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Arany S, Cavalcanti L, Phildor D, Watson GE, Kopycka-Kedzierawski DT, Eliav E, Medina-Walpole A, Caprio T. Implementation of a 4Ms approach in age-friendly oral health care at an Academic Specialty Care Dental Clinic. J Am Geriatr Soc 2024. [PMID: 38661080 DOI: 10.1111/jgs.18925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/17/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Implementing the Age-Friendly Health System (AFHS) framework into dental care provides a significant opportunity to link oral health to healthy aging. This project aimed to implement the AFHS 4Ms (what matters, medications, mentation, and mobility) in the provision of oral health care. This article describes the planning, integration, training development, and outcome measurements supporting a 4Ms approach at an academic dental clinic. METHODS The Eastman Institute for Oral Health (EIOH) implemented screening instruments based on the 4Ms framework recommended for ambulatory care clinics by the Institute for Health Care Improvement (IHI). These ambulatory instruments were integrated into the workflows of a Specialty Care Clinic through the development of a plan-do-study-act cycle, utilization of available clinic resources, and creation of interdisciplinary collaborations. RESULTS This project demonstrated the feasibility of implementing an AFHS checklist and tracking forms in dental practice by integrating available resources and prioritizing the 4Ms elements. This effort necessitated interdisciplinary collaborations between dental, medical, and social service professionals. It also created a new age-friendly focused education and training curriculum for dental residents and faculty. CONCLUSIONS This pilot project is the first to establish dental standards for AFHS implementation, adapting the 4Ms assessment and metrics to oral health. This AFHS underscores key oral health processes, including assessment, planning, and personalized oral health care, adapted to the unique needs of the older adult population, especially those with cognitive impairment.
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Affiliation(s)
- Szilvia Arany
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Lia Cavalcanti
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Doris Phildor
- Alzheimer's Association Rochester New York Chapter, Rochester, New York, USA
| | - Gene E Watson
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, USA
- Department of Pharmacology and Physiology, University of Rochester, Rochester, New York, USA
| | - Dorota T Kopycka-Kedzierawski
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Annette Medina-Walpole
- Medicine-Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Thomas Caprio
- Medicine-Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
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