Palliative and End-of-Life Care Symptoms

Raquel Pontes-Gomes et al. (2026) · Palliative medicine

This systematic review of nine studies and 415 participants explored whether Reiki and Therapeutic Touch, two hands-on or hands-near complementary therapies, change symptoms and quality of life in people receiving palliative and end-of-life care. Both are classed as biofield therapies, meaning they are described as working with an energy field around the body, although the review notes that how they might work is still debated. Palliative care is care aimed at easing suffering and improving quality of life for people with advanced, incurable illness. The authors point out that benefits could also come from the attention of a practitioner, relaxation or expectation rather than from any energy effect, so the question was examined with a critical eye. The authors searched three databases for English-language studies from 2013 to 2024, accepting any design in which palliative or end-of-life patients received Reiki or Therapeutic Touch and symptoms or quality of life were reported. Two reviewers worked independently and graded certainty with GRADE (a framework rating confidence in evidence) and GRADE-CERQual (its qualitative counterpart). Nine studies qualified: three randomized trials, five mixed-methods studies and one interview study, with 351 adults and 64 children, mostly people with cancer, from North America and Europe. Sessions ranged from about 15 to 24 minutes, repeated over days to weeks. Several studies reported improvements in pain, anxiety, depression, fatigue and stress, and in sleep, relaxation, energy, hope and emotional well-being. A Turkish trial of 156 adults with advanced cancer reported lower pain, fatigue and analgesic use after Reiki, and a trial of 73 older inpatients reported better spirituality scores and sleep quality after Therapeutic Touch. Results were not consistent, though. In young children, pain and vital signs such as heart rate and oxygen saturation did not change significantly, and in a dementia trial of 49 residents, behavioral symptoms improved during treatment but not afterwards. Participants and caregivers described sessions as calming and comforting. The reviewers rated certainty as very low for both symptom burden and quality of life (meaning the true effect could differ substantially). Only one study tracked harms and reported one serious event judged possibly related, with two unrelated events. The authors conclude that the evidence is too limited and varied to support firm conclusions about whether either therapy works in palliative care. Limitations include small samples, subjective outcome measures, missing control groups in several studies, difficulty blinding hands-on therapies, English-only searching and possible overlap between caregiver samples. Because harms were rarely monitored, the authors state that a lack of reported harms is not evidence of safety. They recommend larger, adequately powered trials with standardized outcome measures and systematic reporting of both benefits and harms.