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Age-Friendly Health Systems include hospitals, clinics, and long-term care facilities that provide state-of-the art care to older adults. They organize care around 5 core principles known as the 5Ms: Mobility, Mentation, Medications, Multicomplexity, and What Matters Most. The 5Ms have not been applied previously to care delivery for older adults with post-intensive care syndrome (PICS); thus, this chapter offers a novel, interprofessional 5Ms approach to evidence-based care delivery for older adults with PICS. The first section provides essential background on interpreting evidence about PICS through the lenses of ageism (bias related to age) and ableism (bias related to disability status). Each of the next five sections explains one of the 5Ms constructs and summarizes relevant evidence related to PICS. The final section summarizes offers a vision linking Age-Friendly Healthcare, Age-Friendly Communities, and Age-Friendly Public Health after critical illness.
The Collaborative Assessment and Management of Suicidality (CAMS) framework is an evidence-based approach to treating individuals with suicidality. It involves collaboration between patients and clinicians to assess, plan and treat suicidal risk, using the Suicide Status Form. This study applies the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to explore the experiences of Irish higher education counselling staff in implementing CAMS, providing insight into the factors that influence its successful integration into student mental health services.
Methods:
A mixed-methods approach was adopted, via an online survey and follow-up interviews with student counselling staff to explore the implementation of the CAMS framework. Sixty-four staff members from student counselling services in Irish higher education institutions completed the online survey. Ten participants engaged in follow-up interviews to further explore survey findings. Data on reach, effectiveness, adoption, implementation and maintenance were gathered through the RE-AIM framework.
Results:
Survey respondents report treating approximately 44% of individuals presenting with suicidal risk using the CAMS framework. The majority (88.1%) of respondents reported positive outcomes for suicidal patients. Most respondents (91%) found the training beneficial and had ‘definitely’ or ‘somewhat’ incorporated CAMS into their management of suicidal patients. There were three main themes identified from interview data: diverse approaches to implementation, the value of CAMS in practice and challenges in implementing CAMS.
Conclusions:
CAMS has provided a strong toolkit for improving suicide-specific skills, communication and collaboration, but fidelity varies due to resource and support limitations. Additional resourcing, increased staff buy-in and further research could lead to smoother implementation in student counselling services.
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