Experiencing death cafés: A qualitative evidence synthesis

Despite death being an inevitable part of life, societal discomfort with discussing mortality often leaves individuals ill-prepared for end-of-life decisions. Notwithstanding its importance in contributing to informed decision-making, death literacy remains underdeveloped globally. Death cafés have emerged as informal, non-therapeutic gatherings fostering open dialogue about mortality. Yet, there is limited effort in synthesizing the experiences of participants and organizers.

To synthesize participants' and organizers' experiences, motivations, mechanisms of influencing one's perspectives toward death and dying and impacts of attending or organizing death cafés using a meta-ethnography approach.

A comprehensive search across eight electronic databases was conducted from their respective dates of inception to 3 February 2025, and qualitative studies examining death cafés from the perspectives of participants and organizers were included. Included studies were assessed using the Critical Appraisal Skill Programme checklist, and the Grading of Recommendations, Assessment, Development, and Evaluation's Confidence in Evidence from Reviews of Qualitative Research was applied to assess confidence in the overall review findings. A three-step meta-ethnographic approach, comprising of reciprocal translation, refutational synthesis and line of argument synthesis was used to present the participants and organizers experiences of death café.

A total of 18 studies were included in this qualitative evidence synthesis. Three themes and eight subthemes were identified from the meta-ethnography. The themes were: (1) Breaking the silence, (2) cultivating psychological safety and inclusivity, and (3) embracing death through actions. These themes contribute to the overall line of argument synthesis, death cafe reframe mortality not as a taboo to be avoided but as a fundamental human experience to be shared, understood, and integrated into everyday life. Death cafes can challenge the dominant norms of death denial by fostering spaces where individuals can engage with mortality reflectively and communally. Although differences in grief readiness, cultural background and life stage may generate moments of tension, these tensions do not detract from the overall utility of the death café but affirm the necessity of creating pluralistic, inclusive platforms for end-of-life discourse.

Death café models can be introduced to encourage open conversations about mortality for enhancing death literacy. Specific iterations of death conversational programs should be curated for individuals with differing needs.

This review protocol was prospectively registered in PROSPERO (CRD42025638237).