Reducing Disparities in the Quality of Advance Care Planning for Older Adults (EQUALACP)
Metastatic Cancer, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease
About this trial
This is an interventional other trial for Metastatic Cancer focused on measuring Advance Care Planning, Disparities, Palliative Care, End of Life Care, African Americans
Eligibility Criteria
Inclusion Criteria for Patients:
- African-American or White
- age 65 or greater
- English-speaking
- residing in non-institutional setting
- cognitively able to participate in advance care planning
- Serious or chronic illness including: metastatic cancer; end stage renal disease; advanced liver disease, heart disease or lung disease; amyotrophic lateral sclerosis, severe Parkinson's disease; 2 or more unplanned hospitalizations in the last year; requiring assistance with any basic activity of daily living
- Serious illness based on the following: Clinician answers "no" to the surprise question: "Would you be surprised if this person died in the next 12 months?"
Exclusion Criteria for Patients:
- residence in nursing home or assisted living facility
- diagnosis of dementia or unable to consent
- documented advance care plan (living will, health care proxy, MOST form, provider note)
- current or prior use of hospice
- current or prior use of non-hospice palliative care except inpatient palliative care consultation
Sites / Locations
- University of Alabama at Birmingham
- Emory University
- University of South Carolina
- University of Texas Southwestern
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Structured Advance Care Planning
Patient Driven Advance Care Planning
In the structured advance care planning approach, patients will participate in a 60 to 90 minute facilitated advance care planning conversation with a trained person using Respecting Choices (First Steps) guide and will receive a state advance directive form. The advance care planning facilitator will follow-up as needed after the session to answer additional questions.
In the patient-driven advance care planning approach, patients receive a Five Wishes Form (easy to understand advance directive written in plain language), a state advance directive form, and at least two follow-up phone calls with an advance care planning contact who will answer questions.