1251 Awareness and misconceptions about palliative care among Chinese Dutch older adults: a focus group study

<h3>Background</h3> For older immigrants, navigating healthcare in a host country and preparing for future health decline can be challenging. <h3>Aim</h3> To explore contemplations of Chinese Dutch older adults when discussing future health decline. <h3>Design</h3> Qualitative data from an exploratory mixed-methods study. Participants played and reflected on ‘The Five Flavors in a Grocery Store’, a board game designed and validated to facilitate advance care planning conversations. Question cards addressed themes including life experiences, perspectives on death and dying, end-of-life care knowledge and preferences. Transcripts of game sessions were analyzed using inductive thematic analysis. <h3>Setting/Participants</h3> Twelve game sessions were held with 43 Chinese Dutch older adults and their relatives in Chinese Dutch community centers and churches in the Netherlands. <h3>Results</h3> The game invited discussions about future health decline, revealing several misconceptions. Chinese Dutch older adults, for instance, believed that if one only has a few months left to live, healthcare providers can no longer offer help, leaving all responsibilities to the family. Chinese older adults assumed that healthcare is unavailable to those who are dying, highlighting a lack of awareness about palliative care. Additionally, Chinese Dutch older adults mentioned euthanasia as a solution to anticipated issues including loss of control or becoming a burden. <h3>Conclusion</h3> Misconceptions among Chinese Dutch older adults contribute to their concerns and unrealistic expectations about future care. These misconceptions include the topic of euthanasia, that is strictly regulated in the Netherlands and may only be an option in case of unbearable and irremediable suffering. This stresses the need to explore how Chinese Dutch older adults perceive the (im)possibilities of palliative care, as well as their potential needs. <h3>Contribution</h3> Our study reveals misconceptions about Dutch healthcare, lack of knowledge of availability of palliative care among Chinese Dutch older adults. These misconceptions may lead to feelings of helplessness regarding future health decline or unrealistic expectations for the future, which could undermine the importance of future care planning and make it difficult for them to navigate the Dutch healthcare system. <h3>Implications</h3> Our findings suggest that addressing information gaps about Dutch healthcare, particularly palliative care, is essential for Chinese Dutch older adults and their families. A potential strategy includes developing easily accessible knowledge packages, co-designed with Chinese Dutch older adults and Dutch healthcare providers, to enhance understanding of the Dutch healthcare system, especially palliative care. Increasing awareness of palliative care may encourage greater engagement in future care planning.