{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:30:07Z","timestamp":1790933407717,"version":"4.1.0"},"reference-count":109,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006662","name":"NIHR","doi-asserted-by":"publisher","award":["NIHR303292"],"award-info":[{"award-number":["NIHR303292"]}],"id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dementia poses a unique challenge to traditional models of a \u2018good death\u2019. Understanding what makes the dying process \u2018meaningful\u2019 offers a more nuanced approach to improving experiences at the end of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop a conceptual framework for meaningful dying in dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative systematic review drawing on five databases, and \u2018best-fit\u2019 framework synthesis. Reported in line with PRISMA guidelines and GRADE-CERQual assessment of confidence. Qualitative and mixed-methods studies were identified that explored concepts related to quality of end of life in dementia. Framework selection was derived from theories of meaningfulness, a good death and personhood in dementia. The conceptual framework was refined working with people affected by dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty studies, from 16 countries, were included. Five central themes were generated: \u20181. Changing identity\u2019, \u20182. Bodily comfort\u2019, \u20183. Connection &amp; relationships\u2019, \u20184. Recognition of spiritual self\u2019 and \u20185. Contribution &amp; legacy\u2019. Underpinning and surrounding these were two themes: \u20186. Respecting the person &amp; maintaining dignity\u2019, and \u20187. Finding coherences &amp; making sense\u2019. This final theme facilitates overarching sense-making, allowing for the conflicts and tensions between the other themes to be reconciled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\u2018Meaningful dying\u2019 emphasises making sense of the dying experience as a whole. By contextualising what is happening within the story of the individual, it facilitates personal dignity in the face of potentially unavoidable suffering. The framework provides conceptual guidance for making decisions on behalf of someone with dementia towards the end of life when mental capacity may be lost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag032","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:41:51Z","timestamp":1770295311000},"source":"Crossref","is-referenced-by-count":2,"title":["Meaningfulness and quality of end of life for people with dementia: a systematic review and \u2018best-fit\u2019 framework synthesis"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-0611","authenticated-orcid":false,"given":"Liam T","family":"Gabb","sequence":"first","affiliation":[{"name":"Cicely Saunders Institute, King\u2019s College London , Bessemer Road, London SE5 9PJ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-7498","authenticated-orcid":false,"given":"Lesley E","family":"Williamson","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute, King\u2019s College London , Bessemer Road, London SE5 9PJ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-7402","authenticated-orcid":false,"given":"Catherine J","family":"Evans","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute, King\u2019s College London , Bessemer Road, London SE5 9PJ ,","place":["UK"]},{"name":"Palliative Care, Brighton General Hospital, Sussex Community National Health Service Trust , Elm Grove, Brighton BN2 3EW ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Owen","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E","family":"Sleeman","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute, King\u2019s College London , Bessemer Road, London SE5 9PJ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"2026022411581081000_ref1","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: An analysis for the global burden of disease study 2019","volume":"7","author":"Nichols","year":"2022","journal-title":"Lancet Public Health"},{"key":"2026022411581081000_ref2","doi-asserted-by":"publisher","first-page":"e883","DOI":"10.1016\/S2214-109X(19)30172-X","article-title":"The escalating global burden of serious health-related suffering: Projections to 2060 by world regions, age groups, and health conditions","volume":"7","author":"Sleeman","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2026022411581081000_ref3","first-page":"CD011513","article-title":"Palliative care interventions in advanced dementia","volume":"9","author":"Walsh","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2026022411581081000_ref4","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.colegn.2022.08.006","article-title":"A good death: A synthesis review of concept analyses studies","volume":"30","author":"Morgan","year":"2023","journal-title":"Collegian"},{"key":"2026022411581081000_ref5","doi-asserted-by":"publisher","first-page":"e593","DOI":"10.1016\/S2666-7568(21)00097-0","article-title":"What would it take to die well? 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