Studies on Care Management Involving End-stage Care for the Elderly

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Methods of care management, with a focus on end-stage care for the elderly, are discussed in this report. The issue has surfaced from the current situation of providing end-stage care at nursing homes for the elderly in Japan.Through this research it became clear that the need for medical services, particularly for care at the end of life, tends to increase, and thus facility residents are often turned over to people engaged in medical care.Based on the above facts, the following three findings were obtained :1. The issues of end-stage care that the facilities for the elderly think they should improve are not necessarily the ones that the families of the residents want to see improved. Therefore certain disparities appear between them, which causes further deterioration in providing care services.2. Families of the residents want to hear from facility personnel a thorough explanation of the conditions at the end of a resident's life. The more frequently that explanations are given, the … More more satisfied the families are in their feelings about end-stage care services.3. In order to provide quality end-stage care to the residents at the facility, it is necessary that either the resident, or his family, or both, clearly show their intentions regarding the care they want to be provided, and that those intentions are sufficiently included in the facility's care plans.Together with these three findings, it also became clear through my research that there have been mounting problems in recent years that need to be solved in addition to the issue of improving end-stage care. One of them is the chronic shortage of care-givers at most facilities. Due to the shortage of staff, sufficient care-giving can not be practiced for residents.A care management program has been introduced to Japan by implementing the elderly care insurance system. In order to develop end-stage care of higher quality, it became clear through my studies that it is critical to immediately create a Care Management System with care managers taking a lead in the project, in which the following three aspects should be incorporated: the family's wishes; the facility's challenges; and social resources.As a part of my studies, ways to improve end-stage care at nursing homes is also discussed in this report. Less