BMC Palliative Care最新文献

{"title":"Radiation-before-pathology approach in the palliative oncology setting: a pragmatic clinical trial protocol (RT-NOW).","authors":"Sympascho Young, Melissa O'Neil, Joanna M Laba, Timothy K Nguyen, X Melody Qu, Christopher D Goodman, Glenn S Bauman, Andrew Warner, Matthew Cecchini, David A Palma","doi":"10.1186/s12904-025-01724-3","DOIUrl":"10.1186/s12904-025-01724-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with incurable but not-yet-biopsied cancers sometimes require urgent palliative radiation. However, wait-times for biopsy procedures and pathologic results can delay treatment, with significant consequences to patient quality of life and/or the chance of irreversible cancer complications. There is no prospective data to guide empirical decision-making in these urgent, palliative contexts.</p><p><strong>Methods: </strong>In this prospective single-arm pragmatic clinical trial, we will enrol 48 patients with incurable cancer where a biopsy is delaying urgent palliative radiation. Patients will receive empiric upfront palliative radiation without biopsy-confirmation. The primary endpoint is the rate of inappropriate radiation, defined when the patient's biopsy shows a non-malignant entity or a malignancy that is better treated upfront with systemic therapy (or therapy other than radiation). Secondary endpoints include: histologic diagnostic accuracy, molecular testing accuracy, biopsy complications rates, evidence of radiation effect in biopsy, time from enrolment to radiation/biopsy, and Edmonton Symptom Assessment Scale (ESAS) scores. Patients are eligible only if the probability of incurable malignancy is deemed > 95% and the risk of lymphoma < 20% by the treating physician, based on clinical examination and imaging investigations.</p><p><strong>Discussion: </strong>This study will provide prospective data to guide oncologists and patients in making informed decisions when weighing the competing risks of delaying palliative radiation versus treating without pathologic confirmation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06156800. Date of registration: December 5, 2023.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"96"},"PeriodicalIF":2.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between caregiver burden and hope in leukemia patients: a cross-sectional study in selected referral hospitals in Tehran, Iran.","authors":"Azam Ghorbani, Moein Salami, Mohammad Mehdi Rajabi","doi":"10.1186/s12904-025-01731-4","DOIUrl":"10.1186/s12904-025-01731-4","url":null,"abstract":"<p><strong>Background: </strong>Leukemia is a life-threatening condition that imposes significant challenges not only on patients but also on their caregivers. Caregiver burden, a multidimensional concept encompassing physical, psychological, and emotional strain, often impacts the quality of care provided to patients. Conversely, hope, a critical psychological resource, plays a pivotal role in patient well-being and coping. Understanding the relationship between caregiver burden and patient hope is essential for improving holistic cancer care.</p><p><strong>Methods: </strong>This descriptive correlational study was conducted at the Cancer Institute and Valiasr Hospital, affiliated with Tehran University of Medical Sciences, between May and November 2024. A total of 400 participants, including 200 leukemia patients and their 200 primary caregivers, were recruited using convenience sampling. Data were collected using the Zarit Caregiver Burden Interview (ZBI) and Snyder's Adult Hope Scale (AHS). Descriptive statistics and Pearson's correlation coefficient were used to analyze the data in SPSS version 16, with a significance level of P < 0.05.</p><p><strong>Results: </strong>The mean caregiver burden score was 37.69 ± 7.12, indicating a moderate level of burden, while the mean hope score among leukemia patients was 32.19 ± 1.88, reflecting relatively high levels of hope. A weak but statistically significant negative correlation was found between caregiver burden and overall hope scores (r= -0.164, P = 0.02). However, no significant correlations were observed between caregiver burden and the subscales of hope, namely Pathway Thinking (r=-0.127, P = 0.073) and Agency Thinking (r=-0.126, P = 0.076).</p><p><strong>Conclusion: </strong>The study highlights a significant inverse relationship between caregiver burden and patient hope, underscoring the interconnected dynamics between caregiver well-being and patient psychological resilience. Interventions aimed at reducing caregiver burden and fostering hope in patients are essential for enhancing the overall quality of care in leukemia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"95"},"PeriodicalIF":2.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on the experience of internet outpatient consultation in palliative care for relatives of cancer patients.","authors":"Shuo Li, Guijun Lu, Yongqing Shen, Jianya Ye, Jingmin Ji","doi":"10.1186/s12904-025-01732-3","DOIUrl":"10.1186/s12904-025-01732-3","url":null,"abstract":"<p><strong>Background: </strong>The palliative Internet-based outpatient service ensures seamless connectivity and equitable patient care; however, there is a lack of research on service quality, as well as the experiences and perceptions of patients' relatives. The aim of this study was to explore the perspectives and experiences of patients' relatives when using the palliative Internet clinic.