Ich will nicht so sterben wie mein Vater!

Abstract

Aim The aim of this qualitative study is to explore the impact of a personʼs motivation to write an advance directive (AD) on the concept of the document. Methods Answers to 3 questions of transcribed semistructured interviews (INT) were analysed for information about certain occasions and/or reasons / causes to write an AD, expectations from having written this AD and the most important things the individualwanted to express. Qualitative approach with inductive categorisation and content analysis. Software:MAXQDA, version 2007. Results Inclusion of 48 individuals (20 healthy people, 16 chronically ill people and 12 palliative care patients); mean age 63.1±4.4 years, 35% male. Mean length of INT: 23:07±10:11 [11:37– 63:10] min. Identified occasionswere either rational (public debate, decision to write down wishes etc.) or emotional (altruism, death of a loved one (DOL) /acquaintance). Reasons, defined as goal-directedness or purpose, could be divided into active (own ideas and concepts) and reactive reasons (mirroringdying of others /DOL). In active reasons, 5 categories of topics for end-of-life care were found, in reactive 2. Five types of motivations with certain characteristics and impact on the concept of an ADwere identified. Negative experience with DOL lead to a concept of AD that can be described as negative blueprint of someone elseʼs death, lacking most important individualized information. Group differences are presented. Conclusions It seems that the motivation to write an AD has an impact on the concept of the document, as it is influencing the frame of mind, i. e. causing a narrow mind frame. Those who advise others in writing an AD should therefore ask for their motivation and reasons to do so in order to allowanticipatorymeasures against the pitfalls of a narrowmind.