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

在特殊养老院中，临终（缓和）护理一直受到限制。为了查明目前提供临终护理的情况和护理的附加费用计算方案的状况，我对兵库县所有特殊养老院进行了调查。临终关怀对这些设施的管理，工作人员的培训，以及设施居民及其家人的满意度的可能影响也进行了研究。临终关怀有助于工作人员的培训和居民及其家人的满意度。然而，从商业角度来看，这被认为是一个问题，不管是否对这种护理收取额外费用。虽然额外的收费表可能不足以从财政上支持这些设施，但它有可能在设施管理人员和工作人员之间建立对临终关怀现状和未来状况的共同认识，改善工作环境，统一和简化工作流程。（生前）和（死后）的“离开”将是未来几年关注的焦点。殡仪业者超越专业化（生与死）的界限，可以较早地进入老人设施行业，并成为持续服务的一部分。

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.