Helping Seniors Plan for Posthospital Discharge Needs Before a Hospitalization Occurs: Results from the Randomized Control Trial of PlanYourLifespan.org

Abstract

BACKGROUND Hospitalized seniors are frequently too sick to make informed decisions about their postdischarge care. Subsequently, loved ones often make support choices (eg, skilled nursing facility placement, caregivers) at discharge. We sought to advance the timeline for postacute care decisions to before a hospitalization occurs. OBJECTIVE Investigate the effect of PlanYourLifespan.org (PYL) on knowledge of posthospital discharge options. DESIGN Multisite randomized controlled trial. SETTING/PATIENTS Nonhospitalized adults, aged ≥65 years, living in urban, suburban, and rural areas of Texas, Illinois, and Indiana. INTERVENTION PYL is a national, publicly available tool that provides education on posthospital therapy choices and local home-based resources. MEASUREMENTS Participants completed an in-person baseline survey, followed by exposure to intervention or attention control (AC) websites, then 1-month and 3-month telephone surveys. The primary knowledge outcome was measured with 6 items (possible 0–6 points) pertaining to hospital discharge needs. RESULTS Among 385 participants randomized, mean age was 71.9 years (standard deviation 5.6) and 79.5% of participants were female. At 1 month, the intervention group had a 0.6 point change (standard deviation = 1.6) versus the AC group who had a −0.1 point change in knowledge score. Linear mixed modeling results suggest sex, health literacy level, level of education, income, and history of high blood pressure/kidney disease were significant predictors of knowledge over time. Controlling for these variables, treatment effect remained significant (P < 0.0001). CONCLUSION Seniors who used PYL demonstrated an increased understanding of posthospitalization and home services compared to the control group. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT0 2256072.

Overcoming Reluctance to Accept Home‐Based Support from an Older Adult Perspective

“…Next steps of this research include leveraging these strategies to develop further negotiating and conflict resolution education for healthcare providers and loved ones to reduce the unmet home‐based needs of older adults. In response to the focus groups, we created an online tool, https://PlanYourLifespan.org, to support older adults and caregivers in communicating and planning for their home‐based health needs in the event of a health crisis https://PlanYourLifespan.org. also informs older adults about resources available locally and nationally that can assist when a health crisis occurs.…”

“…In response to the focus groups, we created an online tool, Pla-nYourLifespan.org, to support older adults and caregivers in communicating and planning for their home-based health needs in the event of a health crisis. 21 PlanYourLifespan.org also informs older adults about resources available locally and nationally that can assist when a health crisis occurs. Tools such as this may help older adults overcome reluctance to accept help as they become more informed about resources and assistance available to them, potentially allowing them to maintain independence in their own home for longer.…”

Health-Literate Healthcare Organizations and Quality of Care in Hospitals: A Cross-Sectional Study Conducted in Tuscany

“…The importance of HL has not only been recognized in terms of health outcomes, but also in terms of economic results [11]. The instruments to increase HL levels are considered "inexpensive and easy to implement", but at the same time, capable of reducing costs and improving outcomes in terms of disease prevention [12,13] by means of increased adherence to potentially life-saving screening [14], decrease in hospitalization rates [15,16], and appropriate use of healthcare services [17].…”

Rationale and study design for decision making & implementation of aging-in-place/long term care plans among older adults

“…As inadequate health literacy and cognitive impairment is prevalent among seniors, PYL presents information understandable at all levels of health literacy and sensitive to cognitive load. [ 22 ] The tool uses simplified, large-font, less dense text without scrolling and although it targets people in the United States, other tool information may be useful to seniors from other countries [ 31 , 32 ].

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