Advance care planning among older adults with a Turkish background and palliative care needs: a qualitative interview study

BACKGROUND: Advance care planning is rare among older adults with a migration background because of social, cultural, and religious reasons.

AIM: To explore advance care planning-related knowledge and perspectives among older people from a Turkish background with palliative care needs living in Belgium.

METHOD: Semi-structured interviews were conducted in Turkish. Data were analysed using a combination of inductive and deductive thematic analysis techniques. GPs in Brussels and Antwerp recruited participants.

RESULTS: All 15 interviewees (average age: 79 years) lacked awareness and detailed information about advance care planning. While some had discussed certain end-of-life preferences with family members such as the preferred location of care and burial place, most did not feel the need to discuss future care preferences because of their trust in God and family. However, some of the responders viewed ACP discussions as useful, relieving the burden on families and being able to answer 'what if' questions ahead of time. The self-identified barriers to ACP were fear of making the wrong decision, a 'live in the moment' attitude, and difficulties in talking about death. The mentioned facilitators were obtaining sufficient information about ACP and recent illnesses or a death in the family.

CONCLUSION: Healthcare providers in Belgium should provide tailored information about advance care planning to Turkish-origin adults with palliative care needs. Advance care planning discussions should also explore the individual's health-related knowledge and personal values, paying attention to social and religious cues. Healthcare professionals should also recognise the salience of Turkish families in end-of-life care.