{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:09:23Z","timestamp":1777882163305,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat\ufffdCare"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Goals of care (GOC) discussions and advance care planning (ACP) emphasize patient\u2019s autonomy and dignity in healthcare delivery. These discussions become crucial as individuals approach the terminal phase of their illness, enabling them to make informed decisions about their end-of-life care (EOLC). Globally, there is a rising trend in discussions related to GOC, especially among those with serious or chronic conditions. In Asian countries, including Nepal, cultural factors, family dynamics, and limited awareness among healthcare professionals hinder ACP implementation. Nepal faces challenges in healthcare accessibility, with a significant portion of healthcare expenditure directed toward the elderly population. Palliative care medicine has made some progress in Nepal, despite the scarcity of its resources. Cultural influences contribute to healthcare providers\u2019 and patients\u2019 unawareness and limited proactive involvement in end-of-life decision-making. The integration of GOC discussions in Nepal\u2019s healthcare system is imperative to ensure access to basic palliative care resources in both rural and urban areas. Efforts should focus on addressing challenges in palliative care and promoting understanding of GOC concepts with clear documentation, comprehensive EOLC plans, and increased awareness among both healthcare providers and the public. Implementing a centralized record system can enhance nationwide access to GOC information, contributing to a patient-centered healthcare system.<\/jats:p>","DOI":"10.1177\/26323524251386060","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T12:22:28Z","timestamp":1761740548000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating end-of-life conversations: A reflection on goals of care in Nepal"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3545-6836","authenticated-orcid":false,"given":"Shristi","family":"Nepal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, AdventHealth Orlando, Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2260-373X","authenticated-orcid":false,"given":"Navin","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals\/Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3148-7160","authenticated-orcid":false,"given":"Sunil","family":"Bogati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Mary\u2019s General Hospital and St. Clare\u2019s Denville Hospital, New York Medical College, Passaic, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1202-606X","authenticated-orcid":false,"given":"Bandana","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Health Emergency Operation Center, Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George D.","family":"Everett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, AdventHealth Orlando, Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2020.06.002"},{"key":"e_1_3_3_3_2","article-title":"Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel","volume":"53","author":"Sudore RL","year":"2017","unstructured":"Sudore RL, Lum HD, You JJ, et al. 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