1. Creating an Age-Friendly Health System
Dr Kathleen Brasher

2. A world in which everyone can live a long and healthy life

6. Aligned to the needs of older people
Part of an age-friendly environment

7. Why do we need an age-friendly health system?

8. Health in later life is complex
Multiple long-term health conditions
Physical changes with growing old
Individual effects of long-lived life

9. Health in later life is complex
Health is connected to wellbeing -
Impact of age discrimination Loss of social contacts can lead to loneliness
Housing and transport

10. Health services Designed to cure
Patients treated by single disease state
Multiple points of care

11. Health services Older people are: Hospitalised unnecessarily
Have higher lengths of stay & rates of readmission
Significant decline in their own abilities
More likely to experience hospital-related harm

13. To ensure the positive contribution of older people

14. Remain in the workforce

15. Provide care to family and neighbours

16. Provide social services as volunteers

17. Continue to develop their own lives

18. What is an Age-Friendly Health System?

19. An Age-Friendly Health System
Is one that will measurably improve the quality of care for older adults, and optimise value for the health system.
IHI, 2016

20. In an Age-Friendly Health System
Older adults get the best care possible;
Healthcare-related harms to older adults are dramatically reduced and approaching zero;
Older adults are satisfied with their care; and
Value is optimised for all — patients, families, caregivers, health care providers and health systems

21. Creating an Age-Friendly health system
Physical environment
Social environment
Providing clinical care
Health system

22. Creating an Age-Friendly health system
WHO Integrated care for older people 2017
WHO World report on ageing and health 2015
WHO Age-friendly Primary Health Care Centres Toolkit 2008
Goodwin N, Sonola L, Thiel V, Kodner D. Co-ordinate care for people with complex chronic conditions The Kings Fund ; London; 2013
Institute for Healthcare Improvement

23. 1. Physical Environment Buildings and services are accessible
Transport and parking are close by
Access audits are undertaken regularly

24. 1. Physical Environment Signposting is clear
Buildings and services are easy to navigate or a support person is available to assist

25. 1. Physical Environment There is adequate seating, heating or cooling
Toilets are accessible and clean

26. 2. Social Environment Older patients are respected
Designated care coordinator
Regularly consulted by health services

27. Communication Face to face Separate activity from conversation
Allow more time in general the older/frailer the person
Include family or carer if possible

28. Communication Listen first
Start with the knowledge, ideas, questions of the older person
Use humour (with care)

29. 2. Social Environment
Appointments are at times convenient for older people
Services needed are integrated and coordinated

30. 2. Social Environment When providing information
Use clear simple language
Avoid jargon
Start from specific to general
Be culturally sensitive

31. 2. Social Environment When providing information
Single point of contact if possible
Match written information with verbal
Follow up within a week
Involve family or carers

32. 3. Providing clinical care
The 4 Ms
What matters
Mobility
Medication
Mentation

33. What Matters Know what matters - What are their health goals?
What are their care preferences - now and in the future?
Do they have an end-of-life plan?

34. Are you able to act on what matters for your patients?
What gets in the way?

35. Mobility Implement an individualise mobility plan
Create an environment that enables mobility

36. Medication Implement a standard process for medication reconciliation
De-prescribe and adjust medication to be age-friendly

37. Mentation Ensure adequate hydration, nutrition, sleep and comfort
Engage and orient to maximise independence
Identify, treat and manage dementia, delirium and depression

38. 4. Health System Staff education and training includes
Communication with older people
Normal ageing
The 4Ms

39. Staff have core competencies for working with older people
4. Health System
Indicators and data in place to monitor health status, quality of life, and hospital outcomes for older people
Financial mechanisms in place to ensure older people can afford medicines, safe housing and adequate nutrition
Staff have core competencies for working with older people

40. How will we know if we have an Age-Friendly health system?

41. An Age-Friendly Health System
Provides the care and treatments best suited to older people
Provides integrated care
Lowers costs through preventable health care

42. An Age-Friendly Health System
Respects and values older people for who they are