SHARING Choices: A Pilot Study to Engage Family in Advance Care Planning of Older Adults With and Without Cognitive Impairment in the Primary Care Context.

MedStar author(s):
Citation: American Journal of Hospice & Palliative Medicine. 38(11):1314-1321, 2021 Nov.PMID: 33325729Institution: MedStar Health Research InstituteDepartment: MedStar Institute for Quality and SafetyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Advance Care Planning | *Cognitive Dysfunction | Advance Directives | Aged | Child | Cognitive Dysfunction/th [Therapy] | Humans | Pilot Projects | Primary Health CareYear: 2021Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library:1999-2007ISSN:
  • 1049-9091
Name of journal: The American journal of hospice & palliative careAbstract: CONCLUSION: SHARING Choices was acceptable among older adults with and without cognitive impairment and may increase advance directive completion.CONTEXT: Few advance care planning (ACP) interventions proactively engage family or address the needs of older adults with and without cognitive impairment in the primary care context.METHODS: SHARING Choices was delivered to 40 patient-family dyads from 3 primary care clinics. Facilitators completed post-ACP reports. Patient and family participants completed baseline and 6-week surveys.OBJECTIVES: To pilot a multicomponent intervention involving: an introductory letter describing a new clinic initiative and inviting patients to complete a patient-family pre-visit agenda-setting checklist, share their electronic health information with family, and talk about their wishes for future care with a trained ACP facilitator (SHARING Choices).RESULTS: Patients were on average 75 years (range 65-90). Family were spouses (85.0%) or adult children (15.0%). At 6 weeks, nearly half of dyads participated in ACP conversations (n = 19) or used the agenda-setting checklist (n = 17), one-third (n = 13) registered family to access the patient's portal account, and most (n = 28) provided the primary care team with a new or previously completed advance directive. Of 12 patients who screened positive for cognitive impairment, 9 completed ACP conversations and 10 provided the clinic with an advance directive. ACP engagement, measured on a 4-point scale, was comparatively lower at baseline and 6 weeks among family (3.05 and 3.19) than patients (3.56 and 3.54). Patients remarked that SHARING Choices clarified communication and preferences while family reported a better understanding of their role in ACP and communication.All authors: Aufill J, Cockey K, Dy SM, Echavarria D, Funkhouser T, Guo A, Hussain N, Scerpella D, SHARING Choices Investigators, Sloan DH, Smith KM, Wolff JLOriginally published: American Journal of Hospice & Palliative Medicine. :1049909120978771, 2020 12 16Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: Date added to catalog: 2020-12-31
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33325729 Available 33325729

Available online from MWHC library: 1999 - present, Available in print through MWHC library:1999-2007

CONCLUSION: SHARING Choices was acceptable among older adults with and without cognitive impairment and may increase advance directive completion.

CONTEXT: Few advance care planning (ACP) interventions proactively engage family or address the needs of older adults with and without cognitive impairment in the primary care context.

METHODS: SHARING Choices was delivered to 40 patient-family dyads from 3 primary care clinics. Facilitators completed post-ACP reports. Patient and family participants completed baseline and 6-week surveys.

OBJECTIVES: To pilot a multicomponent intervention involving: an introductory letter describing a new clinic initiative and inviting patients to complete a patient-family pre-visit agenda-setting checklist, share their electronic health information with family, and talk about their wishes for future care with a trained ACP facilitator (SHARING Choices).

RESULTS: Patients were on average 75 years (range 65-90). Family were spouses (85.0%) or adult children (15.0%). At 6 weeks, nearly half of dyads participated in ACP conversations (n = 19) or used the agenda-setting checklist (n = 17), one-third (n = 13) registered family to access the patient's portal account, and most (n = 28) provided the primary care team with a new or previously completed advance directive. Of 12 patients who screened positive for cognitive impairment, 9 completed ACP conversations and 10 provided the clinic with an advance directive. ACP engagement, measured on a 4-point scale, was comparatively lower at baseline and 6 weeks among family (3.05 and 3.19) than patients (3.56 and 3.54). Patients remarked that SHARING Choices clarified communication and preferences while family reported a better understanding of their role in ACP and communication.

English

Powered by Koha