Thanks to breakthroughs like improved sanitation, pacemakers, dialysis, and antibiotics, older adults now live longer than any previous generation — a testament to the power of public health and modern medicine. This extended lifespan is one of humanity’s greatest achievements. For many older people, however, a longer life doesn’t necessarily lead to a better life, especially if they can’t find age-friendly care that appropriately respects and supports their goals, values, and preferences.
Today, many older adults find themselves facing a distressing disconnect between the potential of a longer life and health care’s ability to support it. A recent study by Age Wave and The John A. Hartford Foundation underscores this concern: Only 1 in 10 older adults feel that the U.S. health care system deserves an “A” grade, and a staggering 82% believe it’s unprepared to meet the evolving needs of our aging society.
According to the study, older adults today confront a system that, despite its advancements, often falls short on critical fronts: cost, accessibility, and, frequently, empathy. Many people worry about how they’ll pay for necessary long-term care and whether their providers truly listen to them.
Age-friendly care is an approach that focuses on what matters to older adults. Research shows that older adults who receive age-friendly care report better relationships with their health care providers and better health. Today, more than 4,500 care settings across the country offer age-friendly care, and more providers are joining the movement every day.
At the heart of age-friendly care are the "4Ms," a framework that can guide older adults and clinicians alike:
What Matters. Knowing what’s truly important to someone as they age, and recognizing those priorities may change.
Medication. Closely managing and keeping track of medications, making sure they are safe to take together and that their side effects do not interfere with what matters.
Mind. Taking steps to maintain brain health and monitoring for mood and memory concerns.
Mobility. Staying active and engaged.
Older adults say they want clinicians who understand them as individuals and who ask, “What matters to you?” rather than just “What is the matter with you?” This shift from transactional to truly relational care is crucial to creating a health care system that respects, and reflects, the unique journey of aging. A 65-year-old focus group participant said, “I feel healthy when I feel alive, and that’s not just physical health, but feeling emotionally stable, feeling a sense of purpose, feeling that I am here for a reason.”
There are resources to locate age-friendly providers and to bring to appointments. If such care isn’t available nearby, ask a provider why — it’s a conversation worth having.
Older adults across the United States say they find health care to be costly, confusing, and unresponsive to their needs — but it doesn’t have to be this way. This is a call to action for all — patients, families, and health care providers alike — to advocate for a system and future that is truly age-friendly.
Terry Fulmer, PhD, RN, FAAN, is the president of The John A. Hartford Foundation in New York City, a foundation dedicated to improving the care of older adults.
For more information about how older adults view health care, visit johnahartford.org/crossroads. To learn more about age-friendly care and where to get it, visit johnahartford.org/agefriendly.
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