Southern Maine Health Care has adopted an Age Friendly approach, which considers the 4 Ms – what matters, mobility, mentation and medication – when caring for older patients. Courtesy Photo/Southern Maine Health Care

BIDDEFORD — Dr. Shirley Frederick has been practicing medicine in Maine for 30 years, and while she takes care of a range of people from birth on up, she said she’s seeing many of her patients are approaching their older years.

About two years ago, Frederick started looking at another model of treating patients — the age friendly model.

What does that mean?

“It’s a shift in my thinking,” said Frederick. “It’s finding out what the patient’s goals and plans are, and it’s making a big difference.”

Frederick used high blood pressure as an example. If your medication makes you dizzy, maybe your blood pressure doesn’t have to be at the 120/70 “gold standard,” she said.

“Perhaps you’re dizzy at that number. Maybe 140/80 is fine for you,” said Frederick.

At the same time, Southern Maine Health Care has adopted an age-friendly approach with the Hospital Elder Life Program, designed to make a hospital stay the best it can be. It is the first step toward a geriatrics program at SMHC, said Molly Anderson, who manages the geriatrics program at Maine Medical Center and coordinates with SMHC’s Elder Life Specialist Chesley Ferris.

One way they’re doing that is keeping in mind the four Ms — what Matters, Medication, Mobility and Mentation, or memory and mood.

Maine’s older adult population — those 65 and older — will comprise nearly 30 percent of the total population by 2040 compared to 20 percent nationwide, according to a 2020 Maine State Plan on Aging Needs Assessment prepared by the Muskie School of Public Service and Cutler Institute for Health and Social Policy.

Maine’s median age is currently just over 45. By 2040, it is expected to be 47.

SMHC is among 16 hospitals, medical practices, walk-in clinics and nursing homes that have joined age-friendly health systems, receiving funding funneled to them from the John A. Hartford Foundation, through the Institute for Health Care Improvement in Boston, the American Hospital Association and the Catholic Health Association of the United States.  The COVID-19 pandemic, according to the Hartford Foundation, has increased the urgency among health care systems in general to prioritize age-friendly care.

The growth of age-friendly care movement means that older adults in Maine have a better chance at receiving high-quality, evidence-based care that is tailored to what matters most to them, said John A. Hartford Foundation President Terry Fulmer.

“It takes a special group to step up and do the work,” said Fulmer in a telephone interview from the foundation headquarters in New York. “It really is an incredible testament to the organizations in Maine, a true commitment to the community.”

At SMHC, one example of age friendly care for someone who is hospitalized is keeping an eye on delirium and risk factors associated with it. Pre-pandemic, the hospital had been utilizing trained volunteers to visit with hospital patients for 30 minutes, once or twice a day — an extra set of eyes and ears. SMHC hopes to resume the volunteer program sometime this year.

“We’re very excited,” said Ferris.

The age-friendly, “what matters” 4Ms approach is also making its way to other patients.

“It does carry over into the younger population as well, because once you talk about goals and plans and how mobile they are and wish to be, the lines between a 64-year-old and 65-year-old blur,” said Frederick, who practices in Sanford. “And when a 25-year-old comes in, I find myself asking (the same questions). It really is across the spectrum, very helpful. It’s a paradigm shift and I think medicine in general needs to look at.”

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