PURPOSE: Family members predominantly serve as the primary caregivers for cancer patients. However, the experiences of caregivers in regions lacking palliative care support have not been thoroughly investigated, particularly when elderly cancer patients enter the terminal phase. This study aims to explore the experiences of caregivers for elderly cancer patients in the terminal stage, focusing on areas with limited palliative care resources. This study aims to identify the suffering and desires of caregivers, providing a foundation for enhancing palliative care services in economically underdeveloped regions. METHODS: A qualitative study was conducted from March to October 2023. Face-to-face, in-depth, semi-structured interviews were employed to collect data from 13 Chinese family caregivers of elderly terminal cancer patients. Participants were recruited using purposive sampling. The interview data were analyzed using Colaizzi's seven-step analysis method. The study's rigor was ensured through the application of Lincoln and Guba's criteria. RESULTS: The analysis of gathered data reveals a pernicious cycle wherein physical challenges and psychological distress exacerbate one another, further compounded by a dearth of support. This intricate interplay underscores the complex relationship between physical, psychological, and support-related needs. CONCLUSION: The development and provision of respite services, enhancement of death education, improvement of physicians' communication skills regarding end-of-life information, and establishment of supportive home care plans are deemed necessary. It is recommended that local governments refine the palliative care system, ensuring seamless integration of palliative care from top-tier hospitals to communities and homes. These measures aim to meet caregivers' expectations while assisting them in overcoming their challenges. The findings herein not only contribute to the improvement of local palliative care services but also offer valuable insights for the enhancement of global palliative care provision.