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Article History

Received: 4 October 2017

Accepted: 31 July 2018

First Online: 13 August 2018

Ethics approval and consent to participate

: NSD - Norwegian Centre for Research Data, the Data Protection Official for Research, approved the qualitative part of the study March 4 2015, and approved the quantitative part of the study April 28 2015. Permission was granted September 22 2015 by NSD to record sound and observe conversations. Their reference number is 41114.The regional committee for medical and health research ethics (REC South East) approved April 15 2015 data collection from patient EHRs without consent. The committee demanded however that all patients, or NOK for patients without capacity to consent, received an information sheet that included an opt out opportunity from data collection from patient EHRs. REC South East approved the information sheet. Reference number is 2014/2210 REC South East.Approval to interview bereaved NOK and a hospital physician granted by REC South East March 9 2016.Approval for data collection from patient EHRs for patients who died up to 9 months prior to the intervention was granted by REC South East January 16 2017.All participants in conversations being observed and interviewed signed an informed consent sheet. The application approved by NSD did not contain criteria that determined whether consent could be obtained directly from the patient or from a family member or other legal guardian. All participants received the approved information sheet (Additional file). The first author, who is a nurse with experience working with geriatric patients, assessed patient’s competency to consent. He found all patients competent to consent as they understood they were about to participate in ACP and research, and that sensitive information about them would be made unavailable to others. All patients recognized the relevancy of ACP to their situation and they thought logically about the information received. Finally, all patients orally accepted being observed and interviewed, and signed the informed consent sheet. All those interviewed signed an informed consent sheet. The informed consent sheets were approved by NSD.

: The authors declare that they have no competing interests.

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