Background: Uncertainty about the future is commonly experienced by older adults with advanced multimorbidity, impacting multiple life domains and frequently causing anxiety. Communicating about future uncertainty affects patient satisfaction, quality of decision-making and opportunities for future planning. Patient, carer and healthcare professional experiences of future uncertainty communication have been little studied to date. Aim: In the context of older adults with advanced multimorbidity, to explore patient, carer and healthcare professional experiences and preferences for communication of uncertainty about their future. Design: Multi-method qualitative research utilising in-depth interviews and focus groups with reflexive thematic analysis. Setting/participants: Older adults with advanced multimorbidity ( n = 15), their nominated informal carers ( n = 3), and community and inpatient healthcare professionals working with this population ( n = 17). Results: Participants’ experiences of uncertainty communication were influenced by their acceptance or avoidance of addressing future unknowns. Patients and their informal carers expressed a range of information needs: they prioritised open and honest dialogue with healthcare professionals, tailored to their unique circumstances and supported by reassurance and proactive plans, even when medical options were limited. Healthcare professionals acknowledged the importance of addressing uncertainty: they expressed a lack of experience and confidence and feared upsetting patients or losing their trust. As a result, opportunities for timely and personalised communications may be missed. Conclusions: To support patients and carers navigate the inherent uncertainties of advanced multimorbidity, healthcare professionals would benefit from tailored communication training designed to increase their experience of undertaking honest and open dialogue about future uncertainties, informed by patients’ individual context and preferences.
Fennessy et al. (Mon,) studied this question.