Understanding the Experience of Advance Care Planning for Older Adults Transitioning into Long-Term Care Homes
Bibliographic record
Abstract
During the transition to long-term care (LTC), conversations that prepare individuals and their families for the possibility that the individual may be unable to make healthcare decisions in the future are often overlooked. This research uses a service design approach to understand the LTC transition experience in Ontario with attention to advance care planning. This case study involved qualitative methods to document the perspectives of LTC and advance care planning subject matter experts; and care partners of older adults who transitioned into LTC. This included unstructured interviews with experts; semi-structured interviews with care partners; and follow-up sessions with participants. Results showcased the complicated LTC journey in Ontario and the lack of an integrated approach to advance care planning. Despite the efforts of healthcare workers, many Ontarians have an incomplete understanding, even after transitioning to LTC. Applying service design within this context demonstrated strengths and limitations of the current approach.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.012 | 0.009 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".