P09 - ADVANCED-Comfort: A Novel Model of Care to Promote Comfort and Quality of Life

Over 6 million Americans are living with Alzheimer’s disease and related dementias (dementia), a progressive terminal condition and the 6th leading cause of death in the United States. While people with late-stage dementia should receive comprehensive, person-centered care focused on maintaining comfort and quality of life, many experience pain, distressing symptoms, and interventions, such as feeding tubes and hospital transfers, that do not benefit them. Advanced directives frequently fall short of ensuring comfort and quality of life because they require families to abandon the goal of sustaining life or restoring function in exchange for a focus on comfort. The purpose of this presentation is to describe ADVANCED-Comfort, a novel model of care that represents a major paradigm shift in end-of-life care planning. The model suggests that rather than “giving up,” comfort is actively sought by conducting a thorough assessment and selecting personalized interventions to meet the needs of people living with late-stage dementia in 6Ms adapted from the age-friendly health systems framework (what matters, meaningful activities, mealtime, medications, mobility, make comfortable). Family members complete the ADVANCED-Comfort workbook, which solicits information about the person living with dementia through a series of questions focused on each the 6Ms. Thereafter, families can use the answer sheets to guide conversations with healthcare providers or they can display them in a prominent place to serve as personalized care plans made visible to all those that care for the individual with dementia. Results of initial empirical testing of the model will also be presented.