title: Living will interest and preferred end-of-life care and death locations among Japanese adults 50 and over: a population-based survey.
abstract: The main purpose of this study was to determine the relationships between Japanese individuals' interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged >50 to measure these 2 factors. We examined the associations between the respondents' characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred place for end-of-life care (64%), and a palliative care unit (PCU) was the most commonly preferred place to die (51%). Living will interest was associated with a preference for care (odds ratio [OR] 4.74, 95% confidence interval [CI] 1.95-12.1) and death (OR 2.75, 95% CI 1.70-4.47) in a PCU rather than a hospital, but it was not associated with the choice between receiving care or dying at home instead of a hospital. We must consider why Japanese people think home death is impracticable. The Japanese palliative care system should be expanded to meet patients' end-of-life needs, and this includes not only facilitating home care but also increasing access to PCU care.
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama 700-8558, Japan.nishie-h@cc.okayama-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishie
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizobuchi
authors.forename: Etsuji
authors.initials: E
authors.lastname: Suzuki
authors.forename: Kenji
authors.initials: K
authors.lastname: Sato
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Toda
authors.forename: Junji
authors.initials: J
authors.lastname: Matsuoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D007564:Japan; D016224:Living Wills / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology; D057240:Patient Preference / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*