title: Perspectives of healthy elders on advance care planning.
abstract: OBJECTIVE
  To present a qualitative study that explored the perspectives of healthy elders on advance care planning.
  
  
  METHODS
  Data were gathered through four focus groups and a demographic questionnaire. The focus group data were analyzed using content analysis. A convenience sample of 20 healthy men and women, aged 60-94 years old, was drawn from one community senior center and two assisted living facilities.
  
  
  CONCLUSIONS
  The data reveal five major themes: advance care planning is strongly influenced by concern for others; elders assume that preferences are known to their trusted friends, family, and providers, even in the absence of explicit communication with these people; elders value a healthcare system that supports provider time, focus, and continuity; being "known" to a provider is critical to comfort that advance care planning preferences will be respected; and elders are generally ready and eager to discuss advance care planning. Additional findings include: elders are better prepared for the event of death than the dying process; lawyers and financial planners play a prominent role in guiding elders through end-of-life decisions; and elders believe that the optimal time for advance care planning discussion is during periods of relative wellness.
  
  
  CONCLUSIONS
  Enhanced understanding of the patient perspective is key to incorporating advance care planning for healthy elders in the ideal milieu of primary care.
authors.affiliation: Emerald Physicians, Adult Primary Care, Sandwich, Massachusetts, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Malcomson
authors.forename: Shannon
authors.initials: S
authors.lastname: Bisbee
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration*; D024362:Advance Directive Adherence / Q000523:psychology; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D033062:Friends / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration*; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D019727:Proxy; D036301:Qualitative Research; D012944:Social Support; D011795:Surveys and Questionnaires