Advance Care Planning Support for Formerly Chronically Homeless Older Adults Living in Permanent Supportive Housing A Randomized Study Comparing Group and One-on-One Sessions

What this Trial Is About

Researchers are evaluating adapted advance care planning ACP programs for formerly chronically homeless older adults living in permanent supportive housing PSH. This study aims to address the low rates of ACP in this aging population, which faces accelerated aging, high mortality, and risk of having their end-of-life wishes unmet. The trial focuses on comparing different ways to deliver ACP and improving engagement among residents of PSH. The study tests two ways of delivering the PREPARE-PSH program, an evidence-based, easy-to-use online ACP program with videos and easy-to-read advance directive forms tailored for the PSH setting. Participants are randomly assigned by site to either a one-time 90-minute facilitated group session or a one-on-one ACP visit, both including viewing videos about choosing a medical decision maker and deciding what matters most in life. The program also provides workbooks and legal forms with PSH-specific content. Participants will be followed over time with surveys measuring their engagement in advance care planning at the start, 3 months, and 6 months after the sessions. Researchers will also conduct interviews and focus groups to understand factors influencing engagement and sustainability of the program. The total participation includes attending the session and completing follow-up assessments to evaluate ACP behaviors and preferences.

Advance Care Planning With Formerly Homeless Older Adults Residing in Permanent Supportive Housing