As the aging population in the United States grows, UMB and UMMC are focusing on age-friendly practices and philosophies to support healthy aging in their patients and workforce.
In the United States, we are living longer than ever before — that’s good news!
But it also means that organizations, resources, services, and other aspects of our society must adjust to support, engage, and promote optimal aging for a growing population of older adults.
By 2030, Maryland is projected to be home to nearly 1.7 million people 60 and older, up from approximately 1.4 million in 2020. Demographic data indicates that people older than 85 are the fastest-growing segment of our population. This demographic shift underscores the need for comprehensive, coordinated, patient-focused services and high-quality health care.
This is of particular importance at the University of Maryland, Baltimore (UMB), where health care is a primary focus of teaching, learning, and working, in collaboration with the University’s academic-hospital partner, the University of Maryland Medical Center (UMMC).
To that end, in 2019, UMB earned designation as an Age-Friendly University (AFU), which indicates that the University has met the 10 AFU principles, committing itself to a culture of age-inclusivity in its programs and policies. UMB’s eight-member AFU Steering Committee includes two UMSON faculty members: Elizabeth Galik, PhD ’07, CRNP, FAAN, FAANP, professor and chair, Department of Organizational Systems and Adult Health; and Barbara Resnick, PhD ’96, RN, CRNP, FAAN, FAANP, professor; Sonya Ziporkin Gershowitz Chair in Gerontology; and co-director, Biology and Behavior Across the Lifespan Organized Research Center.
“The AFU principles give the institution a valuable guiding framework for distinguishing and evaluating how it can shape age-friendly programs and practices, as well as identify gaps and opportunities for growth,” says Resnick, who is nationally and internationally recognized for her research and scholarship focused on the care of older adults with regard to optimizing health, function, and physical activity. She is also a member of an interprofessional team of faculty and UMMC employees involved in the hospital’s efforts to provide high-quality care to an aging population, recognized in May 2021 by UMMC’s designation as an Age-Friendly Health System (AHFS) participant. The initiative focuses on delivering care according to the 4Ms:
- What Matters: aligning care to what matters most to the patient
- Medications: using age-friendly medications, when necessary, that do not interfere with what matters to the older adult
- Mentation: preventing, identifying, treating, and managing delirium
- Mobility: ensuring that older patients move safely every day to maintain function and do what matters
When implemented together, Resnick says, the 4Ms represent a broad shift by health systems to focus on the needs of aging adults.
“We hope to bring the UMB and UMMC age-friendly efforts together by engaging University faculty and students in the age-friendly activities at the University of Maryland Medical System,” she adds.
One such student is Anissa Nahabedian, MS ’17, RN, AMB-BC, NPD-BC, CNL. As a student in the Doctor of Nursing Practice Post-Master’s option, she became involved as part of her doctoral studies. “I have an interest in educating others about the older adult population and mitigating caregiver burden,” she explains. The goal of involving students in the age-friendly efforts is to meet the complex needs of older adults by educating a diverse interprofessional team of health care providers prepared to enter the workforce with the knowledge and skills to promote healthy aging. Nahabedian has worked with faculty mentors University-wide to create an AHFS Trainee Initiative that outlines a structured process for interprofessional team members/trainees to develop quality improvement initiatives incorporating the 4Ms. Nahabedian’s doctoral project specifically focuses on the “What Matters” aspect of the 4Ms. She has reviewed curricula related to healthy aging, while other trainees have investigated topics such as food insecurity, the need for dental care in underserved communities, and social isolation related to older adults.
“This has been an incredible opportunity,” Nahabedian says. “I learn from each team member and feel extremely fortunate to be a part of such a dynamic, informed team of leaders. I have learned a lot about the older adult population and the impact of age-friendly efforts on the University and hospital sides, such as shifting our language from ‘elderly’ to ‘older adult,’ looking at our environment to ensure the campus is age friendly — Are there ramps, signage, font size on websites, etc.? — and examining campus engagement of older adults, including what types of courses are available and what the demographics are.”
The importance of these efforts is paramount from social and administrative perspectives, Resnick says, as the number of older adults in communities across the United States is growing annually at unprecedented rates.
“The focus on aging is critical, as we have an increasing number of consumers who are older adults using the health care system, and being age-friendly can help not only to improve quality of care and patient satisfaction, it has the potential to decrease costs, shorten lengths of stay, and decrease rehospitalizations,” Resnick explains.
Nurses, in particular, play a pivotal role in moving age-friendly practices forward. “Nurses provide holistic care and spend the most time with patients at the bedside,” Nahabedian says. “We are also their advocates, coordinators of care, and we often communicate with team members and family members. Nurses will be the ones driving the implementation of the 4Ms.”
And for the University’s part, the AFU designation is a workforce issue and an ongoing process. “We have a large and growing aging faculty and staff and a need to retain the knowledge that older employees bring to the University,” Resnick says. “We also need to increase our focus on research that addresses aging issues and makes the University environment one that older individuals can navigate safely and want to come to for research and other learning activities.
“We have learned much by pulling together individuals and resources across the campus and health care system that focus on these initiatives and helping to assure they are successful.”