Social Work Support for Anticipatory Grief in Rural Palliative Care Transitions: A Narrative Review for South Africa

Family caregivers play a central role in palliative care, especially during hospital-to-home transitions, when rural families may assume complex care with limited preparation and uneven professional support. Anticipatory grief, the grief experienced before a loved one's death, can intensify emotional, practical, social and financial strain. A SANRA-informed, agenda-setting narrative review integrated literature on palliative care, caregiver burden, anticipatory grief, transitional care, rural healthcare and social work to develop a research and practice agenda for rural South African public health settings, with particular relevance to the Eastern Cape. Searches conducted from March to May 2026 covered PubMed/MEDLINE, Scopus, Google Scholar, African Journals Online, Sabinet African Journals, ScienceDirect and selected policy and professional sources. Of 124 records initially considered, 44 full texts or source documents were examined and 32 were retained for synthesis. The evidence supports anticipatory grief as a key dimension of hospital-to-home transition and indicates that established social work functions can be sequenced across a five-phase pathway grounded in transition theory, family systems thinking and the person-in-environment perspective. Because Eastern Cape-specific evidence remains limited, the framework is presented as a theory-informed agenda for empirical testing rather than a validated intervention. Priorities include local caregiver research, grief-informed assessment, multidisciplinary discharge planning, rural follow-up systems, practical resource linkage and culturally responsive bereavement support.