Advance Care Planning for Older Homeless Adults
(ACP-PSH Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial ensures that older adults who were once chronically homeless have their healthcare wishes respected at the end of their lives. It tests two methods to assist these individuals in planning their future care: facilitated one-on-one Advance Care Planning (ACP) visits and facilitated group ACP sessions. Both options teach participants how to select someone to make medical decisions for them and identify what matters most in their healthcare choices. Suitable candidates are English-speaking adults who were chronically homeless and now reside in permanent supportive housing. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance end-of-life care planning for vulnerable populations.
Do I need to stop my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications.
What prior data suggests that these advance care planning interventions are safe for older homeless adults?
Research shows that both group and one-on-one advance care planning (ACP) sessions are generally well-received by participants. Previous studies have found these ACP sessions effective in increasing patient satisfaction and involvement without causing significant problems. The sessions often include easy-to-read materials and guided discussions to help participants understand their healthcare options.
Reports from past trials do not indicate any serious negative effects from these sessions. Instead, participants usually find them helpful for making informed decisions about their future healthcare. Since this trial does not test a new drug or medical procedure, the risks are minimal. Participants can expect a safe environment focused on planning their healthcare wishes.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it focuses on advance care planning (ACP) for older homeless adults, a group often overlooked in healthcare planning. Unlike traditional ACP methods that might not consider the unique challenges faced by this population, this trial uses tailored, facilitated sessions, both one-on-one and in groups, to engage participants. The use of a movie version of the PREPARE program, along with new content specific to permanent supportive housing (PSH), makes the process more relatable and accessible. By incorporating easy-to-read advance directives and personalized video content, this approach aims to empower individuals to make informed decisions about their healthcare priorities.
What evidence suggests that this trial's advance care planning interventions could be effective for older homeless adults?
Research has shown that planning for future medical care, known as advance care planning (ACP), helps patients with serious health issues feel more involved and satisfied with their care. This applies to older adults who have experienced homelessness as well. In this trial, participants will attend either a facilitated group ACP session or a facilitated one-on-one ACP visit. Studies indicate that these ACP sessions, whether in groups or one-on-one, help people prepare for future medical decisions and increase participation in making choices about end-of-life care. This can lead to healthcare that is more personalized and respects individual wishes. Overall, participating in these sessions can significantly ensure that personal preferences are followed.12367
Who Is on the Research Team?
Rebecca Sudore, MD
Principal Investigator
University of California, San Francisco
Margot Kushel, MD
Principal Investigator
University of California, San Francisco
Are You a Good Fit for This Trial?
This trial is for formerly chronically homeless individuals over age 50 who now live in permanent supportive housing. It aims to ensure their end-of-life wishes are respected. Participants must be capable of making decisions and providing consent.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Co-development
Co-development of PREPARE-PSH through in-depth interviews and focus groups with PSH residents and the Community Advisory Board
Intervention
Participants attend a one-time 90-minute ACP session, either one-on-one or in a group, to review the PREPARE program
Follow-up
Participants are monitored for ACP engagement and adverse outcomes at 3 and 6 months
What Are the Treatments Tested in This Trial?
Interventions
- Facilitated Group ACP Session
- Facilitated one-on-one ACP visits
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of California, San Francisco
Lead Sponsor
National Institute on Aging (NIA)
Collaborator