Age-Friendly Health Systems: Care That Matters—and Keeps You Mobile

When it comes to keeping people safe and healthy as they age, there is no one-size-fits-all-solution. But one thing is clear: to meet the distinctive needs of this fast-growing population, we must tailor care to their needs and preferences.

Burke Rehabilitation is part of the nationwide Age-Friendly Health Systems Initiative*, which addresses critical gaps in care for older adults by focusing on what matters most to them. Rather than centering care on the disease, the initiative centers care on each person’s goals and abilities, to foster dignity, independence, and quality of life, says Dr. Malav Shah, Director of Inpatient Orthopedic and Limb Loss Rehabilitation Medicine at Burke Rehabilitation Hospital.

The initiative follows what we call the 4Ms Framework to address the unique needs of older adults, including:

• What Matters—We understand and act on each older adult’s specific health goals and care preferences, ensuring that care aligns with their life priorities. This can vary from wanting to remain active, travel, and play with grandchildren to wanting to sit in a favorite chair and watch the football game on TV without pain.
• Medication—The vast majority of older Americans take medication, and many take five or more medications. Age-Friendly Health Systems like Burke optimize each patient’s medication use to avoid harm, focusing on medications that align with the older adult’s goals and evidence-based care while minimizing side effects.
• Mentation—Paying attention to the older adult’s ability to engage with the world around them, we identify and address cognitive impairments, depression, and delirium to support mental and emotional well-being.
• Mobility—We help older adults maintain or improve functional ability by ensuring they move as safely and independently as possible.

Spotlight: Maintaining Mobility

As we enter the snowy winter season, we talked to Dr. Shah for tips on the last M, Mobility, which plays a central role in independence and well-being as people age. At the heart of mobility is falls prevention, including these areas of focus to stay safe:

Your surroundings

A clear path to falls prevention is a clear path. Inside the house, remove clutter as well as tripping hazards such as moveable rugs and mats. Handrails and good lighting complete the safety picture.

Outside, wintertime can amplify fall risk for people of any age but especially for vulnerable seniors. So keep paths shoveled and salted (do not do this yourself, but make sure you have an arrangement in place, ideally before winter). And make sure you have adequate lighting and handrails where needed.

Your footwear

Good shoes go a long way towards keeping you upright, and winter demands non-slip soles with good traction. Make sure you have non-slip soles on your footwear inside, as well; avoid stocking-feet and slippers with no traction.

Your stability and balance

Strength and balance are core to preventing falls. Tai Chi, seated yoga and Pilates for seniors are a few good ways to keep your core strong and your balance on point. Many such programs are available online (including at Burke) or in the community, including at senior centers.

Your points of contact

Assistive devices such as walkers, canes or trekking poles can be game changers. When you stand, you have two points of contact (two feet) with the ground. When walking, one foot is always off the ground, so you only have one point of contact. “With a walker, suddenly you have five or six points of contact with the ground, so your ability to remain stable is multiplied greatly,” notes Dr. Shah

Your team

At Burke Rehabilitation, a patient’s informal caregivers such as family and friends are an essential part of the rehabilitation journey. They are also important in the prevention journey. Encourage family members to learn alongside you to help you stay strong and healthy and keep your inside and outside space safe.

Your safety net

At Burke, our social work teams who prepare patients to transition home from the hospital pay special attention to creating a safety net in the home, especially for older adults who live alone. Work with your care team to have and program the appropriate alerts, which could include wearables or voice-activated devices.

Promoting Independence Across the Continuum

While “rehabilitation” is right there in our name, Burke Rehabilitation, we are committed to the continuum of care, including working with individuals and communities even before they need our interventions—highlighting prevention of illness or injury along with delivering care along the entire physical rehabilitation journey.

“We give tips and tools for patients at all ages and different levels of physical and mental status to avoid getting hurt in the first place, as well as to improve or maintain their health and well-being if they do end up ill or injured,” says Dr. Shah. “The whole idea of rehabilitation medicine is maintaining quality of life and maintaining independence.”

*Burke Rehabilitation is the only free-standing hospital in New York State to achieve the Level 2 Age Friendly Healthcare Systems designation, Committed to Care excellence