Developing a Life Story Intervention for Hospitalized Older Adults with Dementia or at Risk of Delirium: A Multi-Stage, Stakeholder-Engaged Co-Design Study
ABSTRACT
Background:
Hospitalized older adults with chronic or acute cognitive impairment, such as dementia or delirium, face unique barriers to person-centered care and higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life stories have demonstrated promise in enhancing person-centered care by improving patient-care team relationships and providing information to enable care tailored to individual needs and values.
Objective:
This study engaged patient, care partner, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for older adults with dementia and at risk of delirium in the acute care hospital setting.
Methods:
A three-stage co-design process including in-depth qualitative interviews and surveys with 27 key stakeholder informants including patients, care partners, and interdisciplinary care team (IDT) members.
Results:
Stakeholders were unanimously interested in integrating life stories into the hospital care setting. Stakeholders shared potential topics for life stories to cover including social support, information on patients’ key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story sharing methods, and barriers and facilitators. IDT members shared preferences on electronic health record (EHR) integration, resulting in three co-designed mock-ups of EHR integration options. Stakeholders also shared their thoughts on potential impacts of life stories, including improving patient/care partner-IDT member relationships, humanizing patients, increasing clinical team and patient/caregiver satisfaction, and enabling more specific-tailored care for patients with dementia and at risk of delirium.
Conclusions:
This study resulted in a feasible co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting. Clinical Trial: N/A
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