Resources to Practice Age-Friendly Care


  1. Getting Started Guides
  2. The 4Ms Framework
  3. Making the Case for Age-Friendly Health Systems
  4. Working with Older Adults
  5. Case Studies and Media
  6. Ensuring Equity in Age-Friendly Care

1. Getting Started Guides

​​​​​​​​​​Guide to Using the 4Ms in the Care of Older Adults in Hospitals and Ambulatory Practices

The guide is designed to help care teams test and implement a specific set of evidence-based, geriatric best practices called the "4Ms": What Matters, Medication, Mentation, Mobility. 

Download the Guide

Guide to Care of Older Adults in Nursing Homes

IHI, along with partner nursing homes, has developed the Age-Friendly Health Systems Guide to Care of Older Adults in Nursing Homes and companion document, Age-Friendly Health Systems Workbook for Nursing Homes Teams. The Guide presents a systems-based approach to implementing the 4Ms throughout the nursing home, and the Workbook is designed by and for point-of-care teams that interact with individual residents each day.

Download the Guide
Download the Workbook

Guide to Recognition for Geriatric Emergency Department Accredited Sites

Geriatric Emergency Department Accredited sites are well aligned with 4Ms care. This guide provides an overview of each initiative, illustrates the overlap between them, and provides guidance on incorporating What Matters to older adults into Geriatric Emergency Department care.

Download the Guide

Guide to Recognition for Geriatric Surgery Verification Hospitals

Geriatric Surgery Verifiications Hospitals are well aligned with 4Ms care. This guide provides an overview of each initiative and illustrates the GSV Standards that meet the requirements for recognition as an Age-Friendly Health System when provided to adults 65+. 

Download the Guide

New! Guide to Using the 4Ms in the Care of Older Adults in the Convenient Care Clinic

This guide contains resources to help convenient care clinics implement the 4Ms (What Matters, Medication, Mentation, and Mobility) into their setting of care. 

Download the Guide

New! The Three Keys to Cross-Sector Age-Friendly Care

This Implementation Guide and Workbook contains resources to improve how public health and health care organizations work across the care continuum to provide age-friendly care to all older adults.

Three Keys to Cross-Sector Age-Friendly Care Implementation Guide and Workbook

Three Keys to Cross-Sector Age-Friendly Care Workbook

Three Keys to Cross-Sector Age-Friendly Care Care Journey Maps

Three Keys to Cross-Sector Age-Friendly Care Driver Diagram, Change Ideas, and Measures

Age-Friendly Health Systems EHR Implementation Guides

Guides to electronic health record (EHR) requirements for adoption of the 4Ms, one with Cerner examples and one with Epic examples.

Download the EHR Implementation Guide with Cerner Examples

Download the EHR Implementation Guide with Epic Examples

Download the Epic Implementation Guide

For feedback or questions about these guides, please email afhs​

Age-Friendly Health Systems: Measures Guide

Download a guide on ​how to use and track a series of measures ​​to help study your performance.​

Spreading Age-Friendly Care: From One Care Location to Reach Older Adults Across Your Health System  

 The guide will help health systems in spreading the 4Ms through all sites of care by discussing interntional effort and specific activities to reach this goal. 

2. The 4Ms Framework

The 4Ms Framework ​of an Age-Friendly Health System

Watch the Introduction ​to the 4Ms Framework video from RUSH Center for Excellence in Aging

Downloadable Graphics

The graphics of the "4Ms" Framework of an Age-Friendly Health System may be downloaded and used for related work without requesting permission.

Click the images below to download:

"4Ms" Framework                            "4Ms" Framework with descriptions

4Ms Framework of an Age-Friendly Health System 4Ms Framework of an Age-Friendly Health System with descriptions

4Ms Educational Resources of Healthcare Workforce 

4Ms Educational Resources to Use with Older Adults

NICHE Age-Friendly 4Ms Crosswalk

 Download the NICHE ​Article​

AGS CoCare: HELP & Age-Friendly 

Using AGS CoCare: HELP to Achieve Age-Friendly Care

Getting Started resources providing detailed information on how implementing the HELP program can support a hospital in becoming Age-Friendly: 

3. Making the Case for Age-Friendly Health Systems

The Business Case for Becoming an Age-Friendly Health System​

The business case methodology will help an organization seeking to become an Age-Friendly Health System identify the relevant data, analyze it, and describe its financial implications.

Download the Business Case

​Organizations may use the accompanying ROI Calculators with their own data to eva​luate their Age-Friendly programs.

*For best results, please use Google Chrome to download the ROI Calculators

Inpatient ROI Calculator

Instructions: Inpatient ROI Calculator

Outpatient ROI Calculator

Instructions: Outpatient ROI Calculator

​​​Describe Local Application of the 4Ms at Your Organization

Download the 4Ms ​Age-Friendly Care Description worksheet​​​​ (​Hospital and Post-acute Long-term Care Setting)​​​​

Download the 4Ms ​Age-Friendly Care Description worksheet​​​​ (Ambulatory Care Setting)​​

Frequently Asked Questions about Being Recognized as an Age-Friendly Health System​​

Community-based Resources and the 4Ms 

Identify an Age-Friendly Champion

Learn more about identifying a sponsor and the sponsor role

​​4. Working with Older Adults

4Ms Educational Materials for Older Adults and Caregivers 

Frequently Asked Questions 

Video: What Matters Is Most Important

WebMD partnered with The John A. Hartford Foundation to create a series of videos featuring the 4Ms of age-friendly care to help older adults and caregivers take control of their health.

