Helping Older Adults Assess Their Need for Future Home-Support Services [Internet]

Excerpt

Objective: Few seniors consider the future home support and health needs they may require as they age. We sought to assess the efficacy of the tool PlanYourLifespan.org (PYL) in influencing seniors' planning behaviors, communication of plans and perception of planning, knowledge of home care services, and confidence in accessing services for future needs.

Method: Randomized controlled trial (RCT) of community-dwelling adults aged 65 and older in urban, suburban, and rural areas in Texas, Illinois, and Indiana.

Results: Among 385 participants, the mean age was 71.9 years and 79.5% were female. Between baseline and 1-month follow-up, the average planning behavior score increased 0.22 points in the PYL arm and dropped 0.92 points in the attention control (AC) arm. After controlling for baseline, the mean 1-month planning behavior and communication score was significantly higher in the PYL arm than in the AC arm (1.25 points; CI, 0.37-2.12; P = .0054). For the knowledge/understanding of home services score at 1-month follow-up, the intervention group had a 0.6-point change (SD, 1.6), and the control group who had a −0.1-point change in knowledge score. Linear mixed modeling results suggested that 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 < .0001). Though not statistically significant, secondary outcomes (1) perception of importance of planning (0.60 points; CI, −0.06 to 1.27; P = .0766) and confidence accessing home services (0.47 points; CI, −0.04-0.97; P = .0683) mean scores also exhibited an average overall increase at 1-month follow-up in the active intervention arm compared with the control. Secondary analyses of primary outcome via longitudinal linear mixed modeling suggested a marginal study arm-by-time interaction effect for both planning behavior (P = .0470) and perception of importance (P = .0522). Significant baseline covariates for primary outcome included self-efficacy, education, perceived social support, power of attorney, and history of stroke.

Conclusions and Practice Implications: PYL proved effective in helping seniors plan for and communicate their health and support needs as well as in increasing knowledge and understanding of home-based services. This free, nationally available tool may help individuals understand, plan, and communicate their options for their future support needs.