What Matters Most?

One of the four M's in the age-friendly health care system model is "What Matters"

Understanding "What Matters"

It is the first M in the 4Ms framework because it anchors all the other M's: Medication, Mentation, and Mobility. Everyone knows what matters to them.

When everything is going well, we often feel that making a long-term care plan is not urgent. We think, "Why discuss this with family members or caregivers at this point?" But that mindset can lead us to a day that may be too late. An emergency, a hospitalization, or a sudden decline in health can change everything.

The Importance of Planning Ahead

Uh-oh! Now you are scrambling without knowing what matters most. You may find yourself making presumptive decisions about your care.

Knowing what matters most can be one of the greatest gifts you give your loved ones. When serious illness, injury, or changes due to aging arise, families are often suddenly asked to make difficult medical decisions. In those moments, it can feel overwhelming to not know what your loved one would truly want.

The Gift of Clarity

When values, wishes, and priorities have already been discussed, loved ones are not left guessing. They won't simply follow whatever medical recommendation is presented at the moment. Instead, they can speak with confidence and advocate for care that reflects the person’s own goals, beliefs, and definition of quality of life.

Medical teams can explain treatment options, but only the individual — and those who know them well — can answer questions such as:

• “What kind of life would feel meaningful to me?”

• “What abilities matter most to me?”

• “What trade-offs would I or would I not want to make?”

• “Would I want every possible treatment, or would comfort and quality of life matter more?”

  
  

These conversations help families move from uncertainty toward clarity. They can reduce guilt, conflict, and second-guessing during emotionally difficult times. This approach supports more patient-centered care and shared decision-making.

The Choices We Make

On our POLST and our Advance Health Care Directive, we check little boxes indicating our choices about DNR (Do Not Resuscitate) and DNI (Do Not Intubate).

However, there is one option often left out that is crucial to discuss: DNH (Do Not HOSPITALIZE).

A Different Perspective on Care

Perhaps you are tired of going to the hospital. You may feel that every time you leave, you don’t feel much better. What matters most to you is staying at home in the most comfortable setting. This choice should be an option too.

All too often, the default mode is "treatment," "procedures," and "hospitalization." But maybe it’s time for a Slow Medicine approach. This perspective emphasizes quality of life over aggressive treatments.

Embracing Difficult Conversations

Take the time to have those sometimes challenging discussions with your loved one well before the time comes. Before it's too late, understand their goals, their values, and what Matters. This understanding will empower you to advocate for them when they can no longer do so for themselves.

Conclusion: A Journey Worth Taking

Navigating the complexities of aging and health care can feel daunting. Yet, by focusing on what truly matters, we can create a path that honors our loved ones' wishes. It’s a journey worth taking, one that leads to peace of mind for both you and your family.

In the end, remember that having these conversations is not just about planning for the future. It’s about ensuring that the life you or your loved ones lead is filled with meaning, dignity, and respect for personal wishes. So, let’s start these conversations today. After all, what matters most is the love and care we share with one another.