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9 Perspectives on advance care planning among family members of older Turkish and Moroccan adults

bmjspcare · 2025-09-09 · canonical JSON source

9 visible annotations · policy: published · automated confidence ≥ 75.00%

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Background Significantly fewer individuals with migration backgrounds than native-born individuals undertake advance care planning. Older adults with Turkish and Moroccan backgrounds represent one of the largest ageing non-Western minority groups in Europe. Their relatives could play important roles in facilitating or hindering advance care planning, but their views remain underexplored.Aim To explore advance care planning knowledge, experience, views, facilitators and barriers among older Turkish and Moroccan adults’ relatives in Belgium.Method Qualitative thematic analysis of semi-structured interview data.Setting/Participants Twenty-two relatives of older Turkish and Moroccan adults in Brussels, Mechelen and Antwerp, recruited via general practitioners.Results Participants had limited advance care planning knowledge and had not discussed it with healthcare professionals. Some found discussing end-of-life preferences with relatives beneficial; others opposed the discussion of specific topics or felt discussions were unnecessary, as they felt responsible for caregiving and trusted by their relatives to make future decisions. Barriers included personal and relational characteristics, emotional difficulty and perceived non-urgency. Facilitators included information in older adults’ native languages, general practitioners’ cautious initiation and the involvement of several family members.Conclusions Relatives of older people with Turkish and Moroccan backgrounds are unfamiliar with advance care planning and have highly variable views on it. People should be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives regarding whether and how to engage in such planning should be recognised.What is the unique contribution of this submission?Our study highlights the following key points:Family members have highly variable views on the usefulness, benefits, limits and possibilities of advance care planning.Older adults’ personal characteristics, such as non-acceptance of ageing, and family dynamics, such as parental authority, may impede advance care planning discussions.Implications for Policy and PracticeCare providers should acknowledge Turkish and Moroccan family members’ significance in advance care planning for their relatives, addressing their concerns and emotions.Family caregivers need to be given opportunities to discuss advance care planning in a culturally appropriate manner, and the diversity of perspectives on whether and how to engage in such planning needs to be recognised.General practitioners should facilitate communication about advance care planning between older adults and their family members by initiating discussions and involving all key relatives.