</p><p><strong>Methods: </strong>A qualitative study involving semi-structured interviews with 13 relatives of terminal cancer patients was conducted, and data were analyzed using content analysis.</p><p><strong>Results: </strong>Relatives reported that they were capable of caring for the patients at home but experienced confusion and challenges in managing their symptoms and addressing their psychological issues. They expressed hope that Internet clinics would provide timely and effective professional guidance to families, easing caregiving burdens and enhancing the quality of home-based care.</p><p><strong>Conclusions: </strong>This study highlights the potential of Internet-based palliative care to enhance the quality of home-based caregiving and reduce caregiver burden. In addition, Internet-based consultations as an alternative to face-to-face consultations offers an appropriate option in palliative care settings.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"94"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: \"…They were just treating her Symptom by Symptom\": maternal experiences of having a child with spinal muscular atrophy in Ghana.","authors":"Esther Doe-Yo Tawiah, Jacob Owusu Sarfo","doi":"10.1186/s12904-025-01730-5","DOIUrl":"10.1186/s12904-025-01730-5","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"92"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining \"early palliative care\" for adults diagnosed with a life-limiting illness: a scoping review.","authors":"Colleen E Kircher, Timothy P Hanna, Joan Tranmer, Craig E Goldie, Amanda Ross-White, Elizabeth Moulton, Jack Flegal, Catherine L Goldie","doi":"10.1186/s12904-025-01712-7","DOIUrl":"10.1186/s12904-025-01712-7","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients' quality of life, reduce their symptom burden, reduce use of hospital-based acute care services and extend their survival. However, various definitions exist for the term early palliative care (EPC).</p><p><strong>Objective: </strong>To investigate how EPC has been defined in the literature for adults with life- limiting illnesses.</p><p><strong>Methods: </strong>This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews guidelines and follows the Joanna Briggs Institution methodology for scoping reviews. The literature search was conducted using MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine and Sociology Collections). All articles retrieved were screened by three independent reviewers.</p><p><strong>Results: </strong>153 articles met the inclusion criteria between 2008 and 2024. Five categories of definitions for EPC were created to organize definitions: (1) time-based (e.g. time from advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g. prognosis or the 'surprise question'); (3) location-based (e.g. access point within the healthcare system such as outpatient setting); (4) treatment-based (e.g. physician's judgement or prior to specific therapies); and (5) symptom-based (e.g. using symptom intensity questionnaires). Many studies included patients with cancer (n = 103), with the most common definition category being time-based (n = 53). Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the most common definition category was symptom-based (n = 16).</p><p><strong>Conclusion: </strong>Our findings provide a useful reference point for those seeking to understand the scope and breadth of existing EPC definitions in cancer and non-cancer illnesses and contemplate their application within clinical practice.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"93"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children's palliative care and public health: position statement.","authors":"Julia Downing, Duncan Randall, Katrina Mcnamara-Goodger, Peter Ellis, Gayatri Palat, Zipporah Ali, Jenny Hunt, Rut Kiman, Marie Friedel, Sue Neilson","doi":"10.1186/s12904-025-01653-1","DOIUrl":"10.1186/s12904-025-01653-1","url":null,"abstract":"<p><p>A public health approach to palliative care has been developed in adult palliative care over several years. Despite the concepts of health and wellbeing, and palliation, dying and death appearing at first to be contradictory, a cogent argument has been made to understand palliative care in the context of promoting public health. However, the application to children's palliative care has not been articulated in depth. The need for and development of children's palliative care is well documented globally, with the public health model, and more recently the WHO conceptual model for palliative care development being key to ongoing development and progress in service delivery. Engaging communities to influence care provision is essential and important to ensure provision of appropriate and sustainable care. Positioning children's palliative care within the public health perspective transforms care and service provision and centres around the child, their childhood and their carers, as part of the community and the wider population. Access to healthcare is vital, of course, but so is access to childhoods which guarantee children's human rights and access to being a child living a childhood, whether that childhood is long, short or leads to an adulthood. Uncovering differing perspectives on the intersection of public health and children's palliative care that varied between global regions, led to the development of eight statements. Our collaboration between colleagues in seven countries in different regions has allowed us to set out the context of the children's palliative public health approach. This reflects a balancing of medical/nursing professionalised care and partnerships, co production and participation of communities. The public health approach to children's palliative care is radical, it is transformational, and means changing how we do things in order to improve the lives of children with palliative care needs and their families around the world.