title: [Regional version of guidelines for the use of artificial hydration and nutrition with a decision-making support tool for older adults in Northern Iwate Prefecture, Japan].
abstract: The Japan Geriatrics Society (JGS) published the JGS Guidelines for Decision-making in the Care of the Elderly Focusing on Indications for Artificial Hydration and Nutrition (AHN) in June 2012. While these guidelines have been implemented in medical practice, they have not pervaded the awareness of the common public, especially in the countryside. Therefore, we developed a set of guidelines and a support tool for the use of AHN in older adults in our community, northern Iwate Prefecture, Japan in accordance with the original guidelines. Our guidelines consist of three sections: "The wishes of the patient and his/her family members,""Evaluation of the patient's general medical condition" and "The selection of a facility for medical treatment." People from various occupations took part in our conference, including patients and their family members, attending doctors and nurses, social workers, speech therapists, nursing home staff and so on. The first and foremost priority is to consider whether the decision to extend a patient's life corresponds with that patient's own narrative. It is burdensome for non-experts to participate in a conference attended by a variety of professionals. Therefore, we created a support tool for introducing AHN in order to alleviate psychological stress among the participants of this conference. The tool consists of 28 items in which the participant is asked to answer all questions, in the expectation that this activity will reduce their mental burden. It is important to conduct such activities, as well as improve the quality of the content of the guidelines and support tool.
authors.affiliation: Department of Gastroenterology, Iwate Prefectural Ninohe Hospital.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D005440:Fluid Therapy / Q000592:standards*; D006801:Humans; D007564:Japan; D010288:Parenteral Nutrition / Q000592:standards*; D017410:Practice Guidelines as Topic