Letter from the Primary Care Clinic Introducing Advance Care Planning:
“I read [the letter] and I was happy to get it. This whole thing was in the back of my mind and I’ve been wanting this kind of thing, but didn’t know what to call it… I’m at the stage in life where I really want to cover these issues…I was thrilled that you’re doing this and that my doctor is a part of it.” (Patient age 80 who screened positive for having cognitive impairment) “[The letter] opened a discussion between my husband and I and it was very helpful. (Patient age 77 without suspected cognitive impairment) “The letter was clear and to the point. Good for someone who had not given the topic any thought.” (Spouse of patient who did not screen positive for having cognitive impairment)
Person-Family Agenda-Setting Checklist:
“[The checklist] was immensely helpful. We both filled that out and that was what I found to be the most helpful part of the whole process. It really focused our discussion when we went in and we were both on the same page.” (Adult son of patient who screened positive for having cognitive impairment) “It [included] things I didn’t really think about before…the main one was I didn’t want anyone accompanying me to a certain visit. I had one that was a memory test. I really did not want my daughter in at that point because I had some fears about my memory…I didn’t think before about how to say that I didn’t need someone with me at that visit.” (Patient age 73 who did not screen positive for having cognitive impairment) “It makes you think so you don’t forget. I think it’s a good idea.” (Patient age 66 who did not screen positive for having cognitive impairment)
Facilitated Registration for Shared Access to the Patient Portal:
“I have MyChart myself and I find it immensely helpful. My mom isn’t the most technologically literate person, so I thought I’ll have access and go in there and help her in case she needs it…The convenience of doing it there [in clinic] was a big plus.” (Adult son of patient who screened positive for having cognitive impairment) “I know I want my husband and daughter to have access…to have a second set of eyes. If I’m in a position where I can’t get the information myself, I want someone to be able to.” (Patient age 74 who did not screen positive for having cognitive impairment) “It makes the whole interface with the care team easier.” (Spouse of patient who screened positive for having cognitive impairment)
Access to a Facilitator Trained to Lead Advance Care Planning Conversations:
“[Facilitator 1] did a really thorough job. Our attorney went over it with us, but he didn’t give quite as much detail…It was a really good interview and education because while we had thought about most of that, we hadn’t gotten that specific, so it was really quite helpful.” (Patient age 66 who screened positive for having cognitive impairment) “The convenience was a plus side. The follow-up scheduling worked well, the meeting got a lot done. [Facilitator 2] and [Facilitator 3] helped to organize and speed up thinking about who would be involved…The conversation prompted a call to family.” (Spouse of patient who screened positive for having cognitive impairment) “It was good to have someone go over it with you and the family members. We might not have talked about it otherwise.” (Daughter of patient who screened positive for having cognitive impairment) “I think it’s good to have someone speaking out loud and probing your desires and bringing it out into the open.” (Patient age 77 who did not screen positive for having cognitive impairment)
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