[Loneliness at the end of life].

Advanced incurable diseases are often accompanied by numerous losses and burdens as the disease progresses, leading to a loss of autonomy, self-determination, and dignity for those affected, all of which can subsequently promote feelings of loneliness at the end of life. Declining health, increasing symptom burden, loss of social roles, and the fear of death and dying are among the key risk factors for loneliness towards the end of life. In this article, we provide an overview of the different dimensions of loneliness experienced at the end of life. We discuss existential loneliness alongside emotional and social loneliness, explore causes and health implications of loneliness at the end of life, suggest diagnostic tools for assessing loneliness, and finally provide recommendations for addressing emotional, social, and existential loneliness at the end of life. The loneliness of caregivers is also discussed. We suggest that addressing social and emotional loneliness early in the course of a terminal illness is crucial. Palliative, psychological, and spiritual support can strengthen interpersonal relationships, foster a sense of meaning and purpose, and alleviate the adverse effects of loneliness on mental and physical health as well as quality of life. In contrast, existential loneliness is considered an expression of profound emotional maturity and can offer opportunities for inner growth, contributing to a more refined sense of self while reinforcing identity, dignity, and transcendence at the end of life.

Seiler A ，Evstigneev SR ，Hepp Z ，Hertler C ，Peng-Keller S ，Blum D ... -  《-》

Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

Busolo D ，Woodgate R 《-》

Existential loneliness and end-of-life care: a systematic review.

Ettema EJ ，Derksen LD ，van Leeuwen E 《-》

Personal dignity in the terminally ill from the perspective of caregivers: a survey among trained volunteers and physicians.

Albers G ，de Vet HC ，Pasman HR ，Deliens L ，Onwuteaka-Philipsen BD ... -  《-》

Death anxiety interventions in patients with advanced cancer: A systematic review.

Grossman CH ，Brooker J ，Michael N ，Kissane D ... -  《-》