A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations

Lieve Van den Block; Kim de Nooijer; Sophie Pautex; Lara Pivodic; Nele Van Den Noortgate; Caroline Nicholson; Katarzyna Szczerbińska; Sandra Martins Pereira; Rebecca Tiberini; Barbara Hanratty; Rose Miranda

doi:10.1016/j.eclinm.2025.103403

A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations

Lieve Van den Block, Kim de Nooijer, Sophie Pautex, Lara Pivodic, Nele Van Den Noortgate, Caroline Nicholson, Katarzyna Szczerbińska, Sandra Martins Pereira, Rebecca Tiberini, Barbara Hanratty, Rose Miranda

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Abstract

BACKGROUND: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.

METHODS: We conducted an international Delphi study, comprising an iterative preparatory phase using literature and input from international and interdisciplinary experts in research, practice, and policy, (between 2020 and 2022) and an online consensus-based survey (2023) with 63 professional experts and 19 older person's representatives from 28 countries in Asia, Australia, Europe, and North America.

FINDINGS: The EAPC White Paper comprises 11 key domains that capitalize on the strengths of palliative care, geriatrics, and rehabilitation; and 34 key recommendations that elucidate what is needed from clinical, health service, and public health perspectives to address the multidimensional needs of this population, support their capacities, and maintain their quality of life and well-being until the end of life, including bereavement of carers.

INTERPRETATION: This EAPC White Paper presents a gold standard for the care and support for older people living with frailty and their family carers. It calls for a radical shift in healthcare provision to effectively integrate palliative, geriatric, and rehabilitative approaches to care and support for this population and represents a first critical step in establishing how to achieve this.

FUNDING: Research Foundation Flanders Belgium funded the postdoctoral mandates of RM (12D4523N) and KDN (12AEO24N).

Original language	English
Article number	103403
Pages (from-to)	1-16
Number of pages	16
Journal	EClinicalMedicine
Volume	87
DOIs	https://doi.org/10.1016/j.eclinm.2025.103403
Publication status	Published - Sept 2025

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BASGO17: OZR Basisfinanciering voor Grote Onderzoeksgroepen - EOLC
Van den Block, L. (Administrative Promotor) & Deliens, L. (Administrative Promotor)
1/01/24 → 31/12/30
Project: Fundamental
FWOTM1166: Optimising recruitment and retention in multi-component palliative care trials: A mixed-methods study
De Nooijer, K. (Mandate), Van den Block, L. (Administrative Promotor) & Pivodic, L. (Collaborator)
1/10/23 → 30/09/27
Project: Fundamental
SRP69: SRP-Onderzoekszwaartepunt: Addressing the challenges around serious illness, palliative care and the end of life: public health, health services and clinical innovations
Cohen, J. (Administrative Promotor), Van den Block, L. (Co-Promotor), Deliens, L. (Co-Promotor), Vanderstichelen, S. (Collaborator), Pardon, K. (CoI (Co-Promotor)), De Vleminck, A. (Collaborator), Smets, T. (Collaborator) & Pivodic, L. (Collaborator)
1/11/22 → 31/10/27
Project: Fundamental

EAPC_WhitePaperFrailty.sav
Van den Block, L. (Creator), De Nooijer, K. (Creator), Pautex, S. (Creator), Pivodic, L. (Creator), Van Den Noortgate, N. (Creator), Nicholson, C. (Creator), Szczerbińska, K. (Creator), Martins Pereira, S. (Creator), Tiberini, R. (Creator), Hanratty, B. (Creator) & Miranda, R. (Creator), VUB Institutional Data Repository, 25 Sept 2025
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Van den Block, L., de Nooijer, K., Pautex, S., Pivodic, L., Van Den Noortgate, N., Nicholson, C., Szczerbińska, K., Pereira, S. M., Tiberini, R., Hanratty, B., & Miranda, R. (2025). A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations. EClinicalMedicine, 87, 1-16. Article 103403. https://doi.org/10.1016/j.eclinm.2025.103403

Van den Block, Lieve ; de Nooijer, Kim ; Pautex, Sophie et al. / A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers : a 28-country Delphi study and recommendations. In: EClinicalMedicine. 2025 ; Vol. 87. pp. 1-16.

