Optimizing Patient Centered Care in the Physical Therapy Management of Older Adults with Heart Failure using the Geriatric 5Ms

Abstract

The American Physical Therapy Association has published a clinical practice guideline and subsequent knowledge translation document that promote and support evidence-based practice in the management of patients with heart failure (HF).  These documents provide physical therapists with a broad base of knowledge related to treatment interventions and the application of these interventions in practice. However, neither document provides insight on explicit management considerations for older adults with HF. The American Geriatric Society and the American Physical Therapy Association’s Academy of Geriatrics call for all geriatric clinicians to use the Geriatric 5Ms (Mind, Mobility, Medications, Multicomplexity, and what Matters Most) framework as a means for optimizing patient-centered care in older adults.

This perspective paper aims to provide clinicians with explicit ways to apply and integrate each of the 5Ms when managing older adults with HF. As movement specialists, physical therapists are encouraged to move beyond mobility considerations and appreciate the interactions across the remaining four Ms. This paper highlights patient-centered strategies related to the assessment of cognition, multicomplexity concerns, medication issues, and concepts that matter most to older patients with HF. The integration of all 5Ms in clinical practice allows physical therapists to align their treatment with a similar framework used by other geriatric clinicians thereby promoting interprofessional communication, showcasing value, and encouraging authentic patient-centered care when treating older adults with HF.