Assessment Tool: Geriatric 5Ms Framework

Work through each of the five domains. Check all findings present, respond to the clinical prompts, use the linked tools for formal scoring, and add domain-specific notes. Generate the summary to inform interdisciplinary care planning and goal-concordant decision-making.

Geriatric 5Ms Framework

A clinical framework developed by the American Geriatrics Society and the Canadian Geriatrics Society to organize comprehensive care for older adults around five high-priority domains: Mind, Mobility, Medications, Multi-complexity, and Matters Most. Use this tool to structure the geriatric assessment, identify priorities, and guide interdisciplinary care planning.

The 5Ms at a glance

🧠

Mind

Cognitive Impairment

🚶

Mobility

Gait

💊

Medications

Polypharmacy

🔄

Multi-complexity

Multimorbidity

🎯

Matters Most

Patient Goals

🧠 Mind — Cognitive Impairment · Dementia · Delirium · Depression

Encompasses all aspects of brain health in older adults: cognitive impairment and dementia, delirium (acute confusion), and depression. Each condition is common, often co-exists, and profoundly impacts function, safety, and quality of life.

Present findings (check all that apply)

Cognitive impairment or dementia (known or suspected) Acute confusion or delirium (new or fluctuating) Depression, anxiety, or significant mood disturbance Formal cognitive screen performed (e.g., Mini-Cog, MoCA, MMSE)

Key assessment questions

› Does the patient have a baseline cognitive diagnosis? What is the patient's normal?
› Has there been any acute change in mental status, attention, or behavior (delirium screen)?
› Does the patient endorse depressed mood, loss of interest, or hopelessness (PHQ-2/PHQ-9)?

Related assessment tools

Mini-Cog MoCA CAM (Delirium) PHQ-9 GDS-15

Clinical notes — Mind

🚶 Mobility — Gait · Balance · Falls · Exercise

Gait and balance impairment, fall history, fear of falling, and physical deconditioning. Mobility decline is both a marker of underlying illness and an independent driver of adverse outcomes including institutionalization.

Present findings (check all that apply)

Fall in the past 3 months Fear of falling or self-restricted activity Gait instability, shuffle, or wide base noted Uses or requires an assistive device (cane, walker, wheelchair) Evidence of deconditioning or reduced exercise tolerance

Key assessment questions

› Have you fallen in the past year? More than once?
› Do you feel unsteady when walking? Do you avoid activities because of fear of falling?
› Perform or observe TUG test or gait assessment.

Related assessment tools

TUG Test Morse Fall Scale Hendrich II JHFRAT Romberg Test

Clinical notes — Mobility

💊 Medications — Polypharmacy · Adverse Effects · Beers Criteria · Adherence

Polypharmacy (≥ 5 medications), potentially inappropriate medications (PIMs per Beers Criteria® or STOPP/START), adverse drug events, drug–drug interactions, and medication non-adherence. Older adults are disproportionately affected by medication-related harm.

Present findings (check all that apply)

Polypharmacy: takes 5 or more prescription medications High-risk medications present (anticoagulants, insulin, opioids, antipsychotics) Potentially inappropriate medications identified (Beers Criteria® or STOPP) Adherence concerns: missed doses, cost barriers, or confusion with regimen Suspected or confirmed adverse drug event contributing to presentation

Key assessment questions

› What medications do you take, including OTC, herbals, and supplements? Who manages them?
› Have you had any new symptoms since a medication was started, changed, or stopped?
› Review the medication list for Beers Criteria® items, anticholinergic burden, and sedation risk.

Clinical notes — Medications

🔄 Multi-complexity — Multimorbidity · Biopsychosocial Complexity · Frailty · Caregiver Burden

The simultaneous presence of two or more chronic conditions (multimorbidity), combined with psychosocial stressors, frailty, or caregiver strain. Multi-complexity requires care coordination and realistic goal-setting beyond disease-specific protocols.

Present findings (check all that apply)

Two or more chronic conditions (multimorbidity) Evidence of frailty (weight loss, exhaustion, weakness, slowness, low activity) Social isolation, limited support network, or caregiver burden Financial or resource barriers affecting health management Complex care coordination needs (multiple providers, frequent transitions)

Key assessment questions

› What chronic health conditions are you managing? How do they affect your daily life?
› Who helps you at home? Do you feel your caregiver is managing well?
› Are there financial or transportation barriers that affect your care or medications?

Related assessment tools

Katz Index (ADL) Lawton IADL Barthel Index DETERMINE (Nutrition)

Clinical notes — Multi-complexity

🎯 Matters Most — Patient Goals · Priorities · Preferences · Advance Care Planning

Understanding what matters most to the individual patient — their values, goals, and preferences — is the cornerstone of person-centred care. This 'M' guides all clinical decisions and ensures care aligns with what the patient defines as meaningful and important.

Present findings (check all that apply)

Patient goals and priorities have been explored and documented Advance care planning document present (POLST, MOLST, AD, DPOA-HC) Current treatment plan aligns with patient-stated goals Health literacy assessed; patient understands their care plan Cultural, spiritual, or religious preferences identified and respected

Key assessment questions

› What matters most to you about your health and daily life right now?
› What are you most worried about? What would you like us to focus on?
› Have you completed an advance directive or spoken with your family about your wishes?

Clinical notes — Matters Most

Geriatric 5Ms Assessment Summary

Active domains

—

of 5 Ms

📋 Priority Domains for Care Planning

The 5Ms framework guides care that is tailored to the whole older adult — not just individual diseases. Share findings with the interdisciplinary team and integrate into a goal-concordant care plan. Reference: Tinetti M et al. "The 5Ms of Geriatrics." J Am Geriatr Soc. 2017.