If I must go to a doctor or the hospital, I want to be a partner in the decision-making process. So far, I’ve been able to keep myself out of that position, which doesn’t mean it won’t happen. My intention, though, is to maintain self-respect and advocate for myself during those circumstances.
This means shifting from being a passive recipient to an active collaborator. By being better prepared, and clearly understanding my concerns and needs, I can be more confident that my preferences and values are driving healthcare decisions.
I’m reading about The 4M’s Framework which focuses on the needs of older adults. It aligns care with personal goals and shifts from looking only at disease to viewing the whole person, and organizing care around their unique needs and strengths, which might lead to better outcomes and satisfaction.
I like the model because it’s not a prescription for how to age, but a reminder that there’s someone with values and feelings behind every diagnosis. This is the focus, briefly.
What Matters refers to identifying goals, preferences, and values, making them central to our decisions and aligning treatment with what’s most important. In other words, what matters to us regarding health care decisions.
Medication refers to reviewing prescriptions, OTC products, and supplements to ensure they aren’t causing harm, checking for side effects, interactions, and true necessity, because age can affect how certain drugs work. In other words, are the treatments we’re receiving honestly helping us live the life we want.
Mentation refers to focusing on a positive state of emotional, psychological, and social health. In other words, medical problems don’t happen to our bodies in isolation - they happens to the whole of us.
Mobility refers to promoting safe movement and physical function, helping us stay strong, active, and independent, preventing falls and maintaining an ability to do what matters. In other words, what do we want to be able to do during the rest of our lives?
Below, I use the 4M’s Framework to compare what I’m finding as an 87 year old and what experts generally say.
Experts say taking control of appointments require prioritizing our concerns by documenting the most important symptoms or questions in advance - noting dates, frequencies, and factors that make us feel better or worse.
What I’m Finding:
This is where What Matters and Mentation from the 4M’s Framework comes in.
Rarely have I been given the time for such discussions in a doctor’s office. I’m not sure the health system is prepared either with a typical in-office visit lasting about 15 -20 minutes.
Which is why we need to be prepared to discuss our goals, preferences, values and emotional, psychological, and social health during the visit.
Experts say we should keep conversations clear and focused asking these three questions: What is my main problem? What do I need to do? Why is it important for me to do this?
What I’m Finding:
The 4M’s Framework helped me understand that my preference is to work with medical professionals who view emotions as part of the body.
The Medication component of the model provides a way for me to share my concerns about taking prescription drugs or having unnecessary surgery.
Overall, I want a doctor who considers both conventional and alternative options which typically look at the whole person.
Experts say we should ask providers to explain their diagnosis and offer evidence supporting or ruling out specific conditions.
What I’m Finding:
That seems wise if the provider agrees to such a relationship. It’s never been my experience, but I know others who have.
With the 4M’s Framework, we consider whether or not the treatments we’re receiving are helping us live the life we want and provide ways to stay in control.
Experts say we should discuss our emotional and mental well-being, daily lifestyle, and family health history openly and honestly so the doctor can treat us holistically.
What I’m Finding:
The doctors I’ve met never seemed interested in the emotional side of an illness, the need for treatment, or my daily lifestyle.
That’s why it’s up to us to implement it.
We have a life to live—and that life is shaped not only by our health, but our values, emotions, lifestyle, and choices. So, perhaps the 4M’s Framework can help us do that.
A question to consider is this: Have you received medical care that resembles the 4M’s Framework?
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Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She’s been writing a newsletter on Substack for five years and recently published a book based on the articles entitled, “ The Insider’s Guide to Aging Well - Longevity Through the Eyes of an 87-year-old.”
The Insider’s Guide to Aging Well brings together many of the ideas and themes we’ve discussed. It’s not separate from the newsletter, which is my primary focus, but an extension of it—a way to collect the articles in one place for those of you who may find that format more useful.
This link takes you to the book on Amazon. All proceeds will be donated to the Alzheimer’s Association in my husband’s name.
We have a life to live—and that life is shaped not only by our health, but our values, emotions, lifestyle, and choices. So, perhaps the 4M’s Framework can help us do that.