BACKGROUND: The condition of middle adult patients with palliative disease is prone to experiencing physical weakness and psychological suffering, disrupting dignity. As a caregiver at home, the family plays an essential role in providing support to maintain patient dignity. AIM: This study aims to determine the image of the dignity of the middle adult patient with palliative care needs by family at home. METHODS: This research is a qualitative study with a phenomenological approach. Participants were seven people with the purposive sampling method. Data collection methods were conducted using in-depth interviews and semi-structured observation. Research instruments included interview guidelines, field notes, and an observation form. Data validity used reference material, rich and thick description, and peer debriefing. Data analysis included data collection, data reduction, data presentation, and conclusion. RESULTS: The results showed that the dignity of patients was considered by six themes; self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes. CONCLUSION: This study had six themes depicting the dignity of patients that consisted of subthemes. The themes included self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes.