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

Abstract

BackgroundNursing homes are becoming increasingly important as end-of-life care facilities. However, many older adults want to stay in their homes as they age. ObjectiveTo assess the feasibility of a deinstitutionalization process on selected institutionalized older adults who are willing to initiate the process. MethodsThis 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. DiscussionAlternatives to institutionalization with adapted accommodation and community support can allow people who wish to return to the community. Trial registrationNCT05605392.