The Elm

Interprofessional teams offer a world-class model of care for older adults with complex health needs. In education, multidisciplinary environments enhance cooperation, learning, and satisfaction.

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By Christine R. Valeriann, Nicole Brandt, Nick Kouwenhoven, Daniel Mansour, Diane Martin, and John Schumacher

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Our increased life expectancy is a remarkable public health success. However, we are living longer but not necessarily healthier lives. Despite dramatic increases in longevity over the past century, the portion of life spent in moderate and poor health has not changed.¹ This has serious implications for older adults and those who care for them.

Health and wellness can vary across the human lifespan, swinging like a pendulum between well and ill.² Typically, health needs become more complex as we age, including developing different combinations of chronic conditions, advanced illnesses, disabilities, and psychological/social needs. Older adults may visit several specialists as well as their primary care physician multiple times a year, averaging two primary care providers and five specialists annually.³

Because providers and specialists often operate in silos, they don’t always communicate or share information across networks and systems. Indeed, less than half of primary care physicians knew when specialists changed their patients’ medications or care plans.⁴ Older adults may also receive care from multiple systems (e.g., hospitals, emergency departments, nursing facilities) and experience transitions in care (e.g., to the hospital and back home). This can result in isolated treatment, with no timely or routine notification and no records sharing with primary care physicians.⁴ This disconnected care leads to poorer patient outcomes for older adults with chronic conditions, including increased emergency department visits and hospitalizations.³

Older people may also face barriers like fixed incomes, food insecurity, violence (crime or abuse), and isolation/loneliness, which can limit their access to health care, medication, services, and healthy food. These changing conditions and health needs may cause issues of independence and quality of life for older adults and their caregivers.

Addressing the Needs of Older Adults

Too frequently, care is fragmented, confusing, and not reflective of the needs of older adults. Quality age-friendly care requires the collaboration and communication of multiple health/behavioral health care specialists treating various chronic and advanced conditions. The aging population (plus escalating health care costs) is driving the shift to a more integrated and collaborative model that focuses on the patient and prioritizes the quality of care over the quantity of services.⁵ By bringing together professionals from various disciplines, teams can address the multifaceted needs of older adults, including their physical, cognitive, and psychosocial care.

Interprofessional teams may include members from a wide range of disciplines (Table 1).^6,7,8 Non-clinical staff may be on the team, such as administrators, community workers, counselors, environmental/housekeeping personnel, and receptionists.⁷ Members have clear roles and responsibilities, a shared vision and purpose, and are jointly accountable for ensuring effective treatment and improved outcomes.⁶ The teamwork required to make these collaborations effective is recognized by the World Health Organization as a vital strategy in the delivery of high-quality, coordinated care.⁹ 

Table 1. Disciplines: Interprofessional Team Members

• Audiology
• Nutrition
• Psychiatry/Psychology
• Dentistry
• Optometry
• Social Work
• Geriatrics
• Pharmacy
• Speech-Language Pathology
• Nursing
• Physical/Occupational Therapy

Importantly, older patients are members of the team and encouraged to be active partners in their care. The team also includes the patient’s caregivers, who are a critical component of effective treatment, as they ensure adherence, monitor outcomes, and provide physical/emotional support. Additionally, caregivers can offer unique and important insight based on their personal relationship with the older adult.

The field of geriatrics is known for embracing interprofessional teams, working with families and caregivers, considering all aspects of patient health, and treating older adults as whole people.¹⁰ The “4Ms Framework” is an outgrowth of this collaborative, holistic approach to age-friendly care.⁸ It is an evidence-based framework with four core elements that drives all decision-making: What Matters, Medication, Mentation, and Mobility. When implemented together, the framework makes the multifaceted care of older adults more manageable, organizing care and keeping the focus on the older adult’s wellness and strengths, not solely on disease.⁸ Interprofessional teams are well-suited to this comprehensive, preventative approach to care and are perfectly positioned to help older adults maintain independence and well-being for as long as possible.

Benefits of Interprofessional Teams

Beyond the immediate benefits of more comprehensive and better coordinated person-centered care, patients report higher satisfaction levels with care from teams of diverse professionals.⁹ Research also indicates that interprofessional teams reduce medical errors, improve patient outcomes, and lower overall health care expenditures.⁹ Including pharmacists on the team significantly reduces preventable adverse drug events by as much as 78 percent.⁹ Furthermore, the collaboration, communication, and coordination required of these teams can directly influence quality and safety. Older patients experience a reduced number of days in the hospital under an interdisciplinary model, an average of 1.2 days shorter than in traditional care settings.⁹ Hospitalization often results in functional decline for older adults due to interactions of aging, disease, and hospital factors.¹¹ Shorter hospital stays decrease both the likelihood of functional decline¹¹ and the risk of hospital-acquired infections.⁹ Interprofessional hospital 30-day readmission has also been reduced.^12,13

The benefits extend to the workforce. By fostering cooperation and mutual support, interprofessional teams contribute to a healthier work environment, improve provider satisfaction, and prevent practitioner burnout.⁹ Health professionals also experience enhanced education and bidirectional learning.⁹ Multidisciplinary environments allow for “learning with, from, and about” each other and the sharing of perspectives and processes across disciplines.¹⁴

