the Current State: Conduct a baseline assessment to understand existing gaps in care or community infrastructure for older adults.
- Form a Dedicated Team: Establish a leadership committee or team responsible for championing the age-friendly initiative.
- Identify Key Actions: Select specific, measurable actions based on the 4Ms or WHO domains to address the most critical needs.
- Test and Adapt: Start with small-scale tests of new workflows or projects (e.g., a PDSA cycle) and refine them based on feedback.
- Monitor Progress: Continuously collect data and monitor the impact of the changes to ensure they are reliably improving outcomes for older adults.
Conclusion
The age friendly standard represents a vital and proactive strategy for addressing the needs of a rapidly aging global population. Whether through the structured clinical approach of the 4Ms Framework or the comprehensive community focus of the WHO's framework, these initiatives provide a roadmap for creating more inclusive and supportive environments. By prioritizing the unique needs of older adults, health systems and communities can improve not only the lives of seniors but the well-being of all their citizens, building stronger, more resilient societies for the future. For more information on health system implementation, visit the Institute for Healthcare Improvement (IHI).
