Implementation of a Telehealth Palliative Care Model for Persons With Dementia (IMPACT)

University of Maryland Baltimore (UMB)

Status: Completed

Conditions: Dementia; Palliative Care

Treatments: Other: Palliative Care Consultation

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05001620

HP-00095001

U54AG063546 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Grounded in the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) Model, this study will assess the implementation outcomes of the Nurse Practitioner (NP) delivered telehealth Palliative Care Consultation in Post-Acute Care (PCC-PAC) intervention for persons living with dementia (PLWD) and their care-partners newly admitted to nursing homes (NHs) for post-acute care.

Full description

This single arm embedded pragmatic pilot clinical trial will provide data to assess the implementation outcomes of the Nurse Practitioner (NP) delivered telehealth Palliative Care Consultation in Post-Acute Care (PCC-PAC) intervention among 30 persons living with dementia (PLWD) and their care-partners newly admitted to one nursing homes (NH) for post-acute care.

Enrollment: 16 patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Stakeholders:

• (1) PC provider
• (2) Social Work (SW) NH champions
• (3) post-acute care unit nursing staff and providers (including medical directors)
• (4) NH leadership, information technology staff
• (5) PLWD and their care partner(s).

Person Living with Dementia (PLWD)

• documented dementia diagnosis
• admitted for post-acute care
• age ≥ 60 years
• if unable to participate in a conversation or lacking capacity to make healthcare decisions as determined by the NH staff/providers, a care partner who can act as a surrogate decision maker in the PCC-PAC.

Exclusion criteria

Stakeholders:

-PLWD who receives the intervention

PLWD:

• planned discharge within 48 hours of screening
• currently receiving hospice care

Trial design

Primary purpose: Supportive Care

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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16 participants in 2 patient groups

Palliative Care Consultation in Post-Acute Care

Experimental group

Description:

Subjects will receive usual care plus a telehealth palliative care consultation by specialty providers who will document their findings in the Electronic Health Record (EHR), and communicate their findings and recommendations to the clinical team.

Treatment:

Other: Palliative Care Consultation

Stakeholder Engagement

No Intervention group

Description:

We will engage stakeholders in a stakeholder engagement plan that include Palliative Care providers; Social Work (SW) NH champions; post-acute care unit nursing staff and providers (including medial directors); NH leadership, information technology staff; and a PLWD and their care partners in focus groups and one on one semi structured interviews via phone or videoconference.