New program aims to improve care for aging population
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As America ages, a critical question looms: Is the country prepared to care for seniors in a way that values their needs, preferences, and dignity? With 84 million adults expected to be 65 or older by 2050 — nearly a quarter of the population — the healthcare system faces an unprecedented challenge. For Michael Layne, MD, assistant professor of Family & Community Medicine at Macon & Joan Brock Virginia Health Sciences at Old Dominion University, the answer lies not just in what can be done medically, but what should be done.
Dr. Layne spent eight years as a palliative care physician in rural Virginia, an experience that deeply shaped his approach to healthcare. “One thing I learned was that older patients have better clinical outcomes and quality of life when more gentle and conservative care is provided at the right time,” said Dr. Layne. “That means incorporating individual patient values into care planning and delivering care based on their priorities.”
Driven by this philosophy, Dr. Layne co-founded What Matters Most Virginia in early 2024 by building relationships with a coalition of medical professionals, educators, and leaders in Virginia and the Hampton Roads community. United by their dedication to deliver value-informed, compassionate and appropriate medical care to senior patients, their mission is to shape the next generation of healthcare providers through innovative curricula, experiential learning and patient-centered education.
From the start, coalition members have volunteered their time, expertise and experience to the venture. Members include Norfolk community and non-profit leaders, local medical providers, and professors from regional universities.
Together they developed curriculum for medical students and residents, including a seven-part lecture series that will ultimately coordinate with the existing standardized patient program. “It will put them through the pitfalls of interacting with a patient who may lack medical decision-making capacity,” said Dr. Layne. “How do you determine how to make choices? Who's the power of attorney? How do you develop a plan of care for someone with complex illness?”
By learning how to take on the role of team leader within the healthcare team, they become effective advocates and stewards for their patients, particularly those who have competing disease processes or conditions which are not easily solved.
Popular literature has been trending upwards on this topic, with experts discussing the greater need for palliative care and shared decision-making in healthcare. This is a conversation people are eager to have because it addresses the ongoing challenges providers face in caring for patients, particularly in an era of rapidly advancing technology and a wide range of treatment options.
But Dr. Layne says the healthcare system may not be equipped to guide patients and their loved ones and caregivers through the next phase of aging. “I ran into that when dealing with my parents,” said Dr. Layne. “It was very hard to get people in a room to talk about all the moving parts. When physicians and learners understand how to have those conversations and provide that stewardship, they can deliver care and give the patient agency by not making them feel like just a passenger on the train.”
Given this need, another goal of What Matters Most Virginia is to link patients and their families to community resources which offer supportive care, recreational activities, advanced care planning, and more. Together, Dr. Layne says, they will join to curate a geriatric care journey which begins with the patient’s visit to a family medicine or generalist provider.
The foundation of What Matters Most Virginia rests in the principles outlined in the 4Ms Framework of an Age-Friendly Health System, a nationally recognized guide to the care of older adults as they navigate the healthcare system. The 4Ms – what matters, medication, mentation and mobility – are concepts designed to be implemented together and consistently for all older adults.
The lectures, experiential learning, and curriculum developed by What Matters Most Virginia were designed with future expansion in mind. Dr. Layne is eager to engage other departments and explore opportunities for collaboration with additional programs within the Macon and Joan Brock Virginia Health Sciences at Old Dominion University.
Patients may make an appointment with EVMS Medical Group Family & Community Medicine in its Senior Strong Clinic, where Dr. Layne’s associate, Mary Rubino, MD, associate professor at Macon & Joan Brock Virginia Health Sciences at Old Dominion University Family & Community Medicine leads the clinic, providing personalized care for medically or socially complex older adults based on the 4Ms of age-friendly healthcare.