Fundamentals of end-of-life communication as part of advance care planning for older people: An interview study with nursing staff

•Many fundamentals can be traced back to a number of basics of nursing and being human.•Through using senses and intuition, nurses connect and adapt to needs and preferences.•End-of-life communication is a dance in which nurses move along with older people. This exploratory interview study investigated nursing staff members’ perspectives on the fundamentals of end-of-life communication with older people as part of advance care planning in home care, nursing home, and hospital settings. Separate semi-structured interviews were conducted with 17 nursing staff members about their experiences, opinions, and preferences before, during, and after end-of-life conversations. Overall themes clustering the fundamentals include preconditions such as feeling comfortable talking about the end of life and creating space for open communication. Fundamentals related to the actual conversation–such as using senses and applying associative communication techniques (e.g., using understandable language), following conversation phases, and being aware of interprofessional collaboration–were also considered important. This study emphasizes the importance of moving along with the older person as well as connecting, adapting, and letting go of control over the conversation's outcome. Many fundamentals can be traced back to the basics of nursing and the humanity of conversation.