title: End-of-life care at group homes for patients with dementia in Japan. Findings from an analysis of policy-related differences.
abstract: In Japan, the number of group homes for patients with dementia (GHs) has been increasing in recent years. A growing number of elderly people now prefer to spend their final years in group homes or other long-term care facilities, a choice that their families support. The aim of this nationwide study is to clarify the current end-of-life care policies and practices of GHs. The subjects were 3701 managing directors of GHs. Data were collected through mailed, anonymous, self-reported questionnaires in 2003. The content of the questionnaires included: (1) general characteristics of the GH, (2) end-of-life care policies and experiences, (3) available end-of-life care services at the GH, (4) staff education concerning end-of-life care, and (5) types of information provided to users and families. The response rate was 45.6%. Many GHs had implemented progressive policies for end-of-life care. GHs with progressive policies for end-of-life care were found to have different backgrounds than those with regressive policies. Only a few GHs provided end-of-life care education for their staff. GHs with progressive policies for end-of-life care tended to have the following characteristics: availability of medical intervention within and outside of the GH, self-contained physical plant and staff education about end-of-life care. Further research is needed to determine the most effective end-of-life care systems for GHs.
authors.affiliation: Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. y.hirakawa@k8.dion.ne.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Masuda
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Uemura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
authors.forename: Takaya
authors.initials: T
authors.lastname: Kimata
authors.forename: Akihisa
authors.initials: A
authors.lastname: Iguchi
mesh_terms: D000368:Aged; D003704:Dementia / Q000628:therapy*; D005260:Female; D016352:Group Homes / Q000458:organization & administration* / Q000592:standards*; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D007564:Japan; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes / Q000592:standards*; D016134:Organizational Policy; D013727:Terminal Care / Q000458:organization & administration* / Q000592:standards*