Survey of Trends in End-of-Life Care for the Elderly in Japan in the Areas of Healthcare, Medical Care, and Welfare

在这份报告中，我集中讨论了老年人临终关怀的三个领域：健康护理、医疗护理和社会福利。从我的研究中可以清楚地看到，日本对这些细分领域的研究都是单独进行的，没有合作。关于保健的研究报告通常附有关于死亡的统计分析。它们涉及死亡情况与季节变化之间的关系;死亡原因与年龄之间的联系;以及所提供的护理类型。许多关于医疗护理的研究都涉及如何治疗晚期患者。特别重要的是两个方面：护理和治疗。大多数社会福利研究都集中在使用评级量表分析护理状况。这些问题包括在家中照料临终病人的情况、在老年人机构照料临终病人的条件以及照料者在临终护理方面面临的压力。我的研究表明， ...更多信息 在医疗护理领域进行了深入研究，例如如何治疗垂死的病人。然而，其他两个领域，医疗保健和福利，仍然停留在基础研究的最基本的水平，对生命终了护理和相关事项。我的研究进一步揭示，在临终关怀中，负责治疗病人的医疗专业人员发挥着核心作用，而护理这些病人的辅助医务人员只起着次要作用。该报告证实，日本进行的关于临终关怀的研究呈金字塔形结构：从医学角度对临终者的护理位于顶部，对支持患者心理健康的其他护理人员的研究位于下方。在当今社会，医疗保健和福利之间的联系非常需要。这种纽带在癌症病人的临终关怀中发挥了良好的作用，但在老年人的临终关怀中仍处于不令人满意的状态。关于如何治疗临终者的研究还不够发达，停留在基础研究的层面。少

In this report, I focused on three areas of end-of-life care for the elderly : health care, medical care, and social welfare. It became clear from my research, titled above, that studies in Japan on each of these segment areas are conducted separately with no collaborative work. Research on health care is usually reported with statistical analyses on deaths. They deal with the relationships between situations of death and seasonal changes ; connections between causes of death and age ; and the type of care given. Many of the studies on medical care deal with how to treat end-stage patients. Particular significance is placed on two aspects : care and cure. Most of the social welfare research is centered on analyses of the situation of care using rating scales. They include situations of attending the deathbed at home, conditions of care for the dying given at institutions for the elderly, and stress on caregovers concerning end-of-life care. My research revealed that advanced studies in … More the area of medical care are made in depth, such as on how to treat dying patients. However the other two areas, healthcare and welfare, still remain on the fundamental level of basic research on end-of-life care and related matters. My research further revealed that in the care of the dying, medical-professionals, who cure patients, take the central role, and paramedical staff, who care for such patients, merely take a secondary role. The report confirmed that studies on end-of-life care performed in Japan are structured in a pyramid shape : care of the dying from medical perspectives comes at the top, and studies on other caregivers, who support patients' mental health, are situated beneath as a subordinate body. Linkage between healthcare, medical care, and welfare is demanded greatly in our society today. Such ties function well in terminal care for cancer patients, but those for the elderly are still in an unsatisfactory state. Studies on how to treat dying people are not developed enough and remain at the level of fundamental research. Less