Introduction The goal of advance care planning (acp) is to ensure that individuals receive future care consistent with their expressed preferences. Benefits of acp include: increased adherence to a person’s preferences, higher staff satisfaction, reductions in unwanted hospitalisations and medical treatments, and reduced stress and anxiety for family. Despite clear benefits, uptake of acp has been limited in Australian aged care settings. This research explored barriers and enablers to implementing acp in residential and community aged care settings, from the perspectives of aged care staff and older people.

Method Focus groups and interviews with aged care staff and older people were conducted in four Australian states. Sixty staff from 15 residential and community aged care organisations and 24 older people participated. A thematic analysis was undertaken to identify facilitators and barriers.

Results Factors identified as impacting on the experiences and implementation of acp included: knowledge and understanding access to education/training understanding of relevant legislation having defined roles/responsibilities cognitive capacity of the older person timing of initiating the conversation availability of clear policies/procedures engaging older people and their families diversity within the workforce and older people.

Conclusions Aged care staff indicated there are a range of factors that can impact on acp implementation. All these factors may need to be considered when implementing acp within Australian aged care organisations. The findings informed the development of a new national resource titled Advance care planning in aged care: a guide to support implementation in community and residential settings.