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While Namaste Care may enhance comfort, its effect on symptoms during the last week of life has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To assess the frequency of symptoms experienced by nursing home residents with dementia during the last week of life, and to evaluate the delivery of Namaste Care Family during the last week of life and its effect on comfort and symptom burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This mixed-methods study combined quantitative data from a cluster-randomised controlled trial with semi-structured interviews. Symptoms were assessed using the End-of-Life in Dementia (EOLD) Scales \u2013 Symptom Management (SM; family perspective) and Comfort Assessment in Dying (CAD; staff perspective). Multilevel analyses examined the effect of the Namaste Care Family programme on symptom burden. Interview data was analysed using a content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>\n                      Ten nursing homes implemented the Namaste Care Family programme, while nine provided usual care. During the study, 103 of 231 residents with moderate to advanced dementia died (47 intervention group, 56 control group). Interviews (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200932) were conducted with family caregivers, staff and volunteers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Serenity (80%), discomfort (72%), and pain (70%) were most frequently observed. The programme had no significant effect on symptom burden (EOLD-SM \u22120.14\u2009points, 95% CI \u22125.25, 4.96,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.96; EOLD-CAD 0.35\u2009points, 95% CI \u22121.98, 2.68,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.77). Interviews showed difficulties in implementing the programme during the last week of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Comfort and distressing symptoms were both present at the end-of-life phase with dementia. The Namaste Care Family programme did not influence this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>This trial was registered with the CCMO Research with human participants (ID 5692\/5570).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261486997","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:32:51Z","timestamp":1792067571000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comfort and symptoms at the end of life with dementia in the Namaste Care Family cluster-randomised trial"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1391-6104","authenticated-orcid":false,"given":"Yara J.","family":"Schepen","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4961-2978","authenticated-orcid":false,"given":"Maartje S.","family":"Klapwijk","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"},{"name":"University Network for the Care Sector South Holland, Leiden University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-1020","authenticated-orcid":false,"given":"Jos W. R.","family":"Twisk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science, Amsterdam University Medical Centre, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9227-7135","authenticated-orcid":false,"given":"Wilco P.","family":"Achterberg","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"},{"name":"University Network for the Care Sector South Holland, Leiden University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-7501","authenticated-orcid":false,"given":"Jenny T.","family":"van der Steen","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"},{"name":"Cicely Saunders Institute, King\u2019s College London, UK"},{"name":"Department of Primary and Community Care and Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7836-431X","authenticated-orcid":false,"given":"Hanneke J. 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