Background Supportive living (SL), also known as assisted-living, residents are at risk of progressive cognitive decline and physical frailty, requiring treatment decisions. As such ACP is recommended but the factors associated with readiness to engage in ACP in SL are not fully understood.

Aim The purpose of this study was to explore perceptions of readiness, barriers and facilitators to ACP of SL residents, their families and clinicians.

Method This qualitative study utilised an Interpretive Descriptive (ID) approach. Participants were 9 residents from 3 SL facilities, 6 family members and 8 SL clinicians in a health region with an ACP policy and procedure. Data collection consisted of semi-structured interviews with participants. Interviews were coded, analysed and themes developed within each group. Themes were also compared across the groups to understand areas of convergence and distinctness.

Results For SL residents, ACP is closely related to making the transition to SL rather than health decisions. Clinicians are either task oriented or conflicted regarding ACP implementation. Families of SL residents draw on personal experience as most have lost a relative or experienced prior decision making for a family member. Early analysis demonstrates the emergence of five themes across the groups: conceptualization of ACP, readiness for engagement, health uncertainty and difficulty in decision-making, barriers/facilitators.

Discussion These findings will be used in a knowledge-to-action program to inform the clinical approach, resources and health region processes aimed at increasing readiness for ACP and ACP engagement by patients and families in SL.