The 4Ms: Simplifying complex care decision making for older adults

Medical training focuses on curing or treating as many of a patient's health problems as possible, but in the process of providing complex care for older adults with multiple chronic diseases, it can be easy to lose focus on what outcomes matter most to the patient. The “4Ms” of the Age-Friendly Health Systems Initiative(www.ihi.org) can help guide care and decision making:

• What Matters (What outcomes are most important to the patient?)

• Medication (What are the drug’s side effects?)

• Mentation (Is the patient affected by depression, dementia, or delirium?)

• Mobility (How well can the patient move around?)

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