Caregiver Misconceptions and Barriers to Palliative Care in Saudi Arabia: A Comprehensive Narrative Review

BackgroundPalliative care (PC) services have expanded in Saudi Arabia, yet caregiver misconceptions and limited service visibility may delay referral and create uncertainty about symptom management. Because families play a central role in care navigation and decision-making, caregiver's understanding influences when PC is considered. Addressing misconceptions is essential to improving care quality.MethodsA structured narrative review guided by the Scale for the Assessment of Narrative Review Articles involved a search of MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar for literature published from January 1, 2000, to January 16, 2026, with targeted citation and gray literature updates through 2026. Search terms included "PC," "end-of-life care," "caregivers/families," "awareness," "opioids," "communication," "religion," "Saudi Arabia," and the "Gulf Cooperation Council." Of 925 unique records screened, 279 underwent full-text assessment, and 63 met eligibility. The review synthesized 42 eligible evidence and implementation sources, with methodology and clinical tools supported by primary sources.ResultsSix themes were identified: (1) Misunderstanding Purpose and Scope; (2) Fear of Opioids; (3) Cultural and Religious Dynamics; (4) Noncancer Awareness Gap; (5) System-Level Barriers; and (6) Implementation-Level Gaps. Nursing priorities included repeated caregiver assessment, clear symptom and medication education, teach-back, and coordinated transitions.ConclusionCaregiver misunderstanding remains an important barrier to PC use in Saudi Arabia. Improvement requires nurse-led and interdisciplinary caregiver education, culturally attuned and faith-sensitive communication, earlier PC integration, coordinated transitions, and expanded home- and community-based services.