Nurses' experience of advance care planning in home care services for elderly people: A qualitative study.

• The use of advance care planning in home care services is limited. • Systematic and planned conversations would be beneficial to enhance collaboration with elderly chronically ill home-dwelling patients. • It could be difficult to decide when and for whom advance care planning should be conducted. • The importance of spontaneous conversations must not be forgotten in addition to using structured tools. This study explores nurses' experience and reflections on the use of advance care planning (ACP) for older adult patients in home care services. The study employs an explorative qualitative design. Five focus groups with 21 nurses in home care services were conducted and analyzed using content analysis. Three main categories were identified; 1) limited experience with the use of ACP, 2) reflections on systematic use of ACP and 3) prerequisites for successful ACP conversations. The participants revealed limited experience with ACP but recognized that such conversations could provide important clarifications for patient and family caregiver support. The use of ACP needs to be individually tailored, involving family caregivers, and being conducted in collaboration with a physician. The need for open conversations initiated by the patient or family caregivers should be addressed. For successful implementation, competence building, a planned process, and support from management are essential. ACP could be beneficial in the follow-up of older, chronically ill patients living at home, but should not substitute the need for individualized spontaneous conversations. [ABSTRACT FROM AUTHOR]