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ArticleEuropean geriatric medicine2026

Differences in perceptions of quality of dying scores during the last days of life on Belgian acute geriatric wards: a prospective observational study in relatives, nurses, and doctors.

Tim Biesbrouck, Maïté Leleu, Margaux Delporte, Wim Janssens, Johan Flamaing, Nele Van Den Noortgate, Ruth Piers, Maaike L De Roo

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Article in European geriatric medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Tim BiesbrouckDepartment of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0001-5117-1027
Maïté LeleuDepartment of Geriatrics, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
Margaux DelporteDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.ORCID http://orcid.org/0000-0001-6234-8860
Wim JanssensDepartment of Geriatrics, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.ORCID http://orcid.org/0000-0002-2170-2330
Johan FlamaingDepartment of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0003-3749-5433
Nele Van Den NoortgateDepartment of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.ORCID http://orcid.org/0000-0001-5546-5380
Ruth PiersDepartment of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.ORCID http://orcid.org/0000-0001-5261-220X
Maaike L De RooDepartment of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium. Maaike.deroo@uzleuven.be.ORCID http://orcid.org/0000-0002-2972-0867

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis multicentre prospective observational study aimed to describe the evolution of pain and comfort during the last days of life in older people, comparing assessments by relatives, nurses, and doctors.

methodsRelatives, nurses and doctors of patients with an expected death, admitted to acute geriatric wards in two Belgian university hospitals, completed the End-of-Life in Dementia-Comfort Assessment in Dying scale (EOLD-CAD, range 14-42, higher scores indicating higher comfort) once per day. Pain scores were retrieved from medical charts. Linear mixed models assessed longitudinal evolutions and inter-rater correlations.

resultsAfter the last days of life were recognised, median time until death of 103 included patients was 39.6 h. Nurses and doctors completed scales for 84 patients and relatives for 42. Doctors scored higher on the EOLD-CAD scale compared to relatives (+ 3.4, p = 0.005), with largest difference on the dying symptoms subscale. EOLD-CAD-scores increased over time for relatives (+ 1.2 per 24 h, p = 0.001). Compared to relatives, doctors' and nurses' scores increased 0.7 less (p = 0.09) and 1.1 less (p = 0.004) per 24 h, respectively. Patient level correlations were weak, with highest correlation between nurses and doctors (maximum r = 0.25, p = 0.005). All correlations with relatives were low and non-significant.

conclusionQuality of dying scores improved over time. Perceptions evaluated with EOLD-CAD scale differ between relatives, nurses and doctors, particularly regarding dying symptoms. These results underscore the importance of timely and active communication to explore relatives' perspectives during the last days of life.

Indexed as

GeriatricsNursesPalliative careQuality of dyingSymptom burdenTerminal care

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PMID42530751

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