Effect of an Advance Care Planning Intervention

Effect of an Advance Care Planning Intervention on Documentation of Advance Directives and Goals of Care in Assisted Living Centers

The intervention being studied is an advance care planning intervention. The trial has two arms: usual care and information arm.

Eligible patients whose assisted living centers are randomized to the information arm will receive a letter from their clinician with links to informational video. Eligible patients whose assisted living centers are randomized to the usual care arm have advance care planning discussions with a clinician at admission, annually, and sometimes with a hospitalization or other change in condition.

Inclusion Criteria:

• Partnering assisted living center with at least 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes)
• Patients not on hospice
• Patients who do not have comfort care or do-not-hospitalize orders at baseline

Exclusion Criteria:

• Partnering assisted living center with less than 20 patients with a dementia diagnosis (based on International Classification of Diseases, version 10 codes)
• Patients on hospice
• Patients with comfort care or do-not-hospitalize orders at baseline