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"89"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Views and attitudes of healthcare professionals on do-not-attempt-cardiopulmonary-resuscitation in low-and-lower-middle-income countries: a systematic review.","authors":"Mayank Gupta, Udita Joshi, Seema Rajesh Rao, Mirella Longo, Naveen Salins","doi":"10.1186/s12904-025-01676-8","DOIUrl":"10.1186/s12904-025-01676-8","url":null,"abstract":"<p><strong>Background: </strong>Healthcare Professionals (HCPs) are important stakeholders and gatekeepers in resuscitation decision-making. This systematic review explored the views and attitudes of HCPs on do-not-attempt-cardiopulmonary resuscitation (DNAR) in low-and-lower-middle-income countries (LLMICs).</p><p><strong>Methods: </strong>PubMed, EMBASE, PsycInfo, CINAHL, Cochrane library, Scopus, and Web of Science were searched from 01-Jan-1990 to 24-February-2023. Empirical peer-reviewed literature exploring views and attitudes of HCPs on DNAR for adult patients (aged ≽18 years) in LLMIC were included. No restriction on empirical study designs was imposed. Two independent reviewers performed screening, data extraction and critical appraisal. Hawker's tool and Popay's narrative synthesis were used for critical appraisal and data synthesis respectively. Review findings were interpreted using Cognitive Dissonance theory (CDT).</p><p><strong>Results: </strong>Of the 5132 records identified, 44 studies encompassing 7490 HCPs were included. The median Hawker score was 28 with 27% studies having low risk of bias. Three themes emerged. 1: Meaning-Making of DNAR construct. Most HCPs agreed that DNAR avoided inappropriate resuscitations, needless suffering and allowed fair allocation of resources. However, there was a lack of consensus on DNAR timing. 2: Barriers and Facilitators. Sociocultural norms, lack of legal clarity, organisational policies, societal and family views, religious and ethical beliefs, and healthcare providers' presuppositions often hindered DNAR practice. HCPs had inconsistent religious and ethical beliefs about DNAR. 3: Tensions and complexities of contemporary practice. HCPs expressed fears, concerns, guilt and distress while recommending DNAR. HCPs differed on involving patients. The DNAR practice was arbitrary and suboptimal like informal DNAR orders, pretended and symbolic CPRs.</p><p><strong>Conclusion: </strong>Most HCPs in LLMICs viewed DNAR as essential However, they faced barriers to DNAR implementation at macro-(law, sociocultural norms), meso-(organization) and micro-(HCP- and family views) levels. These barriers contributed to HCPs' fears, concerns and distress concerning DNAR. The CDT provided the lens to link HCPs cognitions, affect and behaviour into a chain of events that explained suboptimal resuscitation practices.</p><p><strong>Trial registration: </strong>CRD42023395887.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"91"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiving burden, receipt of palliative care, and the use of bereavement support: secondary analysis of population-based data.","authors":"Maja Furlan de Brito, Lucy E Selman, Natalia Calanzani, Jonathan Koffman, Irene J Higginson, Barbara Gomes","doi":"10.1186/s12904-025-01705-6","DOIUrl":"10.1186/s12904-025-01705-6","url":null,"abstract":"<p><strong>Background: </strong>The levels of support needs among people bereaved due to cancer are high; however, bereavement support services are underutilised. Reasons are unknown. We aimed to examine the relationship of caregiving burden and involvement of palliative care with the utilisation of formal bereavement support by family carers of people who died of cancer.</p><p><strong>Methods: </strong>Secondary analysis of population-based mortality follow-back study (QUALYCARE) with bereaved relatives of adults who registered the death of an adult due to cancer and involved in caregiving. We ran a multivariate logistic regression to determine whether caregiving burden and palliative care involvement explain the utilisation of bereavement support.</p><p><strong>Results: </strong>Out of 523 family members involved in caregiving (66% women, M_age=59 (SD = 14), 43% spouses/partners, 41% adult children), 149 (28.8%) utilised formal bereavement support (73.8% women, M_age=60 (SD = 14), 55% spouse/partner, 36% adult children). We found higher grief intensity (measured by the Texas Revised Inventory of Grief) than the reported population norms. Bivariate analysis confirmed the hypothesised associations. However, these were not retained in the multivariate model. Utilisation of bereavement support was associated with presence at the moment of death (OR 1.769, 95%CI = 1.044-2.994) and grief intensity (1.036, 95%CI = 1.015-1.058).</p><p><strong>Conclusions: </strong>Subjective experiences such as grief intensity and being present at the moment of death are associated with the need for formal bereavement support, raising the issue of continuity of care for family carers into bereavement. Further research is warranted to better understand the complex relationships between caregiving, bereavement, and the role of palliative care in facilitating access to bereavement support.