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title = "A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations",

abstract = "BACKGROUND: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.METHODS: We conducted an international Delphi study, comprising an iterative preparatory phase using literature and input from international and interdisciplinary experts in research, practice, and policy, (between 2020 and 2022) and an online consensus-based survey (2023) with 63 professional experts and 19 older person's representatives from 28 countries in Asia, Australia, Europe, and North America.FINDINGS: The EAPC White Paper comprises 11 key domains that capitalize on the strengths of palliative care, geriatrics, and rehabilitation; and 34 key recommendations that elucidate what is needed from clinical, health service, and public health perspectives to address the multidimensional needs of this population, support their capacities, and maintain their quality of life and well-being until the end of life, including bereavement of carers.INTERPRETATION: This EAPC White Paper presents a gold standard for the care and support for older people living with frailty and their family carers. It calls for a radical shift in healthcare provision to effectively integrate palliative, geriatric, and rehabilitative approaches to care and support for this population and represents a first critical step in establishing how to achieve this.FUNDING: Research Foundation Flanders Belgium funded the postdoctoral mandates of RM (12D4523N) and KDN (12AEO24N).",

author = "{Van den Block}, Lieve and {de Nooijer}, Kim and Sophie Pautex and Lara Pivodic and {Van Den Noortgate}, Nele and Caroline Nicholson and Katarzyna Szczerbi{\'n}ska and Pereira, {Sandra Martins} and Rebecca Tiberini and Barbara Hanratty and Rose Miranda",

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Van den Block, L , de Nooijer, K, Pautex, S, Pivodic, L, Van Den Noortgate, N, Nicholson, C, Szczerbińska, K, Pereira, SM, Tiberini, R, Hanratty, B & Miranda, R 2025, 'A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations', EClinicalMedicine, vol. 87, 103403, pp. 1-16. https://doi.org/10.1016/j.eclinm.2025.103403

A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations. / Van den Block, Lieve ; de Nooijer, Kim; Pautex, Sophie et al.
In: EClinicalMedicine, Vol. 87, 103403, 09.2025, p. 1-16.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers

T2 - a 28-country Delphi study and recommendations

AU - Van den Block, Lieve

AU - de Nooijer, Kim

AU - Pautex, Sophie

AU - Pivodic, Lara

AU - Van Den Noortgate, Nele

AU - Nicholson, Caroline

AU - Szczerbińska, Katarzyna

AU - Pereira, Sandra Martins

AU - Tiberini, Rebecca

AU - Hanratty, Barbara

AU - Miranda, Rose

PY - 2025/9

Y1 - 2025/9

N2 - BACKGROUND: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.METHODS: We conducted an international Delphi study, comprising an iterative preparatory phase using literature and input from international and interdisciplinary experts in research, practice, and policy, (between 2020 and 2022) and an online consensus-based survey (2023) with 63 professional experts and 19 older person's representatives from 28 countries in Asia, Australia, Europe, and North America.FINDINGS: The EAPC White Paper comprises 11 key domains that capitalize on the strengths of palliative care, geriatrics, and rehabilitation; and 34 key recommendations that elucidate what is needed from clinical, health service, and public health perspectives to address the multidimensional needs of this population, support their capacities, and maintain their quality of life and well-being until the end of life, including bereavement of carers.INTERPRETATION: This EAPC White Paper presents a gold standard for the care and support for older people living with frailty and their family carers. It calls for a radical shift in healthcare provision to effectively integrate palliative, geriatric, and rehabilitative approaches to care and support for this population and represents a first critical step in establishing how to achieve this.FUNDING: Research Foundation Flanders Belgium funded the postdoctoral mandates of RM (12D4523N) and KDN (12AEO24N).

AB - BACKGROUND: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.METHODS: We conducted an international Delphi study, comprising an iterative preparatory phase using literature and input from international and interdisciplinary experts in research, practice, and policy, (between 2020 and 2022) and an online consensus-based survey (2023) with 63 professional experts and 19 older person's representatives from 28 countries in Asia, Australia, Europe, and North America.FINDINGS: The EAPC White Paper comprises 11 key domains that capitalize on the strengths of palliative care, geriatrics, and rehabilitation; and 34 key recommendations that elucidate what is needed from clinical, health service, and public health perspectives to address the multidimensional needs of this population, support their capacities, and maintain their quality of life and well-being until the end of life, including bereavement of carers.INTERPRETATION: This EAPC White Paper presents a gold standard for the care and support for older people living with frailty and their family carers. It calls for a radical shift in healthcare provision to effectively integrate palliative, geriatric, and rehabilitative approaches to care and support for this population and represents a first critical step in establishing how to achieve this.FUNDING: Research Foundation Flanders Belgium funded the postdoctoral mandates of RM (12D4523N) and KDN (12AEO24N).

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Van den Block L , de Nooijer K, Pautex S, Pivodic L, Van Den Noortgate N, Nicholson C et al. A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations. EClinicalMedicine. 2025 Sept;87:1-16. 103403. doi: 10.1016/j.eclinm.2025.103403

A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations

Abstract

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Projects

BASGO17: OZR Basisfinanciering voor Grote Onderzoeksgroepen - EOLC

FWOTM1166: Optimising recruitment and retention in multi-component palliative care trials: A mixed-methods study

SRP69: SRP-Onderzoekszwaartepunt: Addressing the challenges around serious illness, palliative care and the end of life: public health, health services and clinical innovations

Datasets

EAPC_WhitePaperFrailty.sav

Cite this