The University of Southern Indiana has received a three-year, $332,360 grant from the Indiana State Department of Health to study the integration of advance care planning into nursing homes in southwest Indiana. Specifically, new long and short-stay residents, along with their healthcare agents or representatives, will be invited to participate in an advance care planning conversation as part of the nursing home admission process. Following each conversation, the goal is to complete an advance care plan and, if directed by the resident consistent with his or her wishes, initiate a comprehensive advance directive or update current documentation. The new or updated documents will be integrated into the resident plan of care.
Dr. Kevin Valadares (chair of health administration and associate professor of health services) will be the Principal Investigator (PI) and will be responsible for the successful implementation, measurement and evaluation of the project. Dr. Katie Ehlman (Director of the Center for Healthy Aging and Wellness & associate professor of gerontology) and Dr. Marie Pease (associate professor of social work), both USI faculty, will be co-investigators. All three will assume the role of faculty coach and will be direct liaisons to the nursing homes. Members of the New Harmony Conversations Team will serve as peer mentors within the selected nursing homes.
Based on the Respecting Choices ® Last Steps ® model, this program will seek to recruit a total of 15 nursing homes and 75 ACP facilitators and train them in providing care planning for individuals with serious life-limiting illness, terminal illness, and advance frailty, and for those residing in a nursing home. The total number of nursing home residents affected through the project is projected to be 750, with 95 staff, family members and volunteers certified as Last Steps ® facilitators.
Recruitment of Nursing Homes
In year one, five nursing homes will be recruited to participate in the program’s intervention group. In years two and three, five additional nursing homes will join per year for a total of 15 nursing homes. The nursing homes participating in years two and three will serve as the control group for the previous year of the project to allow for an intervention and control group research design for year one and two of the project. Nursing homes participating in the Southwestern Indiana Collaborative for Performance Improvement will be invited to join the project. At least 50% of participant nursing homes will be located in a rural community.