Age-Friendly Health Systems and Care

Age Friendly Health Systems is an initiative of the John A. Hartford Foundation and Institute for Healthcare Improvement in partnership with the American Hospital Association and Catholic Health Association of the United States.  The initiative is based on the rapidly growing number of older adults nationwide who experience a disproportionate amount of harm while in the care of health systems.  The growing social movement is guided by four elements of high-quality care known as the 4Ms: What Matters, Medications, Mobility, and Mentation (including dementia, delirium and depression).  The framework shifts the focus from disease-focused care, “What is the matter? to person-centered care, “What matters most when you think about your health and healthcare?”

Brief training materials, links to expert resources, and information about upcoming events are provided to help advance the adoption of the 4Ms framework by health systems and practitioners, and also support older adults and their family member to demand the 4MS as the standard of care. 

Csomay Center has partnered with the University of Iowa Carver College of Medicine Division of Continuing Medical Education (CCOM CME) to deliver this talk to be able to offer continuing education credits. To access this talk for credit, you will need a CCOM CME account, which takes just a couple of minutes to create. This one-time registration allows you to access these courses anytime and saves your progress if you are not able to complete a talk in one sitting. Details can be found in the course listings on the CCOM CME site. After creating an account, you will need to direct yourself back to the course listings under Online courses, scroll down to the talk, and register.

Click here to be redirected to the COM CME course webpage

Training Materials

Age Friendly Overview

This program introduces the Age Friendly Health Systems social movement and 4Ms framework for care and treatment of older adults. What Matters, Medication, Mobility, and Mentation, including Dementia, Delirium, and Depression are briefly reviewed.

What Matters

What Matters most to older adults, their healthcare goals and preference, guides care and treatment. This program discusses best practices to identify and use the person’s health priorities and goals to guide care and treatment.

Mentation: Dementia

Dementia may (or may not) impact the person’s ability to participate in discussions about What Matters. This program reviews brief cognitive assessments and discusses the importance of engagement and person-centered decisions and care.

Mentation: Delirium

Distinguishing delirium from dementia is critically important given common overlaps in symptoms. This program introduces delirium screening tools and easy-to-use interventions to address acute confusion.

Mentation: Depression

Clinical depression symptoms are too often masked or misunderstood as “understandable” parts of aging. Using assessment tools to document symptoms and act on depression using simple interventions is reviewed.


Using Age Friendly Medications means avoiding drugs that are known to cause adverse effects in older people, and also deprescribing medications to address the older person’s health priorities, or What Matters. Key resources and approaches are reviewed.


Doing What Matters often relies on mobility, but medications and other health care practice interfere with mobility. This program reviews, screening tools to document possible needs for physical therapy or activities, and supports safe daily activity for all older adults.


Age-Friendly and Dementia Friendly Social Movements

Important national and international social movements are working to advance quality of living for older adults, including both Age-Friendly Health Systems and Age-Friendly Communities, and Dementia Friendly Communities. This program provides a brief overview of each movement to help learners understand similarities and differences, and in turn, best support care and community-base initiative to advance adoption.

Additional Resources

We gratefully acknowledge support of the Health Resources and Services Administration (HRSA) Iowa Geriatric Workforce Enhancement Program (GWEP), project #U1QHP28731; primary care partners that are adopting the 4Ms in their health system and/or practice, including Jefferson County Healthcare, Fairfield, IA; Eastern Kansas Veteran’s Administration Health System, Topeka, KS; College of Nursing Faculty Practice leaders who are advancing 4Ms care in senior living settings where they practice; and both the J.A. Hartford Foundation and IHI for their support of the social movement and linkages to their resources.