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

在这篇报告中，我着重讨论了老年人临终关怀的三个方面：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出，在日本，这些细分领域的研究都是单独进行的，没有合作。关于卫生保健的研究报告通常附有对死亡的统计分析。它们处理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；以及所给予的护理类型。许多关于医疗保健的研究涉及如何治疗终末期病人。特别重视两个方面：护理和治疗。大多数的社会福利研究都集中在使用评定量表对护理状况进行分析。这些问题包括在家中照顾临终病人的情况、在老年人机构照顾临终病人的条件，以及照顾者在临终关怀方面的压力。我的研究表明，在医疗保健领域的研究越来越深入，例如如何治疗垂死的病人。然而，另外两个领域，医疗保健和福利，仍然停留在临终关怀和相关事项的基础研究的基础水平。我的研究进一步表明，在对临终者的护理中，治疗病人的医疗专业人员扮演着中心角色，而照顾这些病人的医务辅助人员只是扮演着次要角色。报告证实，在日本进行的关于临终关怀的研究呈金字塔形：从医学角度对临终者的护理位于顶部，而对支持患者心理健康的其他护理人员的研究位于下方，属于从属主体。在我们今天的社会中，医疗保健和福利之间的联系是非常需要的。这种关系在癌症患者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，这种关系仍处于令人不满意的状态。关于如何治疗垂死之人的研究还不够发达，还停留在基础研究的水平。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