Communicating palliative hope in late-stage dementia: thematic analysis of hope work in care plan meetings with nursing home residents’ families

Topic: Risk, prevention and care in population studies

We identified three main themes of palliative hope in late-stage dementia: 1) Life is good and there is still time, 2) Agency and identity are not lost, and 3) Death will be good and professional support is available. As overarching goals of hope work, we identified acceptance and appreciation. Nursing home professionals have an important role in constructing and maintaining hope and thus supporting families. They can remind families that residents are not lost as people, they are in good care, and that there are still time and opportunities for a good life, meaningful moments, and connection, which families can appreciate despite the progressive illness. By highlighting the possibility of a peaceful death for the resident and willingness to support families in the end-of-life phase, nursing home professionals can help families accept the inevitable. Combined with good-quality palliative care, palliative hope work can support families' social relationships and foster meaningful experiences at the end-of-life stage.

@article{paananen2025-40493796,
  author  = {Paananen, Jenny and Lögren, Aija},
  title   = {{Communicating palliative hope in late-stage dementia: thematic analysis of hope work in care plan meetings with nursing home residents’ families}},
  journal = {The Journals of Gerontology Series B},
  year    = {2025},
  doi     = {10.1093/geronb/gbaf107},
  pmid    = {40493796},
  url     = {https://doi.org/10.1093/geronb/gbaf107}
}

Key findings

• We identified three main themes of palliative hope in late-stage dementia: 1) Life is good and there is still time, 2) Agency and identity are not lost, and 3) Death will be good and professional support is available.
• As overarching goals of hope work, we identified acceptance and appreciation.
• Nursing home professionals have an important role in constructing and maintaining hope and thus supporting families.
• They can remind families that residents are not lost as people, they are in good care, and that there are still time and opportunities for a good life, meaningful moments, and connection, which families can appreciate despite the progressive illness.
• By highlighting the possibility of a peaceful death for the resident and willingness to support families in the end-of-life phase, nursing home professionals can help families accept the inevitable.

Why it matters

This analysis describes how nursing home staff can build and maintain hope with families of residents in late-stage dementia, focusing on themes such as life still being good and the possibility of a peaceful death. It is about communication and palliative support, not about treating, curing or preventing Alzheimer's disease.

Study details

• Evidence strengthLow

Read the original

• DOI: 10.1093/geronb/gbaf107
• PubMed: 40493796
• Original source →
• Free full text: The Journals of Gerontology Series B →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Shared decision-making in dementia: A review of patient and family carer involvement Dementia (London, England) · 2014-11-03 · usefulness score 41/100 · Caregiving

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