Me & My Wishes: An Efficacy Trial Using Videos

Health Communication Clinical Trial

Official title:

Me & My Wishes: An Efficacy Trial of Long Term Care Residents With Alzheimer's Using Videos to Communicate Care Preferences With Caregivers

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03861429
• Other study ID #: IRB_00111417
• Secondary ID: 1R21AG058094
• Status: Completed
• Phase: N/A
• Start date: April 9, 2019
• Est. completion date: January 29, 2021

Study information

• Verified date: December 2020
• Source: University of Utah
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to determine whether the Me & My Wishes intervention positively impacts communication of preferences among nursing home residents with dementia and their family caregivers and care team.

Description:

Me & My Wishes are videos of nursing home residents talking about their preferences for care, including four sections: About Me, Preferences for Today, Preferences for Medical Intervention and End of Life, and Afterthoughts. Knowing what residents want is essential to staff's ability to provide quality care and can inform family caregivers decision making especially in later stages of life as the resident's cognition declines-a time when family caregivers often feel unprepared. Persons with mild to moderate dementia can accurately express their everyday and EOL preferences, however, stereotypes persist about the decision making abilities of people with dementia that often prevent their involvement in conversations about care. The investigators propose to conduct a Stage II efficacy trial of Me & My Wishes-a novel approach for communicating resident care preferences-by creating videos with 48-54 nursing home residents with mild to moderate dementia and sharing their personalized video with informal (family) and formal (staff) caregivers. The investigators will employ a randomized wait-list control design in which residents in control nursing homes will delay sharing their video. Videos may be viewed two ways: 1) in resident quarterly care conferences; and 2) via a web-based link with resident-identified family members or friends.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 124
• Est. completion date: January 29, 2021
• Est. primary completion date: January 29, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Resident Inclusion Criteria:

• Identified as having Alzheimer's or related dementia
• Mild to moderate cognitive impairment (BIMS = 8-15, (MDS C0500) (nursing home residents only)
• Makes Self Understood = <1 (MDS B0700)/present in medical record
• Understood By Others = <1 (MDS B0800)/present in medical record
• Reside at the facility at least 2 weeks identified as a long-term resident
• Age >65 years
• Speaks English

Family Inclusion Criteria:

• Speaks English
• Willing and able to watch the videos
• Willing to complete short surveys. Being unable to attend care conference to view the video (e.g. due to distance) will not exclude family from participating.

Staff Inclusion Criteria:

• Speaks English
• Willing to watch the videos
• Willing to complete short surveys

Resident Exclusion Criteria:

• Limited communication capacity (e.g. aphasia)
• Comatose
• Cognitively intact
• Severe cognitive impairment

Related Conditions & MeSH terms

• Health Communication

Intervention

Behavioral:
• Me & My Wishes
Me & My Wishes videos communicate residents' preferences via personalized video recorded conversations. Me & My Wishes are videos of nursing home residents talking about their preferences for care, and include four sections: About Me, Preferences for Today, Preferences for Medical Intervention and End of Life, and Afterthoughts.

Locations

Country	Name	City	State
United States	Marquis Hope Village Assisted Living	Canby	Oregon
United States	Marquis Forest Grove Assisted Living	Forest Grove	Oregon
United States	Marquis Forest Grove Post Acute Rehab	Forest Grove	Oregon
United States	Regency Gresham Nursing and Rehabilitation Center	Gresham	Oregon
United States	Marquis Wilsonville Assisted Living	Wilsonville	Oregon
United States	Marquis Wilsonville Post Acute Rehab	Wilsonville	Oregon
United States	French Prairie Nursing and Rehab	Woodburn	Oregon
United States	Woodland Care Center	Woodland	Washington

Sponsors (3)

Lead Sponsor	Collaborator
University of Utah	Brown University, National Institute on Aging (NIA)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Congruence of preferences observed in video	Presence/absence of preferences in video 1) Describe presence/absence of preferences in video	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video
Other	Congruence of preferences observed in medical record	Presence/absence of preferences in video 1) Describe presence/absence of preferences in medical record via medical record review	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video
Other	Congruence of preferences observed in video, medical record, and surveys	Presence/absence of preferences in video 1) Describe presence/absence of preferences in surveys via self-report surveys	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video
Primary	Communication of preferences	Goals of care discussions (change in documentation in medical record, e.g. social work note)	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video
Primary	Communication of preferences	Self-reported conversations (change in self report: resident, family, staff surveys)	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video
Secondary	Confidence of communicating preferences	Confidence in expressing or communicating about resident preferences; 1) change in resident, Family, Staff Survey (self-efficacy items, range 1-5, higher is more confident); 2) New or changed care planning documents (e.g. POLST)	Baseline, time of sharing (within 72 hours of sharing video), and 90 days post sharing video