Incurably ill cancer patients (n = 37) and their spouses, while receiving support from a hospital-based palliative service, were assessed monthly regarding quality of life, using the assessment of quality of life at the end of life instrument. Lowest ratings for patients during the final six weeks were found in the following items: ability to do what one wants, physical strength, global quality of life, and meaningfulness. The pain situation was stable over time. Generally, patients were less anxious than spouses. The least-optimal items at the end of life for the patients' partners were: ability to leave the patient unattended, need for assistance with hygiene/dressing and anxiety. Meaningfulness was the item with the strongest correlation to global quality of life, for both patients and spouses. A more ambitious approach to the existential domain appears to be essential if we wish to optimize quality of life for patients within palliative care.
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