Palliative Care Needs of Older Adults with Stroke: A Scoping Review

Background: Stroke is a leading cause of mortality and serious long-term disability. Palliative care may enhance overall quality of life among older adults experiencing a stroke, but a limited understanding of these patients' holistic needs exists. Objective: To conduct a scoping review of the literature exploring the palliative care needs of older adults with stroke, with the aim of tailoring holistic nursing interventions to improve quality of life. Methods: The review followed Arksey and O'Malley's five-stage framework: formulating the review question; identifying relevant studies; screening and selecting studies; charting the data; and collating, summarizing, and reporting the results. Three online databases (PubMed, Embase, and CINAHL) were searched for studies published between 2014 and 2024 using key terms such as "palliative care needs," "older adults," and "stroke". Screening and selection were managed via Endnote and Covidence review management software, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Results: Eighteen studies emphasize the need for holistic palliative care nursing in older adults with stroke. Five overarching themes emerged: physical functioning, psychosocial and emotional support, informed decision-making, symptom management, and comfort-based care. Conclusion: Integrating holistic palliative care nursing into patient-centered stroke services is vital for improving the quality of life in older adults. Findings from this scoping review will inform future nursing research priorities, as well as clinical nursing initiatives, addressing the holistic palliative care needs of older adults experiencing stroke in collaboration with patients, families, and interdisciplinary healthcare professionals.