This article is the first in a new series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive. The articles in this new series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by the John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Guide to the 4Ms of an Age-Friendly Health System for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.

Background: Workforce shortages to meet the mental health needs of the world's aging population are well documented. Within the field of professional geropsychology in the U.S.A., a national conference was convened in 2006 to delineate competencies for psychological practice with older adults and a training model for the field. The conference produced the Pikes Peak Model of Geropsychology Training. The Council of Professional Geropsychology Training Programs (CoPGTP) aimed to produce a competency evaluation tool to help individuals define training needs for and evaluate progress in development of the Pikes Peak professional geropsychology competencies.Methods: A CoPGTP task force worked for one year to adapt the Pikes Peak Model geropsychology attitude, knowledge, and skill competencies into an evaluation tool for use by supervisors, students and professional psychologists at all levels of geropsychology training. The task force developed a competency rating tool, which included delineation of behavioral anchors for each of the Pikes Peak geropsychology knowledge and skill competencies and use of a developmental rating scale. Pilot testing was conducted, with 13 individuals providing feedback on the clarity and feasibility of the tool for evaluation of oneself or students.Results: The Geropsychology Knowledge and Skills Assessment Tool, Version 1.1, is now posted on the CoPGTP website and is being used by geropsychology training programs in the U.S.A.Conclusions: The evaluation tool has both strengths and limitations. We discuss future directions for its ongoing validation and professional use.

There is a worldwide shortage of mental health professionals trained in the provision of mental health services to older adults. This shortage in many countries is most acutely felt in the discipline of psychology. Examining training programs in clinical psychology with respect to training content may shed light on ways to increase interest among students and improve practical experiences in working with older adults. A large multinational survey of geropsychology content in university-based clinical and counselling psychology training programs was conducted in 2007 in the U.S.A., Australia, and Canada. Both clinical/counseling programs and internship/practicum placements were surveyed as to staffing, didactic content and training opportunities with respect to geropsychology. Survey response rates varied from 15% in the U.S.A. (n = 46), 70% in Australia (n = 25) to 91.5% in Canada (n = 22). The U.S.A. and Australia reported specialist concentrations in geropsychology within graduate clinical psychology training programs. More assessment and psychopathology courses in the three countries were cited as having ageing content than psychotherapy courses. Many non-specialist programs in all three countries offered course work in geropsychology, and many had staff who specialized in working clinically with an older population. Interest in expanding aging courses and placements was cited by several training sites. Recruiting staff and finding appropriate placement opportunities with older adult populations were cited as barriers to expanding geropsychology offerings. In light of our results, we conclude with a discussion of innovative means of engaging students with ageing content/populations, and suggestions for overcoming staffing and placement shortcomings.

To demonstrate the feasibility of the BRIGHTEN Program (Bridging Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking), an interdisciplinary team intervention for assessing and treating older adults for depression in outpatient primary and specialty medical clinics. The BRIGHTEN team collaborates “virtually” to review patient assessment results, develop a treatment plan, and refer to appropriate team members for follow-up care. Older adults in 9 academic medical center clinics and 2 community-based clinics completed screening forms for symptoms of depression and anxiety. Those with positive screens engaged in comprehensive assessment with the BRIGHTEN Program Coordinator; the BRIGHTEN virtual team provided treatment recommendations based on the results of assessment. A collaborative treatment plan was developed with each participant, who was then connected to appropriate services. Two thousand four hundred twenty-two older adults were screened in participating clinics over a 40-month period. Eight hundred fifty-nine older adults screened positive, and 150 elected to enroll in BRIGHTEN. From baseline to 6 months, significant improvements were found in depression symptoms (Geriatric Depression Scale, p < .01) and general mental health (SF-12 Mental Component, p < .01). The BRIGHTEN Program demonstrated that an interdisciplinary virtual team linked with outpatient medical clinics can be an effective, nonthreatening, and seamless approach to enable older adults to access treatment for depression.