Background Planning for the end of life increasingly has become a necessity in order to ensure autonomy and a dignified death. Yet, little is known about the attitudes of very old people to ACP.

Aim To investigate issues of ACP in a broad data set on health, care and living conditions of very old people in Austria.

Methods The ÖIHS-Study follows a longitudinal design with biannual data collection. It covers a representative sample of 410 people aged 80–85 years in two Austrian regions. A qualitative study with a purposive sampling strategy (n = 40) complemented the survey. Interviews were transcribed verbatim and analysed using an open coding procedure applying MaxQda software.

Results A minority had an advance statement like “durable power of attorney” (11%) or a living will (9,3%). The higher the socioeconomic status the more often an ACP-document was available. We found a lack of information about the relevance of ACP and access to it. Worries about meaning of life and closure, relations to families and social participation were predominant in the interviews.

Discussion Most people did not suffer from a live-limiting diagnosis as specific to the oldest old which might be one reason for little awareness of ACP apart from a general lack of information.

Conclusion As a general approach to deal with issues concerning the future of the oldest old ACP has gained little attention in Austria yet. For promotion in this age group it seems vital to exceed medical perspectives and include issues of social care as well.