Living Longer and Quality of Life: Know the “High Five” of Geriatrics

seniorwomanandnursegivinghighfiveinnurseryhome
People are living longer, which means more older adults are dealing with ongoing, or chronic, health conditions.
seniorwomanandnursegivinghighfiveinnurseryhome

People are living longer, which means more older adults are dealing with ongoing, or chronic, health conditions. Many now face needs that include taking additional medications, support for physical disabilities, mental health issues and having to make difficult decisions about care.

Geriatricians, doctors who specialize in the care of older adults, have a new way to help approach these challenges—the 5Ms, also known as the “High Five” of geriatrics. It’s a health-care checklist for doctors and it focuses care on five, key areas: Mind, Mobility, Medications, (What) Matters Most and “Multicomplexity.” Doctors use these categories of care to evaluate a patient’s needs and create the right approaches to care. Here’s what each category covers, so you can be informed about your care or that of someone you help care for.

Mind

The ability to think changes as we age. It is important for older adults to maintain mental activity and continue to learn new skills. Doctors evaluate patients for depression, anxiety and dementia to see how their minds may have been impacted over time. A visit to a neurologist, psychiatrist, or neuropsychiatrist might be needed. If a patient is found to be acutely ill, the individual is also checked for delirium (an abrupt change in mental function). Once all the appropriate evaluations related to mental health are completed, the proper treatment is prescribed.

Mobility

Staying active as we age is essential to mobility since it helps preserve the ability to walk and maintain balance. There are several conditions, such as arthritis and Parkinson’s disease, that can affect this. If an issue is identified, an older adult may be provided with mobility aids, as well as exercises to improve their physical activity and to help prevent falls or other injuries. Physical and occupational therapists might be needed. It is important that proper attention is given to this category of care because mobility loss can lead to other health problems, loss of independence, and erode one’s quality of life.

Medications

As we get older, most of us will take medications for our increasing health problems, including over-the-counter medications and supplements. It is important to have these regularly reviewed by a doctor. That way, medications that are no longer needed can be stopped, and the doctor can continually assess the possible side effects of taking multiple medications. The harmful effects could include impacts on mobility and mind.

(What) Matters Most

What a patient wants matters. If someone becomes too ill to make decisions or manage personal affairs, it’s important to have a designated power of attorney to share care goals and preferences. A doctor who follows the 5Ms, will consider what is most important to each patient. That way, they can ensure that all treatment plans are in alignment with those preferences. Finally, your preferences may change over time so they should be reviewed regularly. That way, any needed adjustments can be made.

Multicomplexity

The care for older adults is complex at times. Therefore, doctors following the 5Ms consider how the various treatments may impact each other and overall health. Standard approaches to treatment might not always be the best for a particular patient, so ensuring all aspects of care are properly considered can help improve your overall health.

Considering care options

Geriatrics health-care professionals play an essential role in the diagnosis and management of conditions and overall care needs based on what matters to each older adult. Generally, people age 75 or older with a number of diseases and disabilities, including cognitive concerns and frailty, may benefit from a geriatrics consultation. If you or your family find it necessary to see a geriatrician, knowing the 5Ms can help improve your care experience.

 

Wynnelena C. Canio, M.D., is the chief of geriatric medicine and the continuing care department at Kaiser Permanente Santa Rosa.

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