• Ashwin A Kotwal, Deborah E Barnes, Aiesha M Volow, Brookelle H Li, W John Boscardin, and Rebecca L Sudore.
• Department of Medicine, Division of Geriatrics, San Francisco School of Medicine Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences Department of Epidemiology and Biostatistics, University of California Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical, San Francisco, CA.
• Alzheimer Dis Assoc Disord. 2021 Jul 23.

IntroductionEngaging patients with cognitive impairment in advance care planning (ACP), including completing advance directives and naming health care proxies, before they lose decision-making capacity is important.MethodsWe determined the feasibility of the PREPAREforYourCare.org ACP program among 20 diverse older adults with mild-to-moderate cognitive impairment and their caregivers in a 1-week, pre-post pilot. We examined ease-of-use, satisfaction, and feasibility using validated scales, and change in ACP Engagement scores, including knowledge, contemplation, self-efficacy, and readiness subscales (5-point scales), from baseline to 1-week.ResultsParticipants were on average 70 years old (SD=9.0), 45% Spanish-speaking, 60% had limited health literacy, and 15% felt comfortable using the internet. Patients and caregivers rated PREPARE a mean of 8.6 (SD=1.6) and 9.4 (SD=1.1) on the 10-point ease-of-use scale, 4.7 (SD=0.4) and 4.7 (SD=0.3) on the 5-point satisfaction scale, and 4.9 (SD=0.4) and 4.8 (SD=0.6) on the 5-point feasibility scale, respectively. ACP engagement scores increased for 16 of 20 (80%) patients (P=0.03) and 16 of 20 (80%) caregivers (P=0.18). Caregivers experienced increased knowledge (3.8 to 4.7, P=0.002) and self-efficacy (3.6 to 4.5, P=0.034) for ACP.DiscussionThe PREPARE website was feasible and may facilitate ACP engagement among diverse older adults with cognitive impairment and their caregivers.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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