VA Community Living Centers to Home

NCT02211274 | Withdrawn

• 1 other identifier: D1241-W
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 2

Brief Summary

Older adults prefer to live as in the community as long as possible. Creating a standardized treatment planning process that includes assessments of everyday competence and goal-setting techniques to help Veterans move from VA nursing homes back to the community can improve functional health, well-being, and quality of life for older Veterans. Research has shown that 29% of nursing home residents might be able to live safely in the community instead. Currently, VA provides nursing home care to more than 13,000 Veterans across the country, which costs about $3.3 billion a year. It is expensive for VA to provide nursing home care to these inappropriate residents and they are using limited resources that could be given to another Veteran with more urgent needs. The Everyday Competence Assessment and Planning for Community Transitions (ECAP-CT) toolkit will help these Veterans to move back into the community with the services and supports they need based on their individual level of everyday competence.

Conditions

Aged; Frail Elderly

Keywords

Quality of Life; Nursing Homes; Housing for the Elderly; Homes for the Aged

Outcome Measures

Primary Outcomes (1)

• Transition Outcome

  The primary outcome of interest for this pilot study will be transition outcome. Transitions will be "successful" if the resident leaves the CLC with a "community" destination and is not readmitted to the CLC within 90 days. For the purposes of this study, transitions to the "community" include any non-institutional environment that is more independent than the CLCs (e.g., single-family home, senior apartment, assisted living, medical foster home, etc.). For individuals who are unable to transition or who transition and are readmitted to the CLC within 90 days, these transitions will be "unsuccessful".

  90 days post-discharge

Secondary Outcomes (9)

• Goal Attainment Scaling

  Baseline

• Multilevel Assessment Instrument - Environment Scale [MAI-ES]

  Baseline and 90 days

• Multilevel Assessment Instrument - Environment Scale [MAI-ES]

  90 days

• Multilevel Assessment Instrument - Environment Scale

  Baseline and 90 days post discharge

• Money Follows the Person - Quality of Life Scale

  Baseline and 90 days post discharge

Study Arms (1)

Study Group

EXPERIMENTAL

Individuals who want to leave the CLC will be allowed to participate in the study, there will be no assignment to groups. Individuals who want to leave the CLC will undergo transition care planning using the investigators' standardized toolkit. The investigators will compare outcomes to administrative data from other similar VA nursing homes.

Other: Everyday Competence Assessment and Planning for Community Transitions

Interventions

Everyday Competence Assessment and Planning for Community Transitions OTHER

The Everyday Competence Assessment and Planning for Community Transitions (ECAP-CT) toolkit will allow CLC interdisciplinary team members to 1) assess the Veteran's everyday competence for safe and independent living; 2) develop personally meaningful rehabilitation goals that facilitate successful transition out of the CLC based on everyday competence; and 3) conduct structured treatment planning to support resident goals around transitioning back into the community. By considering everyday competence and goal-setting in this context, Veterans will have optimal P-E fit upon returning to the community, ensuring a successful transition.

Also known as: ECAP - CT

Study Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• CLC residents will be included if they are able to demonstrate understanding of the informed consent process through teach-back and to communicate verbally.

You may not qualify if:

• CLC residents will be excluded if they are too cognitively impaired or have serious mental illness too severe to meaningfully participate in interviews (i.e., they are not "transition-capable").
• No participants will be excluded based on gender, race, social class, or ethnicity.

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (2)

Providence VA Medical Center, Providence, RI

Providence, Rhode Island, 02908, United States

Location

Michael E. DeBakey VA Medical Center, Houston, TX

Houston, Texas, 77030, United States

Location

Study Officials

• Whitney L. Mills, PhD

  Providence VA Medical Center, Providence, RI

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 31, 2014
• First Posted: August 7, 2014
• Study Start: July 1, 2016
• Primary Completion: February 28, 2020
• Study Completion: February 28, 2020
• Last Updated: April 9, 2020

Record last verified: 2020-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)