Van den Block L, de Nooijer K, Pautex S, Pivodic L, Van Den Noortgate N, Nicholson C, Szczerbińska K, Pereira SM, Tiberini R, Hanratty B, Miranda R. A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations. EClinicalMedicine. 2025 Aug 12;87:103403. doi: 10.1016/j.eclinm.2025.103403.
Abstract
Background: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.
Methods: We conducted an international Delphi study, comprising an iterative preparatory phase using literature and input from international and interdisciplinary experts in research, practice, and policy, (between 2020 and 2022) and an online consensus-based survey (2023) with 63 professional experts and 19 older person's representatives from 28 countries in Asia, Australia, Europe, and North America.
Findings: The EAPC White Paper comprises 11 key domains that capitalize on the strengths of palliative care, geriatrics, and rehabilitation; and 34 key recommendations that elucidate what is needed from clinical, health service, and public health perspectives to address the multidimensional needs of this population, support their capacities, and maintain their quality of life and well-being until the end of life, including bereavement of carers.
Interpretation: This EAPC White Paper presents a gold standard for the care and support for older people living with frailty and their family carers. It calls for a radical shift in healthcare provision to effectively integrate palliative, geriatric, and rehabilitative approaches to care and support for this population and represents a first critical step in establishing how to achieve this.
Funding: Research Foundation Flanders Belgium funded the postdoctoral mandates of RM (12D4523N) and KDN (12AEO24N).
Keywords: Aging; Frailty; Geriatrics; Palliative care; Rehabilitation.
© 2025 The Author(s).
