Table 4 HCPs’ reflections on the main theme 2: Being supported by others

2.1 “Being there”

HCPs recognized patients’ reluctance to burden their proxies. Some HCPs stated to try to discover what patients mean by burdening; did proxies indeed state not to be willing to be burdened or is this a patient’s pre-assumption?

2.2 Leaving a legacy

Some HCPs experienced that patients indeed reflected upon their lives, however, only if patients were still “clear-headed”. Other HCPs stated chaplains, mostly, were involved in such existential issues. In this light, the importance of multidimensional care was expressed. Furthermore, in the group interviews, HCPs considered the fact that older persons increasingly have to care for one another is one of the important issues for future healthcare and that by this, patients’ own coping processes could be neglected. This was confirmed in some patient interviews. Instead of immediately trying to solve this and arrange things, professionals also do well by getting to know the patient together with his/her social system, the responsibilities patients bear for partners and/or family and potential fears over losing control over their situation. Creating room and some peace of mind could lead to patients acknowledging their personal dying process. HCPs also mentioned the involvement of a case manager specialized in dementia. Such a professional has a role in anticipating on future scenarios and in unburdening the older person. Nowadays, HCPs stated, recognizing the patient’s needs, often, comes too late.

2.3 Reliable healthcare professionals

HCPs acknowledged that an explorative dialogue with (older) patients is essential to learn about their concerns. However, they experience some barriers in talking to older patients: in general, they consider older people less assertive, more modest and more willing to hand over responsibility to HCPs. HCPs stated that shared decision-making “is not for everyone”. In such cases, HCPs try to trust their own gut feeling about what is good for the patient. An additional issue is patients’ lack of time for reflection due to the usually quick succession of news, scans, and treatments. Furthermore, HCPs agreed with patients’ desire to have a central and available HCP instead of changing HCPs. Continuity could stimulate a trusting relationship between patient and HCP.