Assessing future care preparation in late life: Two short measures

Abstract

The purpose of this article is to introduce 2 short forms of the previously published measure of preparation for future care (PFC). Community-dwelling older adults ages 65-94 who had completed the 29-item Preparation for Future Care Needs scale were randomly divided into scale development (n = 697) and scale validation (n = 690) samples. Fifteen items were selected using exploratory and confirmatory factor analyses on the scale development and scale validation samples, respectively. Consistent with PFC theory, the 5 subscales of the original long-form measure (Awareness, Gathering Information, Decision Making, Concrete Planning, Avoidance of Care Planning) were maintained. A 5-item scale with acceptable score reliability and validity was also developed. Compared to the long form, these short forms are more easily incorporated into epidemiologic studies and can be used in medical, psychology, and social work practice to initiate discussions about long-term care planning. (PsycINFO Database Record

Figure 1. Confirmatory Factor Analysis for PFC Short Form Variables in Validation Sample (χ²=226.98, df=79; CFI=.93, TLI=.90, RMSEA=.063, SRMR=.053)

Note: AW=Awareness, GI= Gathering-Information, DM=Decision-Making, CP=Concrete-Planning, AV=Avoidance of Care Planning. After adding one additional correlated error, Gather 1 with Avoid 4 (not shown), the fit was χ²=224.51, df=78; CFI=.94, TLI=.91, RMSEA=.059 (.05-.068), SRMR=.049. We also tested a one-factor model including all subscales, and a two-factor model with one preparation factor and one Avoidance of Care Planning factor (using the full validation sample). Both models had a poor fit (One-factor model: χ²=, df= 90, CFI=.60, TLI=0.54, RMSEA=.13, SRMR=.09; Two-factor model: χ²= 714.87, df=89, CFI=.69, TLI=.64, RMSEA = .12, SRMR =.09), suggesting that the theoretically-driven five factor structure was the best representation of the scale and its domains.