Watch the WebMD VIdeoSeries: What Matters Is Most Important

What Age-Friendly Health Systems Mean to Older Adults 

​​"What Matters” to Older Adults? Toolkit

A toolkit for health systems to design better care with older adults but understanding "what matters" most to each adult.

Download the Toolkit​

How to Have Conversations with Older Adults About “What Matters”: A Guide for Getting Started

A short guide for anyone who cares for older adults, in any setting, to help jumpstart conversations about What Matters most.

Download the Getting Started Guide

"Conversation Ready": A Framework for Improving End-of-Life Care

This white paper presents IHI’s "Conversation Ready" approach to help health care organizations and clinicians provide respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.

Download the IHI White Paper


How to Talk to Your Patients about End-of-Life Care: A Conversation Ready Toolkit for Clinicians

This toolkit is intended to help clinicians address some of the challenges of engaging with patients and families in end-of-life care conversations over time, with the goal of providing respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.

Download the Toolkit


The Conversation Project

The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care. The Conversation Starter Kits are useful tools to help older adults have the conversation with a family member, friend, or other loved one about their end-of-life care wishes. Learn More >>


5. Case Studies and Media

Case Studies


Issue Brief: Creating Value with Age-Friendly Health Systems

Luminis Health Anne Arundel Medical Center


Banner Health System : Reducing Costs and Increasing Patient Satisfaction in Primary Care 

GWEP-CC Age-Friendly Health Systems: 12 Primary Care Case Studies 

Jefferson Center for Healthy Aging: Create an Age-Friendly Health Care Ecosystem (Create an account with to access these case studies) 

Convenient Care Clinic 

MinuteClinicMinute Clinics Forge Ahead with Scaling Age-Friendly Despite Pandemic 


Anne Arundel Medical Center: ACO ACE Unit is Perfect Incubator for 4Ms  

Asan Medical Center: Making Age-Friendly Health Systems work across cultures

Birmingham VA Health System: A Hospital Finds Their Age-Friendly Champion  

Hurley Medical Center: Finding Synergy in Older Adult Care Initiatives    

Kent Hospital, a member of Care New England : 4Ms Continues Momentum When Building an ACE Unit  

MaineHealth / Maine Medical Center: Spreading Age-Friendly Through a Hospital   

Rush University Medical Center: The Value of IHI Action Communities & Community Partnership  

Saratoga Hospital: Building an Age-Friendly Grassroots Movement

Stanford Health Care: Building an Age-Friendly Geriatric Trauma Service-with a Dashboard! 

University of Alabama Hospital: 4Ms Brings Interdisciplinary Team & Leadership Together  

UMPC Mercy: Uniting Geriatric Efforts to Achieve Age-Friendly Care

St. James Parish Hospital: Cost Savings of Age-Friendly Care in the Pandemic  

St. John's Riverside Hospital: Building on Already Existing 4Ms Care  

Nursing Homes

Hebrew SeniorLife: A New Way of Framing Nursing Home Care

The Good Samaritan Society-Quiburi Mission: Communication with Nursing Home Residents Improves with 4Ms Care

Maryland Baptist: 4Ms Care Brings Small Changes with Big Impact in Nursing Homes

Mirabella: “What Matters” is Integral to Providing 4Ms Care in the Nursing Home

Tsali Care Center: Building on a Strong Foundation to Increase 4Ms in the Nursing Home

Scale and Spread  

AdventHealth HendersonvilleAge-Friendly Care in Outpatient, Inpatient, & Home Health  

Northwell HealthUnlocking and elevating age-friendly practices for an entire system

Issue Briefs
These briefs are designed to help care teams identify ways to embed the 4Ms into their processes. The first focuses on alignment of the 4Ms with models utilized by Accountable Care Organizations. The second describes the impact of Medicare Annual Wellness Visits inclusive of the 4Ms.

6. Ensuring Equity in Age-Friendly Care

Ensuring Equitable Age-Friendly Care Article (November 2022)

Focusing on Equity at Every Step of Your Age-Friendly Health Systems Journey Resource

  • This resource outlines the Recipe for Equity in the 4Ms. This includes key considersations to increase equitable and reliable implementation of the 4Ms for all older adults at every step of the journey to becoming an Age-Friendly Health System. 

The Recipe for Equity in the 4Ms Figure

New! Case study with UChicago SHARE Network

Age-Friendly Health Systems Open School Course

Our free Open School course, PFC 203: Providing Age-Friendly Care to Older Adults, provides an understanding of the Age-Friendly Health Systems movement, actionable steps to get started, and how to improve the care of older adults in your setting.

Please see our user guide for navigation assistance.

WIHI Audio Program

Video Playlist

The playlist includes multiple videos describing Age-Friendly Health Systems.

Join Friends of Age-Friendly Health Systems​​

  • ​Updates on the movement
  • Invites to quarterly webinar calls
  • Access to experts ​
  • Get support on the 4Ms Framework

Join the Community​​​