Perspectives of healthy elders on advance care planning

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


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.

MeSH terms

  • Advance Care Planning / organization & administration*
  • Advance Directive Adherence / psychology
  • Aged / psychology*
  • Aged, 80 and over
  • Attitude to Health*
  • Communication
  • Decision Making
  • Family / psychology
  • Female
  • Focus Groups
  • Friends / psychology
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Needs Assessment / organization & administration*
  • Nursing Methodology Research
  • Patient Education as Topic
  • Patient Participation / methods
  • Patient Participation / psychology
  • Proxy
  • Qualitative Research
  • Social Support
  • Surveys and Questionnaires