Why the Gulf needs more hospice and palliative care as its population ages

By Mark Adams, CEO of Clemenceau Medical Center 

UAE—Around the world, conversations about serious illness often revolve around treatment, with doctors discussing available therapies, exploring new options, and planning the next course of action.

However, when medical treatment can no longer change the outcome, attention rarely shifts to equally important questions such as where patients want to spend their final days, who they want beside them, and how they wish to live the remainder of their lives.

Across the Gulf, those questions remain difficult to answer.

Although countries in the region have invested heavily in world-class hospitals, advanced medical technology, and specialised treatment, support for people nearing the end of life has not developed at the same pace.

As a result, many patients and their families still lack the care they need beyond hospital walls.

A Gap Between Patient Wishes and Reality

When asked where they would prefer to spend their final days, most people choose home rather than a hospital.

They want to remain in familiar surroundings with their loved ones close by.

This preference is universal, but it carries even greater significance in Gulf societies, where family plays a central role in culture, faith, and caregiving.

Despite these preferences, many people across the UAE and the wider Gulf still die in hospitals.

This is often not because they choose to, but because community-based hospice and palliative care services remain extremely limited.

Research consistently shows that patients in the UAE who wish to receive end-of-life care at home rarely have that opportunity.

The country has very few community palliative care teams or dedicated hospice facilities outside major hospitals, leaving families with limited alternatives.

Closing this gap would not only improve the quality of life for patients but also provide much-needed support for families while easing pressure on healthcare systems.

Progress has begun, but access remains limited

The UAE has taken important steps to strengthen palliative care over the past two decades.

In 2007, Tawam Hospital in Abu Dhabi established the country’s first comprehensive palliative care programme, laying the foundation for further development.

Since then, services have expanded gradually. However, they remain concentrated within oncology departments in a small number of hospitals, mainly in Abu Dhabi and Dubai.

Consequently, many patients living with advanced heart disease, dementia, chronic respiratory illness, and other life-limiting conditions still have limited access to specialised palliative care.

The World Health Organization also classifies the UAE as having only isolated palliative care services relative to the country’s overall healthcare needs.

Nevertheless, encouraging progress continues.

In late 2023, Burjeel Holdings signed a landmark partnership with London’s St. Christopher’s Hospice, widely recognised as the birthplace of modern hospice care, to establish the UAE’s first dedicated hospice facility in Abu Dhabi.

The project aims to create a compassionate centre for end-of-life care while supporting patients, families, and healthcare professionals.

Although this marks a significant milestone, a single hospice cannot meet the needs of a region with tens of millions of residents.

An aging population will increase demand

The need for palliative and hospice care is expected to grow rapidly over the coming decades.

Although the Gulf currently has a relatively young population, demographic trends point to a significant shift.

According to PwC’s Middle East Megatrends analysis, one in every five GCC nationals will be elderly by 2050, representing a tenfold increase from current levels.

As populations age, chronic illnesses such as cancer, cardiovascular disease, diabetes, and dementia become more common.

Many of these conditions eventually require palliative care rather than curative treatment.

Healthcare systems across the Gulf have invested extensively in diagnosing and treating these diseases.

However, they have devoted far fewer resources to supporting patients whose illnesses can no longer be cured and to helping families manage the physical and emotional challenges that follow.

Building this infrastructure now will help healthcare systems prepare for rising demand rather than struggle to catch up later.

Lessons from the UK’s Hospice Model

The United Kingdom offers one of the world’s most established examples of hospice and palliative care.

The movement began in 1967 when Dame Cicely Saunders founded St. Christopher’s Hospice in London.

Since then, the country has developed a network of more than 200 hospices alongside community-based services such as Macmillan Cancer Support.

Through this model, specialist nurses work closely with general practitioners and families, helping patients manage symptoms, receive emotional support, and remain at home whenever possible.

The results have been impressive.

Studies show that specialist community palliative care increases the likelihood of patients dying in their preferred place by around 50%.

At the same time, healthcare costs during the final year of life fall by approximately 20%.

These outcomes demonstrate that better patient experiences and lower healthcare costs can go hand in hand.

Even so, the UK model cannot simply be replicated in the Gulf. The region’s cultural and religious traditions shape how families approach illness, caregiving, and death, requiring solutions that reflect local values.

Building a Hospice Model that reflects Gulf culture

Islamic teachings view death as a natural transition and emphasize compassion, dignity, and family involvement throughout the final stages of life.

In many Emirati and Arab households, caring for a dying relative is regarded as both a family responsibility and a spiritual duty.

These traditions naturally support many of the principles of palliative care.

Families already value caring for loved ones at home, surrounded by relatives and supported by faith.

What they often lack is the clinical expertise and practical assistance needed to make home-based care possible.

A successful Gulf hospice model should therefore focus on strengthening community services that work alongside families rather than replacing them.

This approach would include specially trained community nurses; palliative care physicians who understand both clinical practice and Islamic ethics; grief counsellors familiar with local bereavement traditions; and accessible Arabic-language resources.

It should also ensure that care remains culturally sensitive and respects gender preferences whenever appropriate.

Developing these services is well within reach if governments and healthcare providers commit the necessary investment and long-term planning.

 Encouraging open conversations about end-of-life care

Alongside expanding services, the Gulf also needs to encourage more open conversations about end-of-life care.

In many healthcare settings across the region, families and clinicians often try to protect patients from learning the full extent of a serious diagnosis.

Although this approach stems from compassion and a desire to preserve hope, it can also prevent patients from expressing their wishes, making important personal decisions, or spending their remaining time in the environment they would have chosen.

High-quality palliative care creates opportunities for these conversations while respecting cultural values and individual beliefs.

Rather than signaling the end of treatment, it focuses on improving comfort, preserving dignity, managing symptoms, and ensuring that patients continue to receive compassionate care throughout the final stage of life.

Creating space for these discussions allows patients, families, and healthcare professionals to make informed decisions together while ensuring that end-of-life care reflects each person’s values, preferences, and dignity.