North Carolina Hospitals Embrace Age-Friendly Care: What You Should Know

UNC Hospitals incorporated age-friendly services such as having a geriatric specific pharmacist oversee medications for older patients.Photo byUNC School of Medicine

North Carolina's population of adults 65 and older is projected to grow by 50% over the next two decades, from 1.8 million in 2023 to 2.7 million by 2040 according to state data.

This aging population will require more care, prompting a new federal rule from the Centers for Medicare and Medicaid Services (CMS). Starting in 2025, hospitals must report whether they have "age-friendly" protocols in place.

The age-friendly initiative is based on the Institute for Healthcare Improvement's "4Ms" framework:

• What Matters
• Medication
• Mentation
• Mobility

This approach emphasizes patient-centered care, including addressing health care goals, managing medications, assessing mental status, and improving mobility. Hospitals must also demonstrate age-friendly leadership.

Implementing these principles will require hospitals to adjust their practices. Some North Carolina hospitals have already started, and many are working on further changes to comply with the new rule.

Jennifer Szakaly, CEO of Caregiving Corner, believes that making hospitals more age-friendly could significantly improve services for older adults. She highlights the importance of addressing issues like medication management and fall prevention, which are common problems for older patients in hospitals.

Hospitals like WakeMed, Duke Health, and UNC Health are already incorporating age-friendly measures, such as using age-appropriate medication dosing and screening for delirium. Duke Health has also introduced an age-friendly executive steering committee to guide these efforts.

Age-friendly care requires interdisciplinary teamwork, involving doctors, nurses, and therapists. The goal is to integrate these practices into existing workflows, making it easier for providers to deliver high-quality care without additional burdens. The CMS measure is seen as a step towards improving care for older adults, with the hope that it will lead to better performance and outcomes in the future.