Advance care planning among older adults in Belgium with Turkish backgrounds and palliative care needs: A qualitative interview study

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

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background
Data on advance care planning (ACP) among migrants in Europe is lacking. Research has shown that few older migrants in the United States perform ACP due to healthcare system distrust, collectivistic values and spirituality/religion.

Objectives
To explore the ACP knowledge and perspectives of older Turkish-origin adults in Belgium requiring palliative care.

Method
General practitioners (GPs) in Brussels and Antwerp recruited Turkish-origin participants aged ≥ 65 years with palliative care eligibility for this qualitative study. A GP conducted semi-structured interviews in Turkish in respondents’ homes between May 2019 and February 2022 using a topic guide. Two researchers performed combined inductive/deductive thematic data analysis.

Results
All 15 interviewees (average age, 79 years) lacked ACP awareness and information. Some had discussed specific end-of-life preferences (e.g. care location, burial place) with family. Still, many did not feel the need to discuss future healthcare preferences, due mainly to trust in God and family for caretaking and decision-making. Some respondents viewed ACP discussions as applicable, relieving the burden on family and enabling proactive addressing of ‘what if’ questions. Self-identified ACP barriers were fear of making wrong decisions, ‘living in the moment’ and difficulty discussing death. Facilitators were obtaining sufficient ACP information and recent family illness or death.

Conclusion
Our sample of Turkish-origin older adults in Belgium requiring palliative care lacked ACP knowledge. Our findings suggest that their lack of engagement in discussing end-of-life medical care planning was linked to their family dynamics and religion. The findings have implications for healthcare providers to ethnic-minority groups.
Original languageEnglish
Article number2271661
JournalEuropean Journal of General Practice
Volume29
Issue number1
DOIs
Publication statusPublished - 30 Dec 2023

Keywords

  • Advance care planning
  • end-of-life care
  • older adult
  • migrant
  • qualitative study

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