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Advance Care Planning Among Older Adults of Turkish Origin in Belgium: Exploratory Interview Study.

 Demirkapu H, Van den Block L, De Maesschalck S, De Vleminck A, Colak FZ, Devroey D. Advance Care Planning Among Older Adults of Turkish Origin in Belgium: Exploratory Interview Study. J Pain Symptom Manage. 2020 Dec 29:S0885-3924(20)30968-4. doi: 10.1016/j.jpainsymman.2020.12.017. Epub ahead of print. 

Abstract
Context.

Although conversations about future medical treatment and end-of-life care are considered to be important, ethnic minorities are much less engaged in advance care planning (ACP).

Objectives
To explore ACP knowledge, experiences, views, facilitators, and barriers among older adults of Turkish origin in Belgium.

Methods
This qualitative study was based on constant comparative analysis of semi-structured interview content. Participants were 33 older adults (aged 65–84 years; mean, 71.7 years; median, 74.5 years) of Turkish origin living in Belgium.

Results
Despite unfamiliarity with the term ACP in this sample, several participants had engaged in some ACP behaviors. Respondents considered ACP to be useful and were ready to engage in conversations about it. The most commonly mentioned facilitator was the provision of tailored information about ACP. Other facilitators included concerns about future care needs, increasing awareness among respondents’ children about the advantages of ACP, and respondents’ desire to avoid “burdening” their children. The most commonly mentioned barrier was respondents’ lack of knowledge about ACP. Other barriers were language issues, a lack of urgency about ACP discussion, reliance on familial support, and older adults’ fear of triggering negative emotions in themselves and their children.

Conclusions
The provision of tailored information about ACP to older adults of Turkish origin in Belgium and the promotion of awareness about the importance of ACP among their children (when patients desire), as well as the use of professional interpreters, could facilitate ACP engagement in this population.