Background Advance care planning (ACP) involves formal structured communication around future health states and wishes, however, uptake is low. Behaviours such as discussing values and expressing wishes for future care may occur informally. This study aimed to map health related communication in older non-native language speakers in Switzerland.
Methods Semi-structured interviews about social connections, health related communication and advance care planning-type behaviours were conducted with 44 non-native language speakers. Interviews were audio-recorded and thematic analysis was conducted directly on audio-recordings.
Results While some participants discussed a quite formal and deliberate ‘checking in’ about their own and their social connections’ health, this was exceptional. Most participants indicated that they are selective about whom they communicate about their health for a variety of reasons: not to bore others, because discussing health isn’t ‘interesting’, not wanting to burden others with their problems, not wanting to worry loved ones who live abroad, and because they feel pressure to move closer to family to be ‘looked after’ in the future. Some discussed the need to ‘manage’ health communication according to their loved ones wishes and sensitivities about other people’s health (not wanting to discuss their own health when they know that their interlocutor’s health is declining). Some indicated that they have a person ‘onsite’ who knows about their health and wishes, who is also in contact with their family abroad, and if future health events arise, they imagine the two communicating and managing the situation well. People who had documented wishes discussed doing so after their own or others serious health event, or wanting to get their affairs ‘in order’.
Conclusion Knowledge about informal advance care planning –type behaviours can equip clinicians with the resources to provide goal-concordant care by knowing where essential information in located within a social network.
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