Optimizing delirium care in the era of Age-Friendly Health System.

Autor: Kwak MJ; Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA., Inouye SK; Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA., Fick DM; Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA., Bonner A; Institute for Healthcare Improvement, Boston, Massachusetts, USA.; Moving Forward Nursing Home Quality Coalition, Washington, DC, USA.; Johns Hopkins University School of Nursing, Baltimore, Maryland, USA., Fulmer T; The John A. Hartford Foundation, New York, New York, USA., Carter E; Division of Geriatric Medicine, Maine Medical Center, Portland, Maine, USA., Tabbush V; Anderson School of Management, University of California, Los Angeles, California, USA., Maya K; Department of Continuing Professional Development, Sutter Health System, Sacramento, California, USA., Reed N; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Waszynski C; Division of Geriatric Medicine, Hartford Hospital, Hartford, Connecticut, USA., Oh ES; Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2024 Jan; Vol. 72 (1), pp. 14-23. Date of Electronic Publication: 2023 Nov 01.
DOI: 10.1111/jgs.18631
Abstrakt: Delirium is a significant geriatric condition associated with adverse clinical and economic outcomes. The cause of delirium is usually multifactorial, and person-centered multicomponent approaches for proper delirium management are required. In 2017, the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) launched a national initiative, Age-Friendly Health System (AFHS), promoting the use of a framework called 4Ms (what matters, medication, mentation, and mobility). The 4Ms framework's primary goal is to provide comprehensive and practical person-centered care for older adults and it aligns with the core concepts of optimal delirium management. In this special article, we demonstrate how a traditional delirium prevention and management model can be assessed from the perspective of AFHS. An example is the crosswalk with the Hospital Elder Life Program (HELP) Core Interventions and the 4MS, which demonstrates alignment in delirium management. We also introduce useful tools to create an AFHS environment in delirium management. Although much has been written about delirium management, there is a need to identify the critical steps in advancing the overall delirium care in the context of the AFHS. In this article, we suggest future directions, including the need for more prospective and comprehensive research to assess the impact of AFHS on delirium care, the need for more innovative and sustainable education platforms, fundamental changes in the healthcare payment system for proper adoption of AFHS in any healthcare setting, and application of AFHS in the community for continuity of care for older adults with delirium.
(© 2023 The American Geriatrics Society.)
Databáze: MEDLINE
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