Palliative Medicine, Ahead of Print.
Background:Broad consensus exists on the relevance of advance care planning in dementia. Although people with young-onset dementia and their family are hypothesized to have distinct needs and preferences in this area, they are hardly ever included in studies.Aim:We aim to explore the experiences with and views on advance care planning of people with young-onset dementia and their family caregivers.Design:A qualitative study was conducted, analyzing semi-structured interviews through the method of constant comparative analysis.Setting/participants:We included 10 people with young-onset dementia and 10 of their family caregivers in Flanders.Results:Participants lacked awareness about the concept of advance care planning, especially as a communication process. They had not or barely engaged in planning future care yet pointed out possible benefits of doing so. Initially, people with young-onset dementia and their caregivers directly associated advance care planning with planning for the actual end of life. When discussing advance care planning as a communication process, they paid ample attention to non-medical aspects and did not distinguish between medical, mental, and social health. Rather, respondents thought in the overarching framework of what is important to them now and in the future.Conclusions:Engagement in advance care planning might be hindered if it is too medicalized and exclusively patient-centered. To accommodate advance care planning to people with young-onset dementia’s and their caregivers’ needs, it should be presented and implemented as a holistic, flexible, and relational communication process. Policy and practice recommendations are provided on how to do so.