Integrated care models for older adults are key to addressing their complex, often coexisting, health, and social needs. In this chapter, we explore their main characteristics and the challenges associated with geriatric care, such as multimorbidity, declining intrinsic capacity, frailty, geriatric syndromes, fragmentation of care, and the role of place of living and informal caregiving.

Through examples of successful models, we present strategies that have been shown to reduce service use, improve well-being, and increase older adults and caregiver satisfaction. In addition, evidence is provided on supportive resources and strategies, such as care transitions, intermediate care, home hospitalization, preventive care, and social prescribing. The need to evaluate the impact of these models through patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) is emphasized, and qualitative research is presented.

Technology has an essential role in facilitating integrated care, although there are still challenges to its adoption. The importance of user-centered design and human factors is highlighted. Finally, the need to improve in training professionals to provide sustainable and effective integrated care for the older person is emphasized.

In old age, usually defined as from age 75 onwards, there is an accumulation of diseases and risk factors, the socalled “cumulative complexity”. This complexity makes the care of the geriatric patient a challenge. Multimorbidity, i.e., the co-occurrence of two or more chronic medical conditions in one person, correlates with age, and currently represents the most common “disease pattern” found in older people. Multimorbidity is characterized by complex interactions of co-existing diseases where a medical approach focused on a single disease does not suffice. New models of care for these patients are needed. In this Chapter, we discuss key factors required for integrated care services for geriatric patients, and describe several successful Integrated Care Models as well as the potential role of new information technologies.