Engaging community advisors to adapt remote me & my wishes: perspectives from persons living with dementia, care partners, and nursing home leaders.
Abstract
Background
Me & My Wishes, is a video recording approach for documenting, viewing, listening, and discussing nursing home (NH) residents' preferences for daily and end-of-life care.
Purpose
To address the feasibility, alignment and measurement domains of the Readiness Assessment Pragmatic Trial Model for implementing Me & My Wishes in a remote format.
Methods
Using a qualitative descriptive design, we conducted focus groups with community advisors representing persons living with dementia (PLWD) (n=6), care partners (n=8), and NH staff (n=9) to inform us of what mattered to them when implementing and evaluating a remote format of Me & My Wishes. We coded and analyzed audio-recorded transcripts, resolved coding discrepancies in team meetings, and derived domains from finalized codes.
Results
Three feasibility domains encompassed Effective Utilization of Care Plan Meetings, Competing Demands, and Utilizing Technology and Learning to Communicate in a Virtual Environment. Five alignment domains included Humanizing the Care Plan Process, Enhancing Resident Voices and Wishes, Improving Knowledge for Better Care, Strengthening Relationships and Connections, and Increasing Accessibility and Involvement. Pragmatic measurement domains included designing a data record template for the electronic health record to capture video highlights, changes in preferences, and results of conversations.
Conclusion
Adaptations focused on feasibility, alignment and measurement aspects of delivering Me & My Wishes remotely would improve pragmatic readiness and may effectively engage various participants while fostering meaningful discussions about end-of-life preferences.