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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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1
Emerald Physicians, Adult Primary Care, Sandwich, Massachusetts, USA.

Abstract

PURPOSE:

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

DATA SOURCE:

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.

CONCLUSIONS:

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.

IMPLICATIONS FOR PRACTICE:

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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