A pilot program that introduces a new model of care in nursing homes is moving forward as a clinical trial.
The model is meant to make treatment in nursing homes more proactive.
The trial is called the Advanced Care Specialist Program. Participating nursing homes consult with residents and their families about their care preferences, so goals of care can be established.
Dr. Kathleen Unroe is a researcher at the Regenstrief Institute and helped create the program. She says the current system of care often doesn’t ask residents about treatment preferences until after a medical crisis has already occurred.
"If that is the first time that overall goals of care are being discussed and trying to be incorporated into acute medical decision making, it’s highly stressful,” Unroe says.
When nursing home residents and staff consult about treatment, it makes people consider their options before an emergency arises, giving them more control.
Dr. Susan Hickman is another researcher at the Regenstrief Institute who helped create the program. She says without proactive consultation about treatment preference, many elderly or sick patients recieve all care available, rather than what would improve their quality of life.
"Advanced Care Planning is all about helping ensure people get the care that they want, and do not get the treatment that they do not want," says Hickman.
Under the program, Unroe and Hickman say many patients opted for less aggressive care and focused more on comfort.
The goal of the clinical trial is to demonstrate that Advanced Care Planning can be implemented on a larger scale.
The pilot trial included four nursing homes in Indiana. The clinical trial will include 170 nursing homes accross the country.
