Using photographs, electronic geriatric assessment, and the “This is Me” tool to guide enhanced supportive care in older adults referred for treatment at a regional cancer centre

Abstract Introduction Healthcare is increasingly shifting from a paternalistic model to one that prioritises person-centred care (PCC). Despite this trend, implementing PCC in the care of older adults diagnosed with cancer remains challenging. The Age-Friendly Health Systems (AFHS) initiative provides a structured framework – the 4Ms (What Matters, Medication, Mentation, and Mobility) - to promote consistent, evidence-based care for older adults. It has demonstrated benefits in general geriatric care; however, applying the 4Ms principles in oncology is underexplored. This study aimed to assess the feasibility of enhancing geriatric assessment (GA) by integrating two novel person-centred elements: Photovoice (two patient-supplied photographs inspired by "Photovoice" principles but not constituting a full Photovoice methodology) and the "This is Me" (TiM) tool. Materials and Methods A cross-sectional mixed-methods study evaluated the feasibility of integrating two novel elements (two patient-supplied photographs and the TiM tool) into GA, with the aim of promoting practice based on the AFHS 4Ms framework principles. Twenty consecutive patients (≥70 years, G8 score ≤ 14) from a regional cancer centre completed the assessment (electronic Rapid Fitness Assessment [eRFA]-Photo-TiM, as well as the Mini-Cog and Timed-Up-and-Go). Results were presented at a weekly "enhanced supportive care" (ESC) multidisciplinary team (MDT) meeting. Participants completed post-assessment surveys and interviews. Results All patients (n = 20), aged 79 years, 45% female, completed the eRFA, 19 completed the TiM, and 18 provided photographs. The combined assessment was overall acceptable and feasible, user-friendly, captured patients' values and contexts, and facilitated supportive care referrals and advance care planning discussions. ESC-MDT members valued the holistic view for informing supportive care decisions. However, photo submission required substantial assistance for most participants, hence a significant barrier to overcome for implementation. Other barriers included digital literacy and delays in completion, which averaged 2.5 weeks. Discussion The eRFA-Photo-TiM approach was feasible and acceptable in a real-world cancer care in a regional cancer centre and may support more person-centred care decision making. Further research should evaluate effect on cancer care outcomes and sustainable implementation.