The 5M’s Framework: Age-Friendly Medical Admissions in a Model 4 Hospital

Abstract Background Age-Friendly Health Systems are designed to promote evidence-based care that aligns with the individual priorities of older adults. Central to this approach is the 5M’s framework—mind, mobility, medications, multi-complexity, and what matters most—which supports a holistic, person-centered model of care. Methods This audit aimed to assess whether medical admissions at Cork University Hospital aligned with the 5M’s framework for age-friendly healthcare: mind, mobility, medications, multi-complexity, and what matters most. A total of 100 medical admissions in patients over 75 years old were reviewed. Data collected included the grade of admitting doctor, patient age, and documentation of each of the 5M components. Results Among the 100 audited cases, 69% were admitted by a Senior House Officer (SHO). The mean patient age was 83 years. Multi-complexity and medications were documented in 96% and 91% of cases, respectively. Mobility was addressed in 60% of cases, and mind in 40%. What matters most, including any mention of patients’ ideas, concerns, or expectations, was documented in only 7% of admissions. Conclusion While documentation around medications and multi-complexity is well established, a key element of the 5M’s, what matters most, is underrepresented in routine medical admissions. These findings highlighted an opportunity to improve age-friendly practices, by encouraging more comprehensive and patient-centered assessments. A quality improvement initiative was developed involving the use of “What Matters” stickers, designed to prompt clinicians to consider and document patient priorities during medical admissions. The audit findings and the purpose of the stickers were presented to the Senior House Officers (SHOs), as they were responsible for the majority of admissions.