The perspectives on advance care planning among older adults at senior day centers: A qualitative descriptive study in Macao

Objective This study aimed to explore the perspectives on advance care planning (ACP) among older adults in Macao. Methods A qualitative descriptive approach was conducted by using three open-endead questions. A total of 285 purposively sampled older adults from senior day centers participated in this study. Content analysis was conducted using NVivo software. Results The study comprehensively understood older adults' perspectives on ACP, identifying key findings comprising 6 clusters and 15 meaning units. It summarized the willingness and unwillingness to participate, pivotal enabling factors, and the indispensable role played by family members throughout the ACP process. Conclusions The findings demonstrated ACP has both positive and negative aspects for older adults and provided a nuanced and detailed picture of the complex family and cultural dynamics that shape older adults' end-of-life care decisions. The results can provide evidence to promote ACP for older people in other cities in China or countries with similar cultures.