Development of collaborative support systems between medical services and care to respond to increased dependence on care of welfare facility residents

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In speci al nursing homes for the elderly, end-of-life (palliative) care has been performed under constraints.I conducted a survey involving all special nursing homes for the elderly in Hyogo Prefecture to identify the current provision of end-of-life care and state of the additional fee calculation scheme for the care. Possible effects of end-of-life care on the management of these facilities, staff training, and feelings of satisfaction among facility residents and their family members were also examined. End-of-life care contributed to staff training and feelings of satisfaction among residents and their family members. However, it was considered a problem from a business standpoint, regardless of the presence or absence of added fees for such care. Although an additional fee schedule may not be sufficient to financially support these facilities, it has the potential to establish a shared awareness of the current and prospective state of end-of-life care among facility managers and staff, improve the working environment, and standardize and streamline work processes.Coherent care encompassing "end-of-life" (before death) and "departure" (after death) will be a focus of attention in future years. Working beyond the boundaries of specialization (life and death), funeral directors may enter the industry of elderly facilities from an earlier stage, and become an accepted part of consistent service.