Latimer Abigail, Moser Debra K, Wu Jia-Rong, Birtcher Kim K, Clancy Malachy J, Portz Jennifer D, Paladino Joanna, Matlock Daniel D, Knoepke Christopher E
College of Social Work, University of Kentucky, Lexington, KY, 40506, USA.
College of Nursing, University of Tennessee Knoxville, Knoxville, TN, 37996, USA.
Clin Interv Aging. 2025 Mar 20;20:325-333. doi: 10.2147/CIA.S493243. eCollection 2025.
Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization of care that has been applied to the care of older adults, including in gastroenterology, ICU care, oncology, and dentistry. In this narrative review, we present 5Ms Model of care for older adults with HFrEF.
护理的复杂性是人口老龄化的必然结果，在患者管理诸如射血分数降低的心力衰竭（HFrEF）等慢性病的情况下尤其如此。HFrEF本身就很复杂，病程起伏不定，心脏性猝死风险增加，还有无数伴随的治疗考量。老年患者中HFrEF的全科管理因并存的合并症、经济毒性的可能性、心理健康症状的可能性以及与目标和偏好不一致的护理风险而进一步复杂化。5M（多复杂性、心智、活动能力、药物治疗和最重要的事）是一种整体护理概念，已应用于老年人护理，包括胃肠病学、重症监护、肿瘤学和牙科。在这篇叙述性综述中，我们介绍了针对老年HFrEF患者的5M护理模式。
