Perspectives of elderly people on advance directives in Japan.
OBJECTIVE
To examine perspectives of Japanese elderly people on advance directives (ADs) and factors related to positive attitudes toward ADs.


METHODS
The data were collected by a structured questionnaire from 313 of 565 older adult members of senior citizens' centers in two cities in Japan. Survey items pertained to demographic characteristics, terminal care preferences, and personal values, including autonomy, family function, and religious piety.


RESULTS
Of the 313 elderly people who completed questionnaires, 72.9% had positive preferences for executing living wills. With regard to durable power of attorney for health care, 62.2% approved of it. The supporters of ADs were more likely to have had discussions about terminal care with family members or physicians, experience of a family member hospitalized for terminal illness or injury, preferences for life-sustaining treatments that were self-determined, and personal values such as religious piety. The relationship between positive preferences toward durable power of attorney for health care and sex, marital status, and living arrangements were significant.


CONCLUSIONS
Most Japanese older adults in this study approved of ADs, and family structure was important to the acceptance of designating a proxy. Discussion about end-of-life care and respect for life-sustaining treatment preferences are important decisions, about the end of life.
Matsui
Miho
M
Department of Gerontological Nursing, Nagasaki University Graduate School of Biomedical Sciences, Japan. mihomatsui1002@yahoo.co.jp
D016223:Advance Directives / Q000208:ethnology* / Q000331:legislation & jurisprudence; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D001293:Attitude to Death / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D001364:Awareness; D002755:Choice Behavior; D004522:Educational Status; D005190:Family / Q000208:ethnology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008020:Life Support Care; D008297:Male; D017533:Marital Status / Q000208:ethnology; D016743:Mental Competency; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D026684:Personal Autonomy; D012069:Religion and Psychology; D012111:Residence Characteristics; D012737:Sex Factors; D011795:Surveys and Questionnaires