Table 1 Inclusion and exclusion criteria by type of study participant
Veteran patient | |
|---|---|
Inclusion criteria | 60 years of age or older |
Obtains care in the primary care clinics (General Medicine, Geriatrics, and Women’s Clinic) at the San Francisco VA Medical Center | |
Has been seen at least twice in the last year by a primary care provider (a measure of established primary care) and had at least two additional visits to the VA in the past year (a measure of frequent the medical center) | |
Exclusion criteria | Dementia by ICD-9 codes, clinician assessment, chart review or self-report |
Blindness or poor vision by ICD-9 codes, clinician assessment, chart review, self-report of blindness or the inability to read print on a newspaper, or research staff assessment of less than 20/200 vision on the Snellen eye chart with corrective lenses [42]. | |
Deafness by ICD-9 codes, clinician assessment, self-report, chart review or research staff assessment | |
Cognitive impairment as assessed by research staff of any deficits on the validated cognitive assessments Short Portable Mental Status Questionnaire (SPMSQ) [43] and the mini-Cog [44] | |
Delirium or psychosis as assessed by a clinician or research staff | |
Does not report fluency in English | |
No phone for additional study contacts and follow-up interviews | |
Active drug or alcohol abuse within the past 3 months determined by clinician assessment, self-report, chart review or research staff assessment | |
Patients who report they will be out of town during their scheduled follow-up interview dates outside of a window of 2 months | |
Patients who cannot answer consent teach-back questions after three attempts | |
Surrogate participant | |
Inclusion criteria | 18 years of age or older |
An enrolled patient must identify the surrogate as someone who could make medical decisions for him or her if needed | |
An enrolled patient must give the surrogate’s contact information and give permission to contact their potential surrogate | |
Exclusion criteria | Self-reported dementia, blindness, or deafness |
Cognitive impairment as assessed by research staff of any deficits on the validated cognitive assessments Short Portable Mental Status Questionnaire (SPMSQ) [43] and the mini-Cog [44] | |
Delirium or psychosis as assessed by research staff | |
Does not report fluency in English | |
No phone for follow-up interviews | |
Surrogates who report they will be out of town during their scheduled follow-up interview dates outside of a window of 2 months | |
Surrogate for whom we cannot schedule an interview greater than 6 months from the Veteran’s final 6-month follow-up interview date | |
Surrogates for whom we have attempted to contact 5 times or more without a response | |
Surrogates who cannot answer consent teach-back questions after three attempts | |