AI Article Synopsis
- Advance care planning (ACP) is crucial for older adults but is not widely adopted in community aged care settings; recent studies suggest that holistic, person-centered approaches may enhance engagement.
- The EARLI trial is a randomized study involving 12 aged care organizations in Australia, aiming to test a combined life story work and facilitated ACP intervention over two years with participants aged 65 and older.
- By assessing outcomes like ACP engagement, documentation, and emotional well-being, the trial seeks to demonstrate that personalized approaches can improve ACP uptake and ultimately benefit older adults and their families.
Article Abstract
Background: Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services.
Methods: The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) trial is an open-label, cross-over, cluster randomized controlled trial with 12 participating aged care organizations in New South Wales and Western Australia. Participants are aged 65 years or older, receiving home care services and capable of providing informed consent at initial recruitment. Recruitment occurs across a two-year period, with study sites randomized to receive the four-session intervention in the first or second year (or a single session 'active control' condition). Primary outcomes are participant-reported ACP engagement and ACP documentation in the aged care client record 12 weeks post-recruitment. Secondary outcomes include measures of decisional conflict, anxiety and depression, meaning-based coping and relationship quality. Analysis will take an intention-to-treat approach.
Conclusion: This trial tests a novel method of reaching older adults using a holistic, person-centered approach to promoting ACP engagement. Enhancing ACP engagement may reduce decisional conflict, minimize hospital admissions and improve outcomes for people and their families. ANZCTR Trial Registration ID: ACTRN12622001399785.
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| http://dx.doi.org/10.1016/j.cct.2024.107795 | DOI Listing |
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