Empirical Research on End-of-Life Care at Special Nursing Homes for the Elderly in Japan

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The main objective of this study was to unearth the actual conditions of nursing home residents who are in the terminal stage of life and the kinds of care given to them. A list of queries was sent to the 600 special nursing homes for the elderly in all parts of Japan to conduct a survey on the time, place, and condition of residents whose lives had ended there, and how care for the dying is given. Out of 600 facilities, 158 responded, and analytical studies were made on them. The investigation was conducted taking a full year from April 1999 through March 2000. The following facts surfaced through this research : 1. Age of death : The older the resident, the more likely they were to die. 2. Length of time spent at facility : 50 % die within three years of their date of admission. 3. Place of death : 36.7 % die in facilities, and 63. 1 % die in hospitals. 4. Daily Living Activities at the time of death : 54. 1 % were in a severe state of dementia, and 79.8 % were bedridden. 5. Who was … More present at the deathbed : Family accounted for only 8.9 %, and facility staff for 47.8 %. It became clear from the above findings that more than 50 percent of nursing home residents die within three years of entering a facility. Among them, people who die at home are rare, and it is reconfirmed that the facilities have actually become a "retirement home" for them. The state of the Activities of Daily Living of most residents approximately three months prior to death had severely declined, and nearly all were bedridden when they drew their last breath. For the carers, it was illustrated that most of their end-of-life care included medical practice, resulting in heavy loads being imposed on them : Besides their daily routine work, which alone keeps them busy, they were further burdened with personal care and medical procedures. Actual conditions of end-of-life care at facilities largely varied depending on the situation they were, placed in, such as by geographical location, and thus inevitably regional differences were seen. Less