Advance care planning among older adults of Moroccan origin: an interview-based study

BACKGROUND: Advance care planning (ACP) is rare among ethnic minorities for social, cultural, and religious reasons.

AIM: To explore advance care planning-related knowledge, experience, and perspectives among adults aged ≥65 years with Moroccan backgrounds in Belgium.

METHOD: Semi-structured interviews were conducted in Darija (Moroccan Arabic). GPs in Brussels and Mechelen recruited participants. Data were analysed qualitatively using a combination of inductive and deductive thematic analysis techniques.

RESULTS: The 25 interviewees (average age 74 years) lacked ACP knowledge and had not discussed it with healthcare professionals. They had discussed burial and residential care wishes with relatives. After a brief explanation, most interviewees did not find ACP useful, mainly for religious reasons. After more extensive explanation with specific examples, they had fewer religious objections and were more willing to have ACP discussions with their GPs and/or relatives. The mentioned facilitators were GPs' provision of information, children's involvement in ACP discussions, and the desire to not be dependent on children. Barriers were a lack of knowledge, procrastination due to good health, lack of organization, and taboos regarding the discussion of illness and death, trust in one's children to take over care and make decisions, and fear of worrying one's children.

CONCLUSION: Despite an initial lack of knowledge about ACP, many older adults with Moroccan backgrounds were willing to talk about it after receiving information in their native language. GPs should facilitate ACP discussions for these patients, paying attention to individual needs and preferences.