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In This Episode:
Dr. K talks with Dr. Stephanie Rogers, MD MPH, about creating Age-Friendly Health Systems at UCSF, and the specific programs they’ve developed to make hospitalization safer and better for older adults. They discuss:
- What are Age-Friendly Health Systems, and why do older adults need them?
- Why Age-Friendly Health Systems emphasize the “4 Ms”: mobility, mentation, medications, and what matters
- How an Age-Friendly Health System differs from usual healthcare
- Why hospitalization is often so risky for older people
- What are Acute Care for Elders (ACE) units and how they help prevent problems such as falls, delirium, and loss of independence
- How UCSF’s Hip Fracture Co-Management Service provides better care and improves recovery
- UCSF’s Delirium Reduction Campaign, which uses a tool called “AWOL” to check every hospitalized patient for delirium
- How delirium can be prevented, and what UCSF recommends that families do
- How UCSF uses Patient and Family Advisory Councils to improve care
- How to find an Age-Friendly Health System near you
Related episodes:
039 – Interview: Creating Age-Friendly Health Systems
062 – Interview: Preventing Hospital Delirium & Maintaining Brain Health
Related Resources:
- About Age-Friendly Health Systems:
- UCSF Geriatric Inpatient Services:
- Welcome to UCSF’s Acute Care for Elders Unit
- UCSF Hip Fracture Protocol
- UCSF Delirium Reduction Campaign (includes information on how families can help!)
- About UCSF’s “AWOL” Delirium Screening Tool
- Related articles on Better Health While Aging:
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Doug Jones says
Hi Dr. Kernisan, Thank you for this very informative Podcast with Dr. Stephanie Rogers about
creating an Age Friendly System at UCSF. I can see how, any older adult, being fortunate enough to be treated in an Acute Care for Elders (ACE) Unit could experience a huge quality of life difference, during and after their hospital stay. I remember that when Cindy and I was serving as Caregivers for our Moms a few years ago, the treatment and discharge protocol was far from the one described here.
With hospitals implementing the Age-Friendly Health System and focusing on the “4Ms” – care during the stay and quality of life after hospitalization, should be much better for our older adults.
My question is: If I understood her correctly, Dr. Rogers stated that an older adult with a hip fracture could be expected to live a year after suffering the fracture. Is this with this with traditional treatment and therapy or with the treatment and therapy such as described in this podcast?
Leslie Kernisan, MD MPH says
Thank you for this comment, I’m so glad you found the episode helpful.
Hip fracture is generally associated with a significant increase in the risk of death within the following year. But most older adults don’t die within the year after hip fracture. The actual death rate during the year post hip fracture depends on the population being studied; in this study of adults aged 65+, it was 27%.
Now, being sick and frail or in dwindling health certainly puts one at risk for hip fracture, and those people are more likely to die within the following year. So I think Dr. Rogers meant to convey that when an older person is hospitalized for hip fracture at UCSF, the team will consider the person’s health prior to the fracture and then will advise the patient and family, if it looks like this person is at high risk for dying within a year.
The improved hip fracture programs described by Dr. Rogers probably do improve outcomes, but my guess is that the relevant research studies won’t be completed and published for a few years yet. (They take a while to organize, conduct, and write up.)
For more on prognosis and estimating life expectancy, I recommend the podcast episode with Dr. Sei Lee:
071 – Interview: How Estimating Life Expectancy Helps Older Adults Get Better Care