Chatbot-Assisted Advance Care Planning Education for Family Members

Messaging-and-chatbot-assisted Nursing Consultation to Empower Family Members of Residents Living in Nursing Homes on Advance Care Planning (ChatACP)

The goal of this clinical trial is to learn if a messaging and chatbot program, called ChatACP, helps family members of people living in nursing homes take part in advance care planning.

The main questions this study aims to answer are:

• Does ChatACP help family members feel more ready to talk about future medical and personal care with their loved one?
• Does ChatACP help family members take part in advance care planning activities, such as having care discussions or completing planning documents?
• Is ChatACP easy to use and acceptable for family members?

Researchers will compare ChatACP to standard self-learning materials about advance care planning to see which approach works better.

Participants will:

• Receive short daily messages with pictures or videos about advance care planning and access to a chatbot specialized in ACP for 10 days
• Complete surveys at the start of the study, after the program ends, and again 3 months later
• Take part in an interview to share their experience with the program

Inclusion Criteria:

• aged 18 years or older
• providing care for an older adult (age 65 or above) living in a care home as a family member (including the family members in the traditional sense and the guardian and persons close to or significant to the older adult)
• able to read, write and communicate in Cantonese or Mandarin
• the resident, care recipient, having a prefrail or frail status as defined by a score of 3 or above on the Clinical Frailty Scale (CFS)
• having a mobile device to receive instant messages and access to cellular network
• engaged in minimal or no prior EOL care discussions with the care home resident as defined by a self-reported status of pre contemplation/contemplation stage on ACP discussions with the resident using the ACP staging algorithm

Exclusion Criteria:

• suffering from moderate to severe cognitive impairment defined by an Abbreviated Mental Test score of 5 or less and unable to give consent
• suffering from communication problems (e.g., deafness or aphasia)