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

Study Overview
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Brief Summary
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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.

Detailed Description
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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).

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

Conditions
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Critical Illness, Illness, Critical

Participation Criteria
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Eligibility Criteria
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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. CAREGIVERS Primary language other than English Is a paid caregiver Unwilling to complete a qualitative interview

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Older adults returning home post-ICU<br>Community-dwelling older adults who return home (either directly or after a stay in short-term rehab (STR)) after an ICU hospitalization. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | monthly up to 6 months | 
| Number of hospital readmissions | Number of hospital readmissions monthly up to 6 months. | monthly up to 6 months | 
| Number of deaths | Number of deaths each month up to 6 months. | 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. | month 6 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional non-recovery | Not returning to the pre-ICU functional baseline within the follow-up period | monthly up to 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Geriatrics, Older Adults