Advance care planning among older people of Turkish origin in Belgium: an exploratory interview study

Hakki Demirkapu, Lieve Van Den Block, Stéphanie De Maesschalck, Aline De Vleminck, F. Zehra Colak, Dirk Devroey

Keywords: Advance care planning, older adult, ethnicity, minority group, qualitative study

Background:

Despite widespread recognition of the importance of future medical needs and end-of-life care are, ethnic minorities show low engagement in advance care planning (ACP).

Research questions:

The aim of this study was to examine how seniors of Turkish origin in Belgium view ACP, and to identify facilitators and barriers to ACP in this population.

Method:

Employing a qualitative study design, a constant comparative analysis of semi-structured interview responses was conducted. A cohort of 33 adults, who were 65–84 years old (mean, 71.7 years; median, 74.5 years) and of Turkish origin living in Belgium, completed the study.

Results:

Although participants were unfamiliar with the term ACP, some had engaged in aspects of ACP. Respondents recognized that ACP was useful and were willing to discuss it. The most frequently mentioned ACP facilitator was the availability of community-adapted information. Other facilitators mentioned included active concerns about future care needs, respondents’ children being aware of the advantages of ACP, and respondents’ desire not to burden their children. The most frequently mentioned barrier was a lack of knowledge about ACP. Additionally, respondents expressed that ACP may be hindered by limited fluency with the national language, a lack of urgency, reliance on family, and worries about discussions of mortality upsetting their families and themselves.

Conclusions:

ACP engagement among seniors of Turkish origin in Belgium may be facilitated by the provision of tailored ACP information, the availability of linguistic interpreters, and programs promoting awareness of the importance of ACP to the community, including to the adult children of the elderly when appropriate.

Points for discussion:

Discussing ACP with ethnic minorities