Image: Caleb Gage (PhD Emergency Medicine) who is lead author and interviewer for the research

When families are caring for someone with a life-limiting illness, moments of crisis can feel overwhelming. A sudden deterioration, uncontrolled symptoms, or sheer caregiver exhaustion may lead to one urgent decision: calling Emergency Medical Services (EMS). However, what is that experience like for patients living with palliative needs, and their families, and how can EMS better support them?

Giving a voice to patients and families
A new South African study explores this question, giving a voice to patients and family members whose lives intersect with emergency care during some of their most vulnerable moments. The open-access article, published online on 9 February 2026 by SAGE Journals, is titled The dynamic of control: A qualitative analysis of the perspectives of patients and family members with palliative care needs on Emergency Medical Services. Authored by Caleb Gage, Liz Gwyther, and Willem Stassen, the study offers an important window into how emergency care is experienced in palliative situations and how it can be strengthened through a person-centred approach.

Palliative care is built on a person-centred approach, recognising that patients and families are not passive recipients of care, but active participants whose values, wishes, and sense of dignity matter deeply. This research highlights how critical it is for emergency care to align with those principles, especially in palliative situations.

Strong need to retain control
Through in-depth interviews, participants described what the researchers call “The Dynamic of Control.” Living with serious illness often brings a profound sense of lost control – over health, routines, decisions, and even identity. Families and patients expressed a strong need to regain or maintain control during moments of crisis. EMS encounters could either restore reassurance and stability or unintentionally deepen distress by taking rather than giving control in these situations, depending on how care was delivered.

Importantly, many participants shared deeply positive experiences. Compassion, calm communication, and respect helped families feel supported and safe. In contrast, when care felt rushed, dismissive, or disconnected from their needs, stress and uncertainty increased. As a result, the authors concluded EMS providers should allow patients and families to set the “tone of interaction” rather than assuming command.

“EMS desperately need a cultural shift towards person-centred care,” says the article’s lead author and interviewer, Caleb Gage. Too much of EMS care is system-centred, indiscriminately imposing our policies on patients and families. Palliative care provides this shift. Palliative care makes better EMS providers. And who better to teach us how to apply this person-centred approach than patients and families themselves? For me, this study was practice changing, and I trust it will be the same for you!”

Why does this matter?
Emergency providers are often the first responders in moments of fear, uncertainty, and emotional strain. Understanding the lived experiences of patients and their families helps shape care that is not only clinically effective, but compassionate and responsive. The study suggests that integrating palliative care principles into EMS education, such as communication skills, shared decision-making, and awareness of family dynamics could transform emergency encounters into opportunities for person-centred support.

This research is especially important in the South African context, where healthcare systems face unique pressures and palliative care access remains uneven. Collaboration between EMS and palliative care services offers a meaningful pathway to improve quality of care, reduce unnecessary hospital transfers, and honour patient preferences.

Ultimately, this study reminds us that emergency care in palliative situations is not only about responding to symptoms. It is about recognising the human experience behind the crisis.

We encourage healthcare professionals, policymakers, educators, and anyone interested in compassionate care to read the full study. Its insights offer practical guidance and a powerful perspective on how emergency services can better serve patients and families when it matters most.

The full Journal article can be found at: https://journals.sagepub.com/doi/10.1177/26323524251409346