PLAN: Preparing and Living for Aging Now a Multi-Methods Study Investigating Older Adults’ Readiness to Plan for Aging and Frailty

Background: Understanding aging through a holistic lens is essential to promote healthy aging in light of population aging and increased life expectancies that are often accompanied by the risk of chronic conditions, frailty, and disability. Planning for aging and frailty (PAF) encompasses five domains of aging (communication/socialization, environmental, financial, physical care, cognitive status) and serves as a proactive way for adults to prepare and plan across the life course. The purpose of this study was to examine the stages of change, experiences (personal and experiences with others), and associations between contextual factors and stages of change for readiness to PAF. And to explore how people perceive the concept of PAF and identify the facilitators and barriers involve in the planning process.

Methods: This study utilized a multi-methods design. Community-dwelling adults age 50-80 years old were recruited from a senior center, two YMCA sites, and ResearchMatch.org. Participants (N=252) completed a survey assessing stages of change for PAF, functional status, frailty, health status, social support, and demographics. Qualitative methods utilized semi-structured phone interviews with participants (N=20).

Results: The distribution of stages of change in readiness across domains of PAF were varied with highest levels of planning in action/maintenance stage in financial (68.7%) and lowest level in cognitive status (28.2%). More participants reported having experiences with others in all domains as compared to having personal. Older participants (³ 70) vs. younger (50-69) reported statistically significant greater planning in action/maintenance stages for all domains (p < .05) except cognitive status. Factors most indicative of planning were older age, marital status, living situation, social support, and vulnerability.

Conventional qualitative content analysis revealed categories of codes in the perception domain (internal, external, and future-oriented), facilitators domain (internal, external, and systems), and barriers domain (internal, systems). The depth of one’s self-identity, life experiences, and societal influences emerged.

Conclusion: PAF is an innovative concept that takes a comprehensive look at the aging process through the promotion of planning. Geriatric APRNs are uniquely positioned to provide education, guidance, and advocacy to older adults that may want to age in place and require guidance in navigating their later years.