Fulfilling End-of-Life Dreams: A Scoping Review of Bucket Lists in Palliative and Hospice Care

Background: Given the holistic nature of palliative care, it is essential to consider an individual’s end-of-life wishes, or ‘bucket list’, as an integral part of routine hospice palliative care. Fulfilling a last wish or accomplishing a ‘bucket list’ desire can serve as an intervention to foster hope and optimism and support individuals preparing for an anticipated death. Thus, the purpose of this scoping review is to provide a comprehensive understanding of how end-of-life dreams and bucket list fulfilment can enrich an individual’s quality of life.

Methods: A scoping review was utilized because it allows for addressing a broad topic based on the analyses of studies that use a variety of designs and without restrictions of quality indicators. The review included all scholarly (e.g., peer-reviewed) research studies published from January 1, 2000, through May 31, 2024. A total of 14 studies met the inclusion criteria out of 2234 search results. The included studies used quantitative (8), qualitative (2), and mixed-methods (4) study design. The participants’ aged from 5-83 years, with sample sizes ranging 15-3056 participants.

Results: We used thematic content analysis which generated five key themes (studies are included in more than one theme). Impact on holistic well-being: Six articles reported improvements in overall well-being through wish-fulfilment in participants which enhanced their emotional well-being, alleviate physical symptoms, and reinforce social connections. Role of family in wish fulfilment: Five studies illustrated the dual role of families as both sources of support and potential sources of emotional complexity during the end-of-life experience. Cultivation of gratitude: Four studies reported fostering a feeling of gratitude with a strong desire to give back the care and support they received through the wish-fulfilment. Collaborative leadership in wish fulfilment: Five studies reveal the role of collaboration among service users, families, and care teams in achieving desired health outcomes for the patients. Service user values and preferences in end-of-life choices: The desire for a peaceful end-of-life experience emerged as a prominent theme across the five reviewed studies, highlighting the significance of environment, treatment decisions, and the cultivation of dignity.

Conclusion and Implications: Despite the demonstrated value of wish fulfilment interventions, gaps in research persist particularly regarding cultural and socio-economic disparities, long term effects, and implementation challenges within the healthcare system. Healthcare providers should receive formal training and awareness on facilitating end-of-life conversations including understanding the cultural nuances in last wishes, and ethical considerations in managing wish fulfilment. The establishment of guidelines and policies by organizations and/or healthcare institutions is essential in overcoming this gap. As palliative and end-of-life care continues to evolve, wish fulfilment interventions represent a powerful resource in enhancing dignity, and holistic experiences for terminally ill individuals. Thus, future research efforts could strengthen programs ensuring every individual is able to achieve a sense of peace, fulfilment, and closure during their care trajectory.