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"88"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to opioids for palliative care in humanitarian settings: two case studies of Médecins Sans Frontières (MSF) experience in India and Bangladesh.","authors":"Amina Bouothmani, Rui Gutierrez, Amin Lamrous, Sakib Burza, Maria Maixenchs, Kathryn Richardson","doi":"10.1186/s12904-025-01673-x","DOIUrl":"10.1186/s12904-025-01673-x","url":null,"abstract":"<p><strong>Background: </strong>Alleviating suffering and preserving dignity are essential components of healthcare. Patients in need of palliative care often require opioid medication to relieve breathlessness and pain. However, a lack of access to essential opioids, particularly morphine, remains a major challenge in low- and middle-income countries (LMICs). This is notably critical in the humanitarian context. We conducted two case studies to identify the barriers and facilitators of access to opioids, particularly morphine, for palliative care patients in humanitarian settings while exploring humanitarian healthcare workers' perceptions and experiences with opioids.</p><p><strong>Methods: </strong>Two case studies were conducted based on two Médecins Sans Frontières (MSF) projects which integrated palliative care: advanced HIV care in Patna, Bihar, India, and paediatric and neonatal care in the refugee context in Cox's Bazar, Bangladesh. Six semi-structured interviews were conducted with key MSF healthcare professionals. Interviews were conducted in English, video- and/or audio-recorded and transcribed verbatim. Transcripts were coded and analysed using the grounded theory approach.</p><p><strong>Results: </strong>Several barriers impeding access to and use of essential opioids in palliative care were reported by the participants. These included limited availability, accessibility obstacles, sociocultural challenges such as low awareness and misconceptions, lack of healthcare providers' training on opioid use, and burdensome regulatory processes. Most participants reported that clinical guidelines, familiarity with the use of opioids and interdisciplinary teamwork were important facilitators of opioid prescribing. Participants expressed the urgency for further educational and advocacy initiatives to improve access to essential opioids for patients requiring palliative care.</p><p><strong>Conclusion: </strong>Humanitarian healthcare workers face multiple challenges, leading to inadequate access to essential opioid medication, which undermines effective palliative care delivery. Further training on the use of opioids and strong advocacy efforts led by humanitarian organizations and the medical community are critical to improving access to these essential medicines for the relief of pain and suffering.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"90"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When life is lived with dignity and decline: integration of rehabilitation and palliation in dementia care - a case report.","authors":"Kristoffer Marsaa, May Bjerre Eiby, Mikkel Ibsen, Martin Schultz","doi":"10.1186/s12904-025-01727-0","DOIUrl":"10.1186/s12904-025-01727-0","url":null,"abstract":"<p><strong>Background: </strong>The loss of meaning in life often underpins a desire to die, while rediscovering purpose and forming relationships can restore the will to live. This pursuit of meaning and the ability to express one's identity are central to both rehabilitation and palliative care. This case report examines the integration of these care principles within the framework of \"Omsorg,\" a Danish word and concept of care rooted in genuine acts of kindness, as implemented at Dagmarsminde, a nursing home for residents with moderate to severe dementia.</p><p><strong>Case presentation: </strong>Kirsten, an 86-year-old woman with advanced dementia, moved to Dagmarsminde in 2020. Upon arrival, she retained some mobility but exhibited limited facial expressions and impaired language. Her care plan emphasized deprescription, authentic surroundings, and \"Omsorg,\" fostering engagement and reducing reliance on pharmaceuticals. This integrated approach combined rehabilitation to improve her physical skills and independence with palliative care to support her search for meaning and dignity in daily life. Following a pelvic fracture in 2023, Kirsten underwent tailored rehabilitation, regaining her ability to walk before her condition deteriorated due to dementia progression. In her final stages, Dagmarsminde prioritized dignity and comfort, employing minimal doses of opioids and benzodiazepines to alleviate suffering. Kirsten passed away peacefully in November 2024, surrounded by her family.</p><p><strong>Conclusions: </strong>Dagmarsminde's holistic care philosophy integrates rehabilitation, palliative care, and \"Omsorg\" to empower residents in expressing their identity and engaging in a meaningful community. By prioritizing authenticity, individualized care, and acts of kindness, this approach fosters dignity and well-being throughout life and in its final stages. The case of Kirsten highlights the profound impact of personalized care in affirming an individual's significance, even amid the cognitive and physical challenges of dementia.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"87"},"PeriodicalIF":2.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}