Live Better at Home, Navarra ( VMNav )

NCT ID: NCT05605392

Last Updated: 2022-11-04

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 241 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-10-05
• Study Completion Date: 2024-06-30

Brief Summary

Alternatives to institutionalization with adapted housing and community supports may allow institutionalized people who so desire to be deinstitutionalized and continue their life in the community. This transition can fulfill the wishes of these people and may improve the quality of their life and functionality.

Detailed Description

Many older adults want to stay and be cared for at home, living in the community. However, long-term care facilities are increasingly becoming places where people live until death. Admissions are often conditioned by the characteristics of the support network rather than by the individual's clinical condition or dependency level. In addition, persistent problems around the cost and quality of housing with a lack of sufficient adapted housing and sheltered housing and inequalities in the distribution of social resources often limit the consolidation of personalized care and support planning.

Under this pretext, and if many people want to live at home for the rest of their lives, our research group aims to offer the possibility to nursing home residents from two nursing homes in Navarra of returning to the community by means of case management methodology and accommodation support. This completely innovative study aims to provide data to help the design and implementation of future studies addressed in this field.

The study consists of two stages:

1. A cross-sectional observational stage for the assessment. Objectives: Quantify the proportion of people who could return safely and quantify the proportion of people who would like to live in the community.

2. An analysis of factors related to the deinstitutionalization process and an intervention stage. Objective: assess the feasibility of this tailored intervention through case management methodology and study the impact of a deinstitutionalization process on participants for whom the transition is achieved.

In addition, this study will be accompanied by a sub-study with a pseudo-qualitative approach. The main objective of this part is to characterize the discourses associated with the willingness to return to the community and the deinstitutionalization process and to identify which evaluative elements concur (barriers and facilitators) and are prioritized in decision-making about a possible deinstitutionalization process. Qualitative research is needed for complex interventions to explore the obstacles and facilitators and to understand the intervention's components.

Conditions

Geriatrics; Institutionalization

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Deinstitutionalization

Group Type: EXPERIMENTAL

Deinstitutionalization process

Intervention Type: OTHER

Phase 1: Comprehensive geriatric assessment to evaluate who might be a candidate for deinstitutionalization.

Phase 2: Intervention:

1. Support plan: design a plan agreed upon with the participant to provide resources to the person's needs and which guarantees support during the transition and beyond.

2. Transition process: progressive withdrawal of support in the institution and implementation of support and adaptation in the community, with different types of accommodation depending on the needs and preferences of each participant. Coordination with primary care teams, social services, and other community resources.

3. Case follow-up and gradual withdrawal of the project team. If the process does not go as the person expects, or difficulties are encountered that cannot be resolved, the participant will have the option and choice, if desired, to return to the residence at any time during the process.

Interventions

Deinstitutionalization process

Phase 1: Comprehensive geriatric assessment to evaluate who might be a candidate for deinstitutionalization.

Phase 2: Intervention:

1. Support plan: design a plan agreed upon with the participant to provide resources to the person's needs and which guarantees support during the transition and beyond.

2. Transition process: progressive withdrawal of support in the institution and implementation of support and adaptation in the community, with different types of accommodation depending on the needs and preferences of each participant. Coordination with primary care teams, social services, and other community resources.

3. Case follow-up and gradual withdrawal of the project team. If the process does not go as the person expects, or difficulties are encountered that cannot be resolved, the participant will have the option and choice, if desired, to return to the residence at any time during the process.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Phase 1:

• To have a place within the recruitment period for an indefinite period of time in one of the participating centers.

Phase 2:

• To express willingness to be deinstitutionalized and return to community.
• To obtain a favorable report in phase 1 from the project team on the feasibility and safety of returning to community.

Exclusion Criteria

• Refusal to sign the informed consent form by the resident or, failing that, by the legal representative.
• The existence of a judicial authorization for involuntary admission of the resident to the residential facility.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Spanish Society of Geriatrics and Gerontology

UNKNOWN

Sponsor Role: collaborator

University of Vic - Central University of Catalonia

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jose Augusto García Navarro

Role: PRINCIPAL_INVESTIGATOR

Spanish Society of Geriatrics and Gerontology

Locations

Residencia Santo Domingo

Estella-Lizarra, Navarre, Spain

Site Status: RECRUITING

Residencia El Vergel

Pamplona, Navarre, Spain

Site Status: RECRUITING

Countries

Spain

Central Contacts

Victoria Roncal-Belzunce

Role: CONTACT

victoriaroncal@ceoma.org

+34613058353

Facility Contacts

Gemma Urralburu

Role: primary

Montse Equiza

Role: primary

References

Roncal-Belzunce V, Atares L, Escalada G, Minobes-Molina E, Pamies-Tejedor S, Carcavilla-Gonzalez N, Garcia-Navarro JA. First steps towards the deinstitutionalization of older adults: A protocol for the implementation of a complex intervention. Rev Esp Geriatr Gerontol. 2024 Mar-Apr;59(2):101453. doi: 10.1016/j.regg.2023.101453. Epub 2023 Dec 15.

Reference Type: DERIVED

PMID: 38103438 (View on PubMed)

Other Identifiers

VMCNav1.0

Identifier Type: -

Identifier Source: org_study_id