Our purpose is to present the Geriatric 5Ms (Matters Most, Medications, Mind, Mobility, Multicomplexity) framework which has been embraced by Canadian and U.S. geriatric medicine specialists, starting in 2017, as an approach to optimize geriatric care.3 The 5Ms are both a mnemonic and framework, translatable to other languages to help medical personnel and physiotherapists address common areas of challenge in the care of older adults. Physiotherapists as primary care providers improve patient access to care, and can improve the quality of care using the 5Ms.4
The major aim was to help improve the quality of care that older adults receive. The 5Ms provide a holistic approach to addressing health complexities seen in older adults and serves as a common language promoting interprofessional practice between professions.5 The goals of the initiative include improving attention to complicated interacting health needs of older adults, reduction of medical error and negative health outcomes, patient and family centered decision making and care, and provision of evidence-based healthcare to improve outcomes of care.6 Geriatric physio best practice principles incorporated the 5Ms to promote their use.7
The AGPT convened a 7 member task force consisting of clinicians, academicians, and researchers with expertise in geriatrics, orthopedic and neurologic physiotherapy, experience ranging from 27 to 46 years, in varied settings. The group met monthly to review the literature on frameworks including the international classification of functioning, disability and health, 5Ms framework and other models in an iterative process, meeting with stakeholders working to apply the 5Ms framework from a medical perspective into one that is useful and relevant to physiotherapy.
By incorporating the Geriatric 5Ms into physiotherapist practice can enhance access to quality primary care physiotherapy. Poor outcomes such as medication errors, falls, and delirium can be mitigated by addressing each “M” individually while recognizing their interconnectedness. In this way, medication effects will be monitored and addressed for impact on mind and mobility. The same for mobility and its association with the mind, or multicomplex issues. The 5Ms provides physiotherapists a comprehensive geriatric care model that addresses the issues commonly cited with poor outcomes such as falls, and delirium.
The task force strongly recommends use of the Geriatric 5Ms model to guide care, increase access to primary care, improve patient outcomes and increase healthcare system efficiencies. The AGPT task force strongly recommends use of the Geriatric 5Ms model to guide care, increase access to primary care, improve patient outcomes and increase healthcare system efficiencies.
This project will directly translate into expanding access to quality primary care provision by physiotherapists.
Primary Care Provider
Geriatric Physiotherapy
