Acceptability of the voice your values, an advance care planning intervention in persons living with mild dementia using videoconferencing technology

Abstract

Advance care planning (ACP) can improve outcomes for persons living with dementia (PLwD). Clinicians see the lack of acceptability of these conversations as a barrier to ACP in individuals with mild dementia. COVID-19 pandemic has magnified the need for ACP discussions in older adults, particularly for those living with dementia. In light of the pandemic, much of the healthcare is provided virtually, but little evidence exists on how to best implement ACP virtually. We designed Voice Your Values (VYV), a tailored ACP intervention for persons living with mild dementia and their trusted individuals such as friends or family. Purpose Determine the acceptability of the VYV intervention, in terms of its content and the potential utility of videoconferencing to deliver it. Methods For this pilot study, we recruited 21 dyads of older adults with mild dementia and their trusted individuals from five geriatric clinics in Ontario, Canada. The tailored VYV intervention was delivered to dyads over two sessions over videoconferencing. Acceptability was assessed using scores on a modified Treatment Evaluation Inventory. The interventionist diary and Researcher Virtual Experience Questionnaire were used to examine facilitators and barriers, whereas Participant Virtual Experience Questionnaire was used to understand their experience. Qualitative data was analyzed using inductive content analysis. Results 100% of the participants rated VYV as acceptable. Participants and researcher rated video and sound quality highly. PLwD who lived with their trusted individuals were more likely to find the intervention acceptable (t = 3.559, p = 0.001, β = 0.323). Five interrelated themes were established that describe the acceptability of the virtually delivered VYV intervention. All PLwD were able to articulate their values and wishes related to being in a terminal and vegetative states and had them documented. Conclusion The virtual VYV intervention was an acceptable approach to ACP in older adults with mild dementia and their trusted individuals.

Tele-rehabilitation interventions for individuals living with dementia during the COVID-19 pandemic: Mixed-method systematic review

“…Studies were conducted in the COVID-19 era and published in 2020 and 2022. Geographically, nine were conducted in European countries: Italy (n=4) (Arighi et al, 2021;Capozzo et al, 2020;Gareri et al, 2022;Panerai et al, 2021), Spain (n=3) (Benaque et al, 2020;Dura-Perez et al, 2022;Goodman-Casanova et al, 2020), Canada (n=1) (Vellani et al, 2022), and the United Kingdom (n=1) (Di Lorito et al, 2021). Three were found in Asian countries: Hong Kong (Lai et al, 2020), India (Lima et al, 2021) and Taiwan (Lai et al, 2022).…”

“…There were different interventional study designs, including randomised control trial (Goodman-Casanova et al, 2020), pretest-posttest interventional design (Lai et al, 2020;Lai et al, 2022), nonrandomised interventional comparison design (Panerai et al, 2021), interventional qualitative study (Di Lorito et al, 2021), cohort study (Dura-Perez et al, 2022), feasibility study (Brandão et al, 2021), pilot study (Vellani et al, 2022) and other preexperimental designs (Arighi et al, 2021;Benaque et al, 2020;Capozzo et al, 2020;Gareri et al, 2022). Five were mixed-method studies (Brandão et al, 2021;Capozzo et al, 2020;Dura-Perez et al, 2022;Goodman-Casanova et al, 2020;Vellani et al, 2022). Lima et al (2021) focused on an intervention development study (i.e., a human-robotic) consisting of three phases: developing, designing and pilot testing.…”

“…Concerning the sample characteristics, seven studies were conducted on individuals living with dementia or mild cognitive impairments (Arighi et al, 2021;Benaque et al, 2020;Dura-Perez et al, 2022;Gareri et al, 2022;Goodman-Casanova et al, 2020;Lai et al, 2022;Vellani et al, 2022). Caregivers had participated in five studies (Capozzo et al, 2020;Di Lorito et al, 2021;Lai et al, 2020;Lai et al, 2022;Panerai et al, 2021).…”

“…Caregivers had participated in five studies (Capozzo et al, 2020;Di Lorito et al, 2021;Lai et al, 2020;Lai et al, 2022;Panerai et al, 2021). Caregivers with their trusted individuals (family or friends) participated in one study (Vellani et al, 2022). One study recruited individuals living with dementia and healthy older adults in the designing phase, while one person with dementia participated in the testing phase (Lima et al, 2021).…”

“…Reported non-pharmacological interventions were cognitive interventions (Brandão et al, 2021;Goodman-Casanova et al, 2020;Panerai et al, 2021), sensory stimulation interventions (Brandão et al, 2021;Di Lorito et al, 2021;Goodman-Casanova et al, 2020), social interventions (Brandão et al, 2021), educational interventions (Lai et al, 2022;Vellani et al, 2022) and assistive technology interventions (Lima et al, 2021). Cognitive interventions included reality orientation therapy (ROT) and memory games (Arighi et al, 2021;Goodman-Casanova et al, 2020).…”