Evaluating the Unmet Needs of Older Adults to Promote Functional Recovery After a Critical Illness

Yale University350 enrolled

Overview

This is a prospective longitudinal study that will evaluate the unmet needs of older adults (65 and older) who return home (either directly or after short-term rehab) after an ICU hospitalization, evaluate the association of these unmet needs with clinically relevant outcomes, and assess barriers and facilitators to addressing these unmet needs. The proposed research will inform the development and evaluation of a subsequent intervention to improve functional outcomes among older ICU survivors, in alignment with the NIH's mission to reduce disability.

To identify unmet needs in multiple domains after return home from an ICU hospitalization, evaluate whether these unmet needs are associated with disability burden in the subsequent 6 months, and ascertain whether these associations are moderated by initial discharge destination (home or STR).

Study Type

OBSERVATIONAL

Enrollment

350

Conditions

Critical Illness Illness, Critical

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: PARTICIPANTS * Age ≥ 65 years * Survived an ICU admission of ≥2 days CAREGIVERS * Age ≥ 18 years * Identified as caregiver of LANTERN participant who is an informal (unpaid) caregiver. Exclusion Criteria: PARTICIPANTS * Advance directive of comfort measures only (CMO) or a transition to hospice * Planned discharge to a location other than home or Short-Term Rehab * Tracheostomy with ventilator dependence * Severe acute or prior neurologic injury (such as anoxic brain injury or acute, massive stroke) * Advanced dementia * ICU admission for monitoring only (e.g., antibiotic desensitization) * Primary language other than English. * Homelessness * Active drug or alcohol use disorder. CAREGIVERS * Primary language other than English * Is a paid caregiver * Unwilling to complete a qualitative interview

Outcomes

Primary Outcomes

Disability Count

Number of instances of disability during activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility activity. Disability is defined as an inability to complete the task or the need for personal assistance to complete the task. The higher the count, the more disability.

Time frame: monthly up to 6 months

Number of hospital readmissions

Number of hospital readmissions monthly up to 6 months.

Time frame: monthly up to 6 months

Number of deaths

Number of deaths each month up to 6 months.

Time frame: monthly up to 6 months

Barriers and Facilitators to addressing unmet needs

Barriers and facilitators to addressing unmet needs will be assessed using qualitative interviews. A subgroup of participants will receive qualitative interviews conducted with members of the study team. Content analysis will then be used to identify barriers and facilitators to addressing unmet needs that will be informative when planning a future intervention.

Time frame: month 6

Secondary Outcomes

Functional non-recovery

Not returning to the pre-ICU functional baseline within the follow-up period

Time frame: monthly up to 6 months

Evaluating the Unmet Needs of Older Adults to Promote Functional Recovery After a Critical Illness

Overview

Conditions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts