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Exploring older people’s end-of-life care preferences over time: A scoping review

Lookup NU author(s): Dr Lucy RobinsonORCiD, Dr Felicity DewhurstORCiD, Dr Amy Huggin, Dr Daniel StowORCiD, Dr Charlotte Stenson, Elizabeth Westhead, Dr Katherine Frew, Professor Barbara HanrattyORCiD, Professor Paul PaesORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© The Author(s) 2025. Background: Understanding the evolution of end-of-life preferences over time is important for dynamic, person-centred palliative care. This is particularly relevant for older people whose preferences can be incompletely expressed and subject to change. Aim: To summarise the nature of the current evidence about how and why the end-of-life preferences of older people change over time. Design: A scoping review was performed, using a predefined protocol and following the JBI manual for evidence synthesis. Data Sources: Final searches of Medline, Embase, PsycINFO and Web of Science were carried out in October 2023. Reference lists were also reviewed. Eligibility criteria included studies recruiting people over the age of 60 that explored how or why end-of-life preferences developed over time. Results: Screening identified 52 articles, reporting on 40 studies. A majority were longitudinal studies collecting quantitative data about treatment preferences. Other preference categories included euthanasia, balancing quality and length of life, goals of care, preferred place of death, decision-making and spiritual preferences. Studies explored a variety of factors that may influence preference change or stability. There was a lack of research with ethnic minority groups and people aged over 80. Conclusions: Existing research has focused on preferences about specific therapies, at the expense of understanding what matters most to older people. Synthesis of the available evidence about why preferences change will guide reviews of patients’ advance care plans. To inform dynamic, person-centred end-of-life care we need studies prospectively exploring how older people construct a broader range of preferences, and negotiate these over time.


Publication metadata

Author(s): Robinson L, Dewhurst F, Huggin A, Stow D, Stenson C, Westhead E, Frew K, Hanratty B, Paes P

Publication type: Review

Publication status: Published

Journal: Palliative Medicine

Year: 2025

Pages: Epub ahead of print

Online publication date: 25/04/2025

Acceptance date: 02/04/2018

ISSN (print): 0269-2163

ISSN (electronic): 1477-030X

Publisher: SAGE Publications Ltd

URL: https://doi.org/10.1177/02692163251331161

DOI: 10.1177/02692163251331161

Data Access Statement: Data are limited to published articles available within the public domain.


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