The 5Ms Of Geriatrics

Even though people all over the world are living longer and healthier lives, our health can change over time because of the different conditions and concerns we may face. Many of us, especially as we reach our mid-70’s and beyond, may develop different combinations of diseases, health conditions, and disabilities. Our health needs become more complex as we get older, and what matters most to us may vary also.

Geriatrics healthcare professionals, like geriatricians and many others who have advanced training in the care of older adults, can play an essential role in diagnosing and managing these conditions and health needs based on what matters to each person. Geriatrics providers focus on 5 key areas, known as the Geriatric 5Ms*. The “Ms” stand for the targets that are important to care for us all as we age.

Geriatric 5MsFocus Areas

MIND/MENTATION

• Maintaining mental activity

• Helping manage dementia (a decline in memory and other mental abilities that make daily living difficult)

• Helping treat and prevent delirium (an abrupt, rapid change in mental function that goes well beyond the typical forgetfulness of aging)

• Working to evaluate and treat depression (a mood disorder that can interfere with all aspects of your daily life)

MOBILITY

• Maintaining the ability to walk and/or maintain balance

• Preventing falls and other types of common injuries

MEDICATIONS

• Reducing polypharmacy (the medical term for taking several medications)

• De-prescribing (the opportunity to stop unnecessary medications)

• Prescribing treatments exactly for an older person’s needs

• Helping build awareness of harmful medication effects

MULTI-COMPLEXITY

• Helping older adults manage a variety of health conditions

• Assessing living conditions when they are impacted by age, health conditions, and social concerns

MATTERS MOST

• Coordinating advance care planning

• Helping manage goals of care

• Making sure that a person’s individual, personally meaningful health outcomes, goals, and care preferences are reflected in treatment plans

The Team Approach

Geriatrics also is known for its team-based approach to caring for older people and working with families and other caregivers. The geriatrics care team may include (but is not limited to) any or all of the following professionals:

• Geriatricians

• Nurses

• Nurse practitioners

• Physician assistants

• Social workers

• Consultant pharmacists

• Nutritionists

• Physical therapists

• Occupational therapists

• Speech and hearing specialists

• Psychiatrists

• Psychologists

These professionals evaluate an older adult’s medical, social, emotional, and other needs. The team also helps manage multiple chronic conditions and medications and focuses on health concerns common in older people, such as falls, memory concerns, and incontinence (inability to hold urine or feces).

Geriatrics team duties include:

• Evaluating a person’s social supports and living situation

• Considering the person’s ability to perform daily activities such as bathing, dressing, and eating

• Giving special attention to personal preferences and values when it comes to planning our care

When to Consult a Geriatrics Health Professional

Consider consulting a geriatrician or other geriatrics healthcare professional when:

• You or an older person you know has health conditions that cause significant impairment or frailty. Impairment most often occurs when people are over the age of 75. Older adults who benefit most from geriatrics expertise typically have a number of diseases and disabilities, including cognitive (or memory) concerns.

• Family members and friends are under significant stress as caregivers.

• You, an older person you know, or their caregivers have trouble following complex treatments or managing relationships with many healthcare providers for multiple health conditions.

© Frank Molnar & Allen Huang, University of Ottawa; Mary Tinetti, Yale University