Brockport

Researchers are studying older adults aged 75 years and older with advanced chronic kidney disease to find out which educational program better supports their kidney therapy decision-making. The study also aims to see if either program can reduce hospital and emergency room visits within the first six months and possibly improve end-of-life care for these patients. This research explores the first palliative care intervention integrated into routine nephrology care to help patients express their treatment preferences and address unanswered questions. Participants will be randomly assigned to one of two programs. Program A includes information from the National Kidney Foundation and meetings with a kidney therapy educator. Program B offers a video and paper decision aid along with coaching from a decision-support specialist who helps with kidney therapy decisions. Both programs focus on supporting patients in making informed choices about their treatment. During the study, participants decision-making process will be assessed at baseline, 4 to 6 weeks, and 12 weeks using the Decisional Conflict Scale. Researchers will also track changes in patients well-being, hospital admissions, intensive care admissions, emergency room visits, and end-of-life care over six months. The study includes surveys and verbal assessments, and participants progress will be monitored to understand the impact of each program on their care and treatment choices.