[A survey on the view of end-of-life care in the elderly -a comparison among elderly patients, family members. physicians, nurses, and other caregivers]

Associations with the Japanese population's preferences for the place of end-of-life care and their need for receiving health care services

PURPOSE

The aims of this study were to identify the associations with the Japanese population's preferences for the place of end-of-life care and their need for receiving health care services.

METHODS

A secondary analysis of a cross-sectional nationwide survey was conducted for 2000 randomly selected Japanese people aged 40-79 years.

RESULTS

A total of 1042 people (55%) responded. Regarding preferred place of care, we set the place within the choices of "Home" (preferred by 44% of respondents), "Acute Hospital" (15%), "Palliative Care Unit" (19%), "Public Nursing Home" (10%), and "Private Nursing Home" (2%). Multinomial logistic regression analysis revealed that the people who preferred "Acute Hospital" tended to have the following need compared to those who preferred "Home," "Palliative Care Unit," or "Nursing Home": higher need for receiving end-of-life care not from its experienced professionals but from the same staff; higher need for using health care services in highly supported environment such as the need for being near health care staff whenever and for receiving treatment possibly until the end; and higher need for consulting nurses whenever. They had lower need for using home care services and daycare services and also lower need for instructing families about how to use insurance/public health services.

CONCLUSIONS

The present findings may help to develop an effective end-of-life care system in Japan considering Japanese people's need for health care services. Also, the results of this study may underscore the importance of education on receiving home care services especially for the people who presently prefer the hospital for end-of-life care.

Japanese people's preference for place of end-of-life care and death: a population-based nationwide survey

CONTEXT

Japanese people's preferred place of end-of-life care may be affected by their experiences, perceptions, and knowledge related to the end of life.

OBJECTIVES

The aims of this study were to clarify the Japanese population's preferences for the place of end-of-life care and death and to identify the determinants of each choice of preferred place of end-of-life care within their experiences, perceptions, and knowledge.

METHODS

A total of 2000 Japanese people aged 40-79 years participated in a cross-sectional nationwide survey.

RESULTS

Fifty-five percent (n=1042) responded. Regarding place of end-of-life care, approximately 44% of the general population preferred home, 15% preferred hospital, 19% preferred palliative care unit, 10% preferred public nursing home, 2% preferred private nursing home, and the remaining 11% was unsure. Multinomial logistic regression analysis revealed that the following factors affect people's preferences regarding place of care: 1) experiences, such as "visiting hospital regularly" and "experiencing home death of relatives," 2) perceptions, such as "giving due thought to their own death on a daily basis" and "perceiving lower home palliative care costs to be appropriate after comparing hospital admission fees," and 3) knowledge of "home care nursing" and "24-hour home palliative system by physicians and nurses using insurance." These factors correlated with preference for hospital, palliative care unit, or public nursing home, when compared with the preference of home.

CONCLUSION

The present findings may help to develop an effective end-of-life care system in Japan, in line with people's various preferred locations for such care.