Article Figures & Data
Figures
- Figure 1.
Core Phases of the About Me Care Card Study
- Figure 2.
Version 1 of the About Me Care Card for Aging Adults With Alzheimer Disease and Related Dementias
- Figure 3a.
The Outside Pages of Version 2 of the About Me Care Card for Aging Adults With Alzheimer Disease and Related Dementias
- Figure 3b.
The Inside Pages of Version 2 of the About Me Care Card for Aging Adults With Alzheimer Disease and Related Dementias
Note: A participating health system with experience using the original About Me Care Card also tested a slightly different version of the About Me Care Card.
Tables
Clinician (n) Care team Delivery setting Setting Implementation timing Patients (n) Phase 1 Social worker (1) Midsize (<$1 billion), not-for-profit US health system home health team Telephone Southeast United States, rural Independent of home visit with social worker to discuss social needs only 10 Senior PCP (1) Private, independent physician (single provider practice) In-person, in assisted living setting Midwest United States, rural During medical visit with physician 8 Palliative care physician (1) Midsize (<$1 billion), not-for-profit US health system palliative care team In-person, palliative care clinic room Southeast United States, rural During medical visit with physician 4 Employed neurohospitalist (1) Midsize (<$1 billion), not-for-profit US neurohospitalist team Hospital room Southeast United States, rural During medical visit with physician, discharge planner, and researcher 3 Social worker (1) Not-for-profit independent area on aging agency Telephone Midwest United States, rural Independent of home visit to ensure understanding of patient’s social needs 10 PACE PCP (1; identical to phase 2) Program of all-inclusive care for elderly PACE care facility Midwest United States, rural Patients completed About Me Care Card with administrator before visit with PCP, then discussed card with PCP during medical encounter 10 Employed PCP (1) Large (≥$1 billion), not-for-profit US health system Skilled nursing facility Midwest United States, small city During medical visit with PCP 6 Phase 1 total 51 Phase 2 PACE PCP (1; identical to phase 1) Program of all-inclusive care for elderly PACE care facility Midwest United States, rural Patients completed About Me Care Card with administrator before visit with PCP, then discussed card with PCP during medical encounter 7 Social worker (1) Midsize (<$1 billion), not-for-profit US social care team, inpatient visit Part of Hospital Elder Life program Southeast United States, rural Social worker conversation with inpatient 5 Nurse practitioner (1) Private, independent memory clinic Telehealth and in-person visits with patients in nursing homes Midwest United States, rural During visit with patients via telehealth or in person to specifically assess for cognitive, memory care 10 Employed PCP (1) Midsize (<$1 billion), not-for-profit US primary care team Primary care clinic Southeast United States, rural Patient asked to complete About Me Care Card when arriving at clinic, immediately before visiting with PCP; PCP discussed card with patient during medical encounter 51 Employed PCPs and nurse practitioners (3) Midsize (<$1 billion), not-for-profit US primary care team Primary care clinic Southeast United States, rural Patient asked to complete About Me Care Card when arriving at clinic, immediately before visiting with PCP; PCP discussed card with patient during medical encounter 16 Employed neurologist (1) Memory clinic/institute Academic tertiary hospital Madrid, Spain (large city) Patient asked to complete About Me Care Card when arriving at clinic, immediately before visiting with neurologist; neurologist discussed card with patient during medical encounter 5 Phase 2 total
Overall total94
145PACE = Program of All-inclusive Care for the Elderly; PCP = primary care physician.
Key design recommendations
Simplify content: decrease options in “My Life” section
Make relevant to user: what is important to you?
Ensure content is easy to review and elicits questions
Feasibility
Conversation preparation: “does not waste time on trying to determine goals…clinician can focus on guiding conversation around goals or concerns”
Flexibility of use: “face-to-face worked well, phone was a little difficult”
Adaptability: “can be used in a variety of clinical settings, assisted living, social care, primary care, home care”
Adoption: “simply need to practice to know how it impacts efficacy”Key design insights
Personalization: [living my best life] “gave me a chance to reflect on my life” (patient)
Elicited new information: “new [patient] information [they] found enlightening, which doctor never knew” (clinician)
Acceptability
Focused on right care: “guided the discussion, permitting a palliative care mindset” (clinician)
Slowed down time: “provided time and space for people to think about what they want and how they want to express it” (clinician)
Expanded conversation: “I found out a patient was lonely…made a referral to social care” (clinician)
SUPPLEMENTAL DATA IN PDF FILE BELOW
- Grande_Supp_Table.pdf -
Supplemental Table. Global steering committee
- Grande_Supp_Table.pdf -
PLAIN-LANGUAGE SUMMARY
Original Research
“About Me” Care Card Tool Can Improve Care Planning and Cognitive Health Management
Background and Goal:Existing tools for cognitive impairment focus primarily on clinical diagnosis but do not support discussions that address patients’ personal fears, goals, and social needs. The goal of this study was to develop and test the “About Me” Care Card, a tool designed to promote dialog between patients, caregivers, families, and clinicians on care related to dementia, cognitive impairment, and aging.
Study Approach:Researchers conducted a feasibility study using a community and user-centered design approach to develop and test the “About Me” Care Card, a tool developed based on shared decision-making principles. An environmental scan identified gaps in existing cognitive care tools, and a global steering committee made up of health care professionals, patient advocacy groups, caregivers/family members, and individuals with dementia provided feedback.
Main Results: Fourteen clinicians consisting of 7 clinician types across 7 institutions piloted the card during in-person visits or by telephone. Observations showed the card (1) allowed time to elicit what matters most to patients, (2) created space for personalized care conversations, (3) opened an examination of social care needs, and (4) moderated emotional relationships between families and individuals. Findings from 44 completed post-use surveys showed that most patients found the card beneficial, with 65% recommending it for those over age 65. However, while 41% found it easy to use, some patients with advanced cognitive challenges required assistance and only 32% felt it helped in creating a concrete plan to address their priorities.
Why It Matters:Findings from this study suggest that integrating tools like the “About Me” Care Card into primary care workflows could help clinicians identify patient concerns earlier.
Feasibility and Acceptability of the “About Me” Care Card as a Tool for Engaging Older Adults in Conversations About Cognitive Impairment
Stuart W. Grande, PhD, MPA, et al
University of Minnesota School of Public Health, Minneapolis, Minnesota
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