{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:53:10Z","timestamp":1791453190160,"version":"4.3.3"},"reference-count":59,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"unspecified","delay-in-days":280,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526103885_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Advance care planning (ACP), including end-of-life (EOL) conversations, helps frail older persons articulate goals and preferences for future treatments and care, ultimately enhancing quality of life. Nevertheless, a substantial gap exists between the many who wish to engage in such conversations and the minority who currently do so. To support earlier and broader engagement, we explored frail community-dwelling older persons\u2019 perspectives and attitudes regarding ACP and EOL discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103885_sec2b\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a qualitative, purposively sampled, interview study of frail community-dwelling older persons (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a016), identified from Dutch general practices. We analyzed the transcripts using reflexive thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103885_sec3c\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We developed 5 themes regarding ACP and EOL conversations: (1) Personal identity as the foundation for ACP and EOL decision-making: personal values strongly shaped EOL preferences and decision-making; (2) external factors\u00a0\u2013 including lived experiences, the social environment, and information channels\u00a0\u2013 influenced EOL perspectives; (3) attitudes and motivations shaped engagement with ACP and EOL conversations, ranging from active engagement to reluctance; (4) organization and conditions of ACP and EOL conversations: the content of conversations varied across conversation partners; and (5) expectations regarding involvement of others in ACP, including EOL conversations: participants expressed a need for proximity to family, close friends, and healthcare professionals and for these others to be involved and take responsibility in supporting decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526103885_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>When asked about ACP, participants focused predominantly on preferences and expectations regarding EOL care and the period surrounding death. These reflections, grounded in personal values and identity, were most often shared with family and close friends and less frequently with healthcare professionals. These findings highlight the central role of informal networks in ACP communication, suggesting that healthcare professionals should actively involve these networks in ACP discussions and decision-making. Furthermore, ACP conversations may benefit from starting from persons\u2019 underlying values and their priorities in life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526103885","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:27:00Z","timestamp":1791451620000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Frail community-dwelling older persons\u2019 advance care planning and end-of-life wishes and preferences: A qualitative interview study"],"prefix":"10.1017","volume":"24","author":[{"given":"Myrthe","family":"van den Heuvel","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05wg1m734","id-type":"ROR","asserted-by":"publisher"}],"name":"Radboud University Medical 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e254"}}