First steps towards the deinstitutionalization of older adults: A protocol for the implementation of a complex intervention

Victoria Roncal-Belzunce; Laura Atares; Gema Escalada; Eduard Minobes-Molina; Sandra Pamies-Tejedor; Nuria Carcavilla-González; José Augusto García-Navarro

doi:10.1016/j.regg.2023.101453

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.

Authors

Victoria Roncal-Belzunce¹, Laura Atares², Gema Escalada³, Eduard Minobes-Molina⁴, Sandra Pamies-Tejedor³, Nuria Carcavilla-González¹, José Augusto García-Navarro³

Affiliations

¹ Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain.
² Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain. Electronic address: laura.atares@segg.es.
³ Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain.
⁴ Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain.

PMID: 38103438
DOI: 10.1016/j.regg.2023.101453

Abstract

Background: Nursing homes are becoming increasingly important as end-of-life care facilities. However, many older adults want to stay in their homes as they age.

Objective: To assess the feasibility of a deinstitutionalization process on selected institutionalized older adults who are willing to initiate the process.

Methods: This study, divided into two phases, will be carried out over 15 months on 241 residents living in two nursing homes in Navarra (Spain). The first phase has a cross-sectional design. We will identify the factors and covariates associated with feasibility and willingness to participate in a deinstitutionalization process by bivariate analysis, essential resources for the process and residents to participate in the process. The second phase has a complex interventional design to implement a deinstitutionalization process. An exploratory descriptive and comparative analysis will be carried out to characterize the participants, prescribed services and the impact deinstitutionalization intervention will have over time (quality of life will be the main outcome; secondary variables will be health, psychosocial, and resource use variables). This study will be accompanied by a pseudo-qualitative and emergent sub-study to identify barriers and facilitators concerning the implementation of this process and understand how intervention components and context influence the outcomes of the main study. Intervention components and the way the intervention is implemented will be of great relevance in the analysis.

Discussion: Alternatives to institutionalization with adapted accommodation and community support can allow people who wish to return to the community.

Trial registration: NCT05605392.

Keywords: Calidad de vida; Case management; Complex intervention; Deinstitutionalization; Desinstitucionalización; Gestión de casos; Intervención compleja; Older adults; Personas mayores; Quality of life.

MeSH terms

Aged
Cross-Sectional Studies
Deinstitutionalization*
Humans
Institutionalization
Nursing Homes
Quality of Life*

Associated data

ClinicalTrials.gov/NCT05605392