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Reconsidering long‐term care in the end‐of‐life context in J apan
Author(s) -
Shimada Chiho,
Hirayama Ryo,
Wakui Tomoko,
Nakazato Kazuhiro,
Obuchi Shuichi,
Ishizaki Tatsuro,
Takahashi Ryutaro
Publication year - 2016
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12736
Subject(s) - context (archaeology) , end of life care , long term care , medicine , scope (computer science) , gerontology , medical care , advance care planning , psychology , nursing , palliative care , computer science , paleontology , biology , programming language
In this article, we propose expanding the scope of long‐term care such that it involves caring for dying individuals; that is, end‐of‐life care. In doing so, we identify challenges that families and care/medical professionals face in attempts to design and provide end‐of‐life care under J apan's societal contexts. Because of the difficulty judging whether an individual is in an end‐of‐life phase, as well as a growing number of older adults who are unable to communicate their care preferences as a result of cognitive impairment, efforts were almost automatically made to prolong older patients' lives. To respect patients' desires and values, communication among older adults, their families, and care/medical professionals has been increasingly encouraged to make a mutually agreeable end‐of‐life care decision. At the same time, older adults are expected to indicate their care preferences earlier because their ability to express their ideas should be limited when approaching the end‐of‐life phase. We thus suggest including advance care planning in the course of long‐term care such that older adults, with the help of care/medical professionals, can tell their preferences to their families, who are required to serve as surrogate decision makers in J apan. Our research, however, has shown that Japanese older adults are hesitant to discuss end‐of‐life issues with their families. On the basis of our findings suggesting older adults' concern that they might make trouble for their families by clarifying their care preferences, we discuss how care/medical professionals should facilitate family discussions on end‐of‐life care. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 132–139.