Departmental Bulletin Paper 在宅療養高齢者の終末期医療に対する事前の意思表示の現状と課題
Current State and Issues Surrounding the Home-care Elderly’s Prior Expression of Will toward Their End-of -life Care

高橋, 方子  ,  菅谷, しづ子  ,  鈴木, 康宏  ,  石津, みゑ子  ,  布施, 淳子

Purpose:The purpose of this research is to consider the current state and issues surrounding the home-care elderly's prior expression of will toward their end-of -life care (hereinafter “End-of -life care”), by basing on the visiting nurse's awareness toward such issues.Method: We chose 756 visiting nurses as the survey subjects, and we had them fill out the answers without revealing their identity and had them mail back the survey.Result:Answers were obtained from 133(17.3%)visiting nurses (with 107 valid responses received). The result showed a staggeringly low number that did not even reach an average of 1 person, for the home-care elderlies who priory expressed their will in writing for their treatment policy, deathbed, description of medical treatment and authorized decision-maker on their behalf. The elderlies who verbally expressed such will also showed a low number of not even reaching an average of 4 persons. Out of survey subjects, 103 persons (96.2%) responded “necessary” when asked about the necessity of elderlies expressing one's will in advance. Furthermore, regarding the reason behind the answer to the questions “why is it difficult to assess the will of elderlies for their end-of -life care?” and “who should be the first person to be notified on the name/state of the illness?”, the subject visiting nurses stated “decline of elderly's decision-making capability” as such reason.Result: The result showed that although very few elderlies priory expressed their will toward their end-of -life care at present state, our speculation is that there is a high need for elderlies to express such will. For the future challenge, we need to figure out an arrangement so that elderlies will have a chance to priory express one's will for their end-of -life care in line with their view of life and death.

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