Key Concepts
Overview โ Older Adult Care in Canadian NP Practice
Adults โฅ65 represent the fastest-growing segment of the Canadian population and the highest users of healthcare services. NPs in primary care, LTC, and acute care routinely manage complex, multimorbid older adults. Key principle: Functional status, not age or diagnosis count, drives clinical decisions in older adults. Two 80-year-olds with the same diagnoses may have vastly different reserve, goals of care, and appropriate management plans. The 4Ms Framework (Age-Friendly Health Systems โ Canadian adaptation): - Medications: minimize medications that may cause harm; deprescribe when appropriate - Mentation: prevent, identify, and treat dementia, depression, and delirium - Mobility: maintain safe mobility and function; fall prevention - What Matters: know and align care with each person's specific health outcome goals and care preferences Domains of the Comprehensive Geriatric Assessment (CGA): 1. Medical: diagnoses, medications, sensory impairment, nutrition, pain 2. Functional: ADLs (dressing, bathing, transfers, toileting, feeding, continence) and IADLs (meals, transportation, medications, finances, housework, communication) 3. Cognitive: dementia screening (MoCA, Mini-Cog), delirium assessment (CAM) 4. Psychological: depression (GDS-15, PHQ-9), anxiety, substance use 5. Social: support systems, living situation, caregiver burden, finances 6. Environmental:...