Article Text

Download PDFPDF

OP26 Effects of a late life supportive care innovation that focuses on what matters most
  1. S Schellinger1,
  2. H Britt2,
  3. M JaKA2,
  4. K Fernstrom2,
  5. A Betzner2,
  6. P Bingham2,
  7. N Shippee3,
  8. T Shippee3 and
  9. E Anderson2
  1. 1Allina Health, St. Paul, MN, USA
  2. 2Allina Hospice and Palliative Care, St Paul, USA
  3. 3University of Minnesota, Minneapolils, MN, USA


Background Whole person care is a new paradigm for serious illness beyond disease specific practice guidelines and lacks robust evaluation. The purpose of this presentation is to describe the effects of LifeCourse(LC), a person-centered program for patients living with serious illness, utilization of healthcare, care experience and quality of life.

Methods This quasi-experimental intervention study with a Usual Care (UC) comparison group was conducted between 2012–2017. Enrolled patients (N=903) were estimated to be within 3 years of end of life and diagnosed with 1+ serious illness. Community health workers (CHWs) delivered standardized monthly 1-hour home visits based on palliative care guidelines to assist patients in identifying self-defined goals, support ongoing person-centered advance care planning, and promote physical, psychosocial and financial wellbeing. Primary outcomes included healthcare utilization measured by electronic health records and patient and caregiver-reported experience and quality of life measured every 3 months.

Results Patients were elderly (LC 74, UC 78 years) and primarily non-Hispanic, white, living at home, and had a cardiovascular primary diagnosis (LC 69%, UC 57%). A higher proportion of LC patients completed advance directives during the study (N=173, 38%) than did UC patients (N=66, 15%; p<0.001). LC patients who died spent more days in hospice (88±191 days) compared to UC patients (44±71 days; p=0.018). LC patients reported greater improvements than UC in communication as part of the care experience (p=0.016).

Conclusions The implementation of person-centered programs delivered by CHWs is feasible. Inexpensive upstream expansion of palliative care models can yield benefits for patients and caregivers.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.