Conversations on Living and Dying: The CLaD study
Research type
Research Study
Full title
Conversations on living and dying. Facilitating advance care planning for community-dwelling older people living with frailty: Developing and intervention.
IRAS ID
243776
Contact name
Caroline Nicholson
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 10 months, 21 days
Research summary
Research Question: What are the most important elements of advance care planning (ACP) for community-dwelling frail elders (frail elders), and what is the best way to discuss ACP with them?
Background: Compared to fit older people, frail elders are at greater risk of sudden health changes, any of which could lead to hospitalisation, loss of mental capacity, long-term care admission, or death. Advance care planning (ACP) is a process that helps people to talk about what matters most about their future care. Communicating these preferences to families and professionals means the person is more likely to receive their preferred end-of-life care. But ACP is not often used with frail elders for many reasons. These include that professionals find it difficult to predict when the frail elder is nearing the end of life, therefore when to start ACP. This study aims to develop an ACP intervention that is appropriate for frail elders. This is important because we cannot deliver personalised end-of-life care if we do not know what a person’s wishes are.
Study design:
1. Understanding clinical perspectives
To explore the experiences and attitudes of frail elders, family and professionals regarding ACP, interviews will be conducted with 16 frail elders and 8 significant others. (A national survey and local focus groups with professionals will also be conducted. Ethics for these have already been obtained).2. Intervention development
To develop an intervention to help professionals to support frail elders with ACP two half-day workshops will be held with frail elders, significant others, professionals, and voluntary sector representatives.3. Intervention refinement
To refine the intervention, 10 community-based professionals will use the intervention in practice with 2-3 frail elders and provide feedback. Frail elders will also be asked to give feedback.Funding: The National Institute for Health Research’s Clinical Doctoral Research Fellowship Programme.
REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
19/NW/0148
Date of REC Opinion
25 Mar 2019
REC opinion
Favourable Opinion