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J Am Acad Nurse Pract. 2009 Jan;21(1):18-23. doi: 10.1111/j.1745-7599.2008.00369.x.

Perspectives of healthy elders on advance care planning.

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Emerald Physicians, Adult Primary Care, Sandwich, Massachusetts, USA.



To present a qualitative study that explored the perspectives of healthy elders on advance care planning.


Data were gathered through four focus groups and a demographic questionnaire. The focus group data were analyzed using content analysis. A convenience sample of 20 healthy men and women, aged 60-94 years old, was drawn from one community senior center and two assisted living facilities.


The data reveal five major themes: advance care planning is strongly influenced by concern for others; elders assume that preferences are known to their trusted friends, family, and providers, even in the absence of explicit communication with these people; elders value a healthcare system that supports provider time, focus, and continuity; being "known" to a provider is critical to comfort that advance care planning preferences will be respected; and elders are generally ready and eager to discuss advance care planning. Additional findings include: elders are better prepared for the event of death than the dying process; lawyers and financial planners play a prominent role in guiding elders through end-of-life decisions; and elders believe that the optimal time for advance care planning discussion is during periods of relative wellness.


Enhanced understanding of the patient perspective is key to incorporating advance care planning for healthy elders in the ideal milieu of primary care.

[Indexed for MEDLINE]

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