Ask the Doctor: Why Implementing Age-Friendly Healthcare is Important


David Koffman, MD, MBA, Vice President of Medical Affairs

Q: How long have you worked at St. Joe’s?
I’ve been with the hospital as a practicing primary care provider for more than 25 years. Three years ago, I took on the Vice President of Medical Affairs role, although I do still see patients one day each week.

Q: What are your primary responsibilities As Vice President of Medical Affairs?
In my role, I:

  • Oversee the medical staff at the hospital and in our practices to ensure the quality of care we provide is exemplary.
  • Work closely with my colleague Sandy Nesin, Esq., Vice President of Operations, to apply a dyad leadership model, which pairs an operations leader with a clinical leader to ensure comprehensive care and optimized operations.
  • Act as a liaison between St. Joe’s and other local specialty providers, like Dahl-Chase Pathology, DownEast Orthopedics and Spectrum Radiology who we’ve partnered with to ensure our community is cared for.

 Q: What is Age-Friendly Healthcare?
It’s an initiative that focuses on making sure every older person receives the best care possible, avoids harm and is satisfied with their care. It focuses on these 4Ms:

  • What Matters – Aligning care with an older adult’s healthcare preferences
  • Medication – Prescribing appropriate medication
  • Mentation – Managing dementia, depression and delirium
  • Mobility – Ensuring that an older adult safely moves every day

 Q: Why is implementing Age-Friendly Healthcare important?
According to the Age-Friendly Health System by 2030 seven to eight million baby boomers will be 65+ years old. In addition, 80% of them will have one chronic ailment and 75% will be managing two chronic ailments. In addition, according to the U.S. Census Bureau, in 2023 Maine was the oldest state in the country.

In the Bangor area these are our patients, and we want to make their care a priority. Older patients tend to see their provider more often, they’re more diligent about follow-up appointments and they’re more likely to hospitalized. At St. Joe’s, we’re adept at caring for older patients which is why we have continued to be successful.

Q: Is the implementation of Age-Friendly Healthcare complete?
We have begun the implementation and continuing to execute it is a priority. More specifically we have:

  • Earned Age-Friendly Bronze Level Certification in our Emergency Department. This means that when a senior enters our Emergency Department, the care team focuses on the 4Ms as shared above.
  • Trained our clinical staff on how to diagnose and treat delirium and dementia.
  • Sent staff to Age-Friendly ‘train-the-trainer’ sessions, so we may continually train our team.
  • Incorporated Age-Friendly care into annual wellness visits when our older patients are screened for fall risk, depression and cognitive impairment. In addition, we review what medications they’re taking and specifically ask what matters most to them. If necessary, we refer them to behavioral health and other resources that can help meet their needs.

In the near future we plan to:

  • Renovate nine rooms on our medical floor to meet Age-Friendly requirements for flooring, bathroom fixtures and lighting.
  • Add a full-time Behavioral Health Specialist and Palliative Care Nurse Practitioner to work with older inpatients.

Q: What’s special about St. Joe’s offering Age-Friendly Healthcare?
Our progressive and compassionate approach to caring for older adults makes us different from other hospitals because it improves the patient experience and outcomes, reduces emergency department visits, minimizes length of stay and limits re-admission – and patients very much appreciate that.

 Q: How does implementing Age-Friendly Healthcare align with St. Joe’s Mission to provide healing and care for the whole person?
Older patients in particular want to come to a hospital where they know providers will take the time to care about them, understand them and build a relationship with them. If a provider can learn about a patient’s background and understand their belief system to earn their trust, they can better provide whole person compassionate care.

To learn more about Dr. Koffman, please click here. To read about a federally-funded award that will allow St. Joe’s to initiate the process of age-friendly renovations, please click here.

(207) 907-1000
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