Training and Programs

As the institution that educates most of the state’s health professionals, the University of Maryland, Baltimore (UMB) has a responsibility to train the workforce to improve the health and quality of life of older adults. UMB offers numerous nationally recognized interdisciplinary research and education programs as well as training opportunities in geriatrics and gerontology at each school. UMB and the University of Maryland, Baltimore County (UMBC) were the first two universities in the state to become members of the Age-Friendly University Global Network. This pioneering network consists of more than 110 institutions on five continents committed to becoming more age-friendly in their programs and policies. Programs taking an interdisciplinary approach to age-friendly principles and age-friendly care include:

The Academy of Lifelong Learning and Aging Forum (UMB) offers multidisciplinary content to inspire, engage, and educate learners from primary school through retirement. Experts from all seven schools answer questions in the Aging Forum on topics like navigating dementia, aging in place, rehabilitation, elder law, and palliative care.

The Center for Community, Innovation, and Aging in the Erickson School of Aging Studies (UMBC) is a transformative hub for applied research, innovation, and community engagement. The center drives evidence-based solutions, fosters interdisciplinary collaboration, and builds sustainable partnerships to enhance the lives of older adults.

The Center for Health, Equity, and Aging is UMBC’s focal point for research on the social dimensions of health, equity, and aging. Housed in the Department of Sociology, Anthropology, and Public Health, the center takes a comprehensive, interdisciplinary approach through qualitative and quantitative research.

The Doctoral Program in Gerontology (UMB and UMBC) is an intercampus, interdisciplinary research degree program and the Mid-Atlantic’s only joint doctoral degree in gerontology.

 The Geriatrics and Gerontology Education and Research Program (UMB) is a state-funded initiative that provides interdisciplinary training for students across the University System of Maryland and beyond.

Leveraging Pharmacists as Age-Friendly 4Ms Champions highlights the role of pharmacists on interprofessional teams to improve the care of older adults and the lives of caregivers. A partnership between the Peter Lamy Center on Drug Therapy and Aging (UMB) and the American Society of Consultant Pharmacists, the program expands the adoption of the 4Ms through medication optimization in various care settings.

The MS in Gerontology (UMB) is an online, flexible program that prepares students with core gerontological knowledge, interdisciplinary learning opportunities, research skills, and specialization options like Applied Thanatology and Social Entrepreneurship.

Leading the Way

Although people are living longer, longer does not always mean better. Many older adults experience complex health issues and fragmented care, which detracts from their quality of life. The current health care system often lacks coordination among providers, leading to poor outcomes like longer and unnecessary hospitalizations.

Interprofessional teams offer a world-class model of care and a collaborative solution by bringing together diverse experts to address the full range of older adults’ needs. UMB and UMBC are leading the way in training future health care professional; developing programs that promote integrated, person-centered care; and creating a more age-inclusive and age-friendly university for students, faculty, and staff.

Authors: Christine R. Valeriann, MS; Nicole Brandt, PharmD; Nick Kouwenhoven, MBA; Daniel Mansour, PharmD; Diane Martin, PhD; and John Schumacher, PhD  

LINKS

Academy of Lifelong Learning and Aging Forum: https://www.umaryland.edu/lifelong-learning/

Age-Friendly University Global Network: https://www.afugn.org/about-us

The Center for Health, Equity, and Aging: https://saph.umbc.edu/chea/

The Center for Community, Innovation, and Aging: https://erickson.umbc.edu/ccia-overview/

Doctoral Program in Gerontology: https://www.graduate.umaryland.edu/gero/

The Geriatrics and Gerontology Education and Research Program: https://www.umaryland.edu/ggear/

Leveraging Pharmacists as Age-Friendly 4Ms Champions: https://www.ascp.com/page/agefriendly

MS in Gerontology: https://www.graduate.umaryland.edu/gerontologyms/

REFERENCES

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8. Institute for Healthcare Improvement. Guide to Using the 4Ms in an Age-Friendly Health System. American Geriatrics Society. Accessed June 19, 2025. https://www.americangeriatrics.org/sites/default/files/inline-files/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf
9. Health in Aging. Tip sheet: The 5Ms of geriatrics. Accessed June 19, 2025. https://www.healthinaging.org/tools-and-tips/tip-sheet-5ms-geriatrics
10. Downers Grove Healthcare Center. The benefits of interdisciplinary teams in health care settings. Accessed June 24, 2025. https://www.downersgrovehc.com/blog/the-benefits-of-interdisciplinary-teams-in-healthcare-settings
11. Mitchell PH, Wynia MK, Golden R, et al. Core principles & values of effective team-based health care. NAM Perspectives. 2012. https://pmc.ncbi.nlm.nih.gov/articles/PMC4422456/
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13. Nall RW, Herndon BB, Mramba LK, Vogel-Anderson K, Hagen MG. An interprofessional primary care-based transition of care clinic to reduce hospital readmission. Am J Med. 2020;133(6):e260–e268. doi:10.1016/j.amjmed.2019.10.040
14. Barr H. Interprofessional Education: Today, Yesterday and Tomorrow. CAIPE; 2002. https://www.caipe.org/resources/publications/caipe-publications/caipe-2002-interprofessional-education-today-yesterday-tomorrow-barr-h