Advance Planning for Home Services for Seniors

The goal of this proposal is to develop and test an advance planning tool to help seniors and families understand projected health needs and plan ways to remain in their own homes when these crises occur. Objectives: Through partnerships with seniors, senior community groups, area agencies on aging, home health nursing agencies, and homemaker agencies, we plan to: Aim 1: Develop an Advanced Planning for Home Services (APHS) tool to assist seniors and their families in making informed choices about issues in their health trajectory that will influence their ability to remain in their own home. Aim 2: Conduct pilot testing of the APHS Tool Intervention with seniors who have low health literacy to measure whether it can improve understanding of health care trajectory and home care services. Aim 3: Conduct a Randomized Control Trial of the APHS Tool Intervention to determine n measures of subject understanding of home care services and health trajectory, Aim 4: Disseminate the APHS Tool nationally through senior focused organizations and clinical outreach. Method: The Advance Planning for Home Services Decision Tool will be developed by seniors, tested by seniors, for use by seniors with the guidance of university based researchers. For Aim 1, a series of focus groups will be conducted with seniors and their support people with the results informing the content/design of the APHS tool. A panel of representatives from each of the above will provide feedback and beta test the APHS tool, prior to it being finalized in paper and electronic versions. For Aim 2, the planning tool will be tested with 100 seniors to determine its ability to improve understanding of health trajectory and available home services. For Aim 3, a randomized control study of the APHS tool will be conducted with 600 community living seniors. With attention control as one arm and the APHS tool as the other arm, process measures and outcomes of understanding of healthcare trajectory, understanding of available home services, comfort communicating with their families/health care providers, and actual utilization of services will be examined. In Aim 4, the APHS tool will be actively disseminated among the senior-focused national organizations of the Village-to-Village Network, Home Care Assoc. of America, and Area Agencies on Aging. This study will produce a viable advance planning for home services planning tool, offering us an opportunity to assist seniors in making informed decisions about living at home safely.