‘Saying goodbye’ - A systematic integrative review of palliative caregiving in intergenerational living contexts

Sep 30, 2026

Uploaded by Liam

Intergenerational co-residence remains common and is resurging amid financial pressures, rising caregiving demands, and ageing populations, especially in end-of-life care. Yet evidence on how this living arrangement influences care quality across cultures is limited. This systematic integrative review synthesizes studies across multiple countries to examine emotional, practical, and cultural effects on palliative and end-of-life care and to identify key themes shaping caregiving roles, decision-making, and support needs.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Abstract

Background

Aim

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Conclusions

What is already known about the topic?

What this paper adds?

Implications for practice, theory or policy

Review Article ‘Saying goodbye’. . . A systematic integrative review of palliative caregiving in intergenerational living contexts Madeleine L Juhrmann1,2,3, Priyanka Vandersman1, Raechel A Damarell1, Ahmed Khamis Sharaf4, Aljon San Martin3,5, Andrew Donkor2,6 and Yakubu Salifu7 Palliative Medicine 2026, Vol. 40(1) 31–49 © The Author(s) 2025 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/02692163251394880](DOI: 10.1177/02692163251394880)[ ](DOI: 10.1177/02692163251394880)[journals.sagepub.com/home/pmj](journals.sagepub.com/home/pmj) Abstract Background: Intergenerational co-residence has historically been prevalent. Recent financial pressures, increasing caregiving responsibilities and ageing populations have led to a resurgence of this arrangement, particularly in end-of-life care. However, understanding of its influence on care quality across cultures remains limited. Aim: To explore how intergenerational co-residence affects emotional, practical, and cultural dimensions of palliative and end-oflife care across different settings, and to identify key themes shaping caregiving roles, decision-making, and support needs in these households. Design: Systematic integrative review and thematic synthesis based on Braun and Clarke’s approach and using the Convoy Model as a theoretical framework. PROSPERO ID: CRD42023446688 . Data sources: Six major databases were searched from inception to 22 May 2023 and updated to 8 June 2025. Eligible papers reported empirical studies on end-of-life care in intergenerational co-residence and were appraised using the Mixed Methods Appraisal Tool. Results: Three themes were constructed from seven studies from China, South Africa, Spain, Uganda, Turkey and the United States. These were: responding to an end-of-life diagnosis, with limited death literacy delaying care; identifying systems of support, where caregiving burdens often fell on women; and concluding the journey and saying goodbye. Conclusions: Intergenerational co-residence can foster support at the end of life, yet it may also reinforce gendered caregiving roles that disproportionately burden women. Effective integration of formal support services with family caregiving remains important in alleviating pressures and promoting equitable care models, highlighting the need for culturally sensitive interventions that address the diverse needs of families, while encouraging collaborative caregiving approaches. Keywords intergenerational relations, extended family, caregivers, palliative care, terminal care 1Research Centre for Palliative Care, Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia 2Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Ultimo, NSW, Australia 3The Palliative Centre, HammondCare, Greenwich, NSW, Australia 4Community Health Nursing Department, Faculty of Nursing, Alexandria University, Egypt 5Susan Wakil School of Nursing, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia 6Department of Medical Imaging, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 7International Observatory on End-of-Life Care (IOELC), Division of Health Research, Lancaster University, UK Corresponding author: Madeleine L. Juhrmann, School of Clinical Medicine, UNSW Medicine & Health; Randwick Clinical Campus, Discipline of Paediatrics & Child Health, UNSW Sydney; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, UK. [Email: m.juhrmann@unsw.edu.au](Email: m.juhrmann@unsw.edu.au) What is already known about the topic? • Intergenerational co-residence has long served as a foundational family structure, particular

FAQs

How does intergenerational co-residence influence palliative and end-of-life care?

The review shows it can strengthen emotional support and continuity of care, shaping caregiving roles and decision-making within households. It can also affect care quality through cultural and practical dynamics in different settings.

What themes were identified across the included studies?

Three themes emerged: responding to an end-of-life diagnosis with limited death literacy; identifying systems of support where caregiving burdens often fell on women; and concluding the journey and saying goodbye.

What are the main implications for practice, theory, and policy?

Culturally tailored interventions are needed to address diverse household needs. Policymakers should support family caregivers—especially women—through training, accessible resources, and financial support, and integrate formal services with family caregiving.

Sep 30, 2026

Uploaded by Liam