Research ArticleResearchPatient EducationWorkflow

Nurses, doctors, and relatives rated end-of-life comfort differently on geriatric wards

European Geriatric Medicine (PubMed)Jul 30, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A prospective study of 103 expected deaths on acute geriatric wards found weak agreement among relatives, nurses, and doctors about comfort during the final days, with doctors rating comfort higher than relatives.

What NurseJet pulled from the source

Clinicians completed daily comfort scales for 84 patients and relatives for 42 patients at two Belgian university hospitals. After the last days of life were recognized, median time to death was 39.6 hours. Relative ratings improved over time, but patient-level correlations between rater groups remained weak.

Why this matters for nurses

Geriatric nurses repeatedly assess comfort and often hear family observations that differ from clinician assessments. The findings support active communication and shared symptom review rather than assuming that staff and relatives perceive the dying experience similarly.

Bedside takeaway

Weak agreement on end-of-life comfort supports explicit symptom review with relatives and the interprofessional team.

How This Applies in Practice

Use this when: Caring for an older adult whose death is expected and coordinating comfort assessment with relatives and clinicians.

On your shift

Complete and trend the approved comfort, pain, and symptom assessments and compare findings with prior observations.
Invite relatives to describe specific signs of comfort or distress and document where their perspective differs from staff ratings.
Escalate unresolved symptoms or disagreement about goals and interventions to the palliative and medical team.

Keep in mind: Different ratings do not establish that one observer is correct; they are a prompt for shared assessment. Follow the end-of-life plan, facility policy, and provider orders.

Key takeaways

The multicenter prospective study included 103 patients with expected deaths on acute geriatric wards.
Doctors scored comfort 3.4 points higher than relatives on the 14-to-42-point EOLD-CAD scale.
Agreement was weak even between nurses and doctors, with a maximum reported correlation of 0.25.
Correlations between relatives and clinician raters were low and not statistically significant.

Practice implications

During expected dying, complete the approved comfort and pain assessments, invite relatives to describe observed symptoms and concerns, and document differences in perception. Escalate unresolved distress, new symptoms, or disagreement about the care plan through the palliative and medical team.

Limitations & cautions

The study involved two Belgian university hospitals, relatives provided ratings for fewer than half of included patients, and observational ratings cannot determine why perceptions differed. The scale and timing may not capture every symptom or apply identically in other cultural or clinical settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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European Geriatric Medicine (PubMed)

European Geriatric Medicine (PubMed). 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.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42530751/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

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AI-summarized from the linked source. Review the original article before applying to practice.

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Nursing implications

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AI-summarized from the linked source. Review the original article before applying to practice.

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AI-summarized from the linked source. Review the original article before applying to practice.

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How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

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