Why do vulnerable older adults need their own set of quality measures?
Vulnerable older people need these for several reasons. While many of the clinical conditions common in older adults are also present in the general adult population, some are not. These include cognitive impairment, pressure ulcers, falls and the need for end-of-life care. These are areas that early quality measurement work had barely touched. The few measures that did exist focused on care for those in the nursing home, and weren’t applicable to vulnerable elders living in the community. Another reason for developing these measures is that quality measures generally assume that patients’ goals for care universally focus on longevity. Typical measures don’t integrate quality of life considerations, or preferences for comfort over longevity, into the equation. These are important considerations for vulnerable older patients. In addition, older patients often cannot adequately advocate for themselves. As opposed to a 20-year-old or a 50-year-old, who might insist on good care, an 80-yea
