Culturally Meaningful End-of-Life Care for a Patient With Cancer of Unknown Primary, and Severe Motor and...

Geriatric and palliative care are becoming increasingly complex, particularly for patients with severe motor and intellectual disabilities (SMID). Cancer of unknown primary origin (CUP) is an aggressive malignancy that is often diagnosed at an advanced stage and requires individualized decision-making and careful integration of patient values into care planning. We report the case of a 68-year-old man with SMID who was diagnosed with peritoneal carcinomatosis of unknown primary origin, accompanied by pulmonary and splenic metastases and peritoneal implants. Because he was unable to express his preferences, repeated discussions with his legal guardian, his aunt, led to a consensus to prioritize comfort-focused care over invasive diagnostics or disease-directed therapy. A culturally meaningful intervention, a music concert featuring favorite songs, was organized within the care facility. The patient exhibited visible emotional engagement that facilitated reconnection with distant relatives. He died peacefully one week later without invasive medical interventions. This case underscores the importance of nonverbal cues, cultural sensitivity, and interdisciplinary collaboration in end-of-life decision-making for patients with profound disabilities. This further demonstrates how personalized non-medical interventions can enhance dignity, emotional comfort, and family cohesion at the end of life.