Content of advance care planning among Japanese elderly people living at home: A qualitative study.
OBJECTIVE
Elderly peoples' values and preferences for end-of-life care have not yet known in details. The aim of the present study was to investigate the end-of-life wishes and decision making among Japanese elderly people who required home care services. The study was designed to qualitative research strategies, using face to face interview data recorded in nursing care records, with a focus on advance care planning.


METHODS
A total of 102 elderly people (47 males, 55 females) of 6 home care support offices in Hyogo prefecture participated.


CONCLUSIONS
We finally extracted the following 5 themes: anxiety about the future, abandonment of control, clinging to current daily life, precarious mutual support, delegating decision-making. While elderly people living at home generally feel anxious and fearful about the future, they seemed to try to avoid thinking too seriously about possible complications in their life. They also tend to leave end-of-life decision to someone else, and their decisions tend to change as they advance in age and as their condition deteriorates. Our findings suggest that medical professionals and care managers always support their patients' decisions, allowing for the views of the informal caregivers on whom elderly people rely for decision-making.
Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan. Electronic address: y.hirakawa@med.nagoya-u.ac.jp.
Yoshihisa
Y
Hirakawa
Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan.
Chifa
C
Chiang
Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan.
Esayas Haregot
EH
Hilawe
Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Japan.
Atsuko
A
Aoyama
D000203:Activities of Daily Living; D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D003657:Decision Making; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D019727:Proxy; D012944:Social Support
Decision making; End-of-life care; Living will; Proxy; Qualitative study