Aging Care 5Ms Competencies

Aging 

1. (A) Describe the demography and epidemiology of aging and its implications. 

(B) Recognize the impact of social determinants of health on aging.

2. Demonstrate knowledge about healthy aging, health promotion, and preventivemeasures in older adults.

3. Describe the physiological changes of aging, and their clinical implications. 

Caring for Older Adults

4. Complete a comprehensive geriatric assessment (CGA):

(A) Complete the data gathering involved in a CGA.

(B) Perform mental status and physical exams.

(C) Apply validated screening/diagnostic tools relevant to the assessment.

(D) Develop a problem list and preliminary management plan.

5. Communicate respectfully and effectively with older adults, family members, and other health care professionals.

6. Understand the role and contribution of different healthcare professionals in caring for older adults.

7. Understand the epidemiology, pathophysiology, risk factors, clinical features, diagnosis, management, and preventive strategies of common geriatric syndromes.

8. Differentiate geriatric syndromes from normal aging.

9. Identify caregiver stress risk factors, signs, and prevention strategies.

10. (A) Describe the continuum of care options for older adults, including home-based and care facility-based resources. 

(B) Understand the components of safe transfers of care for older adults. 

11. Identify hazards facing older adults in different health care settings, and participate in efforts to reduce potential vulnerabilities.

12. Identify the presence of ageism, maltreatment, neglect, system gaps, and opportunities for advocacy when caring for older adults. 

Mind

13. Administer standardized cognitive testing using validated tools and understand theirlimitations.

14. Recognize and differentiate between delirium, dementia, and depression.

15. (A) Recognize delirium as a medical emergency and initiate diagnostic work-up toidentify precipitating factors. (B) Identify predisposing factors and apply preventivemeasures to decrease the risk of delirium in hospitalized patients.

16. Identify safety concerns related to cognitive impairment.

17. Identify behaviors arising from delirium or dementia and outline an initial non-pharmacologic and pharmacologic management approach.

18. Screen for falls, identify risk factors, and formulate a plan for prevention. 

Mobility and Functions

19. (A) Elicit functional status including basic activities of daily living and instrumentalactivities of daily living. (B) Identify safety risks in the living environment.

20. Assess mobility and functional deficits in collaboration with other health careprofessionals. 

Medications

21. Conduct a Best Possible Medication History (BPMH) and structured medication review.

22. Outline pharmacokinetic and pharmacodynamic changes that commonly occur withaging and know how to modify drug regimens.

23. (A) Identify potentially inappropriate medication classes in older adults.(B) Recognizethat new symptomatology, including geriatric syndromes, may be due to medications ormedication changes.

24. (A) Understand the principles of appropriate prescribing to minimize risk ofpolypharmacy and under treatment.

(B) Identify opportunities for deprescribing. 

Multi-Complexity

25. Identify frailty using validated screening tools, and recognize that frailty informs healthcare decisions and impacts health outcomes.

26. Recognize atypical presentations of common medical conditions in older adults.

27. Understand that the approach to diagnosing and managing common chronic medicalconditions can differ in older adults, particularly frail older adults, compared to youngadults.

28. Understand the basic principles of managing multi-morbidity in a patient-centeredmanner and be aware of resources to guide appropriate care in older adults. 

29. Identify patients with limited life expectancy and recognize a palliative approach tocare as an appropriate treatment option for a patient with advanced disease. 

Matters the Most

30. Apply a holistic and patient-centred approach to care, and demonstrate the ability toassess patient priorities and goals.

31. Identify gaps in equity and highlight systemic challenges encountered by older adultswith an anti-oppression and anti-racism lens.

32. Identify and recognize the impact of social isolation and loneliness in older adults.

33. Understand the key ethical and legal issues in caring for older adults.