Shaping the Future of End-of-Life Care: Empowering Dignity and Autonomy Through Community-Led Models and Innovative Practices

This paper explores the growing need for community-led, at-home end-of-life care due to the predicted shortage of long-term care and hospice beds by 2035. It reviews a range of studies on home-based palliative care, end-of-life doulas, grassroots initiatives, and government policies, with a focus on models that support dignity and autonomy during the final stages of life. A literature search was conducted using databases such as PubMed, Google Scholar, and NPHI, with keywords including "home-based palliative care," "end-of-life doulas," "compassionate communities," and "community-led care." The findings highlight the effectiveness of initiatives like end-of-life doulas and Compassionate Communities in improving emotional support and death literacy. Government policies and technology integration, including telehealth and smart sensors, are crucial for equitable, personalized care. The review emphasizes that home-based care offers significant psychological and emotional benefits for patients and families, suggesting a need for a shift towards more community-supported models. However, gaps remain in research, particularly on the long-term effects of digital advocacy and the role of technology in at-home care, warranting further investigation into the scalability and sustainability of these models.