Best Practices for Improving Patient Outcomes in Older Patient Population - Episode 1
Stephanie Chow, MD, MPH: The role of a geriatrician in the community is very important. Because there are not enough geriatricians to serve the growing population of older individuals in the United States and in the world, it’s important for geriatricians to be good communicators, especially good teachers, in the care of older individuals.
A geriatrician needs to be able to work with a good interdisciplinary team, to be able to share ground with multiple specialists and have a lot of well-rounded conversations on how to best care for the older population. It is also important for geriatricians to be leaders in the thoughts of constructing the new health system—building new models of care in the inpatient and the outpatient settings—to better achieve the highest quality of care for our aging population.
There are really not enough geriatricians and individuals trained in the care of older individuals to meet the needs of the growing population of older individuals. We definitely need more geriatricians, geriatric nurses, social workers, psychiatrists—everything in the realm of geriatrics.
As a geriatrician looking at the needs of our older population, I feel that our country hasn’t caught up to the needs as they stand. We need structures of models of care of inpatient and outpatient clinics that can take into account the growing complexity of these older individuals who are living longer with more comorbid conditions. They are increasingly wanting to live in the community, and they want to maintain their independence. Their access to transportation is something that is really difficult, especially in New York City. Their access, or their ability to receive care—caregivers, this is another realm where we are struggling to find support. If an individual doesn’t have family or relatives or friends, the home health aide, the community, the caregiver community, that is also something that needs to be addressed. Access to nutrition and meals. Access to help with finances and how to handle other matters that an individual, as they get older, may have more difficulty with managing. All these kinds of support, social support, social determinants of health, in addition to the medical needs, are things that we really have to catch up with in order to serve our older generation in the highest-quality way.
One way the American Geriatrics Society and geriatricians are trying to promote the knowledge of what it is to be a geriatrician is by creating the 5Ms of geriatrics. These 5Ms are: mind, mobility, multicomplexity or multimorbidity, medications, and what matters most to the patient. And so using these 5Ms is a way for geriatricians to illustrate how they might go through the discussion of an older individual and meet all the basic needs in managing their medical and social care.
Transcript edited for clarity.