特別養護老人ホームの看取り介護についての入居時の意向確認に関する研究  [in Japanese] Study on confirmation of intention concerning end-of-life care upon moving into welfare facilities for elderly requiring care  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

本論文は、高齢者を主体とした看取り介護を行う為には、本人の意向を初期段階から確認したケアの展開が重要であるとの視点にたち、看取り介護を実施している特別養護老人ホームでの、入居時の看取り介護に関する意向確認の実施状況を把握し、意向確認のあり方について検討することを目的とした。特養1000施設(看取り介護実施施設)を無作為抽出し、2008年8月に郵送調査を実施し有効回答の336票を得た。入居時の意向確認は76.2%実施されていたが、意向確認の難しい理由として、判断能力がない、死について語ることのタブー、精神的ショックを与える、高齢者と家族の実感のなさ等が挙げられた。高齢者に判断能力があっても、28.6%は家族のみにしか意向確認を行わず、入居時の意向確認後は、終末期と判断された時がほとんどであった。入居から最期の看取りまでのプロセスを重視した意向確認方法の構築、看取り介護の説明者や窓口の明確化、説明内容の統一化等が求められると示唆された。

From the viewpoint that it is significant to confirm the intention of the elderly concerning end-of-life care at an early stage in order to properly provide elderly-centered end-of-life care, this paper aims to ascertain how elderly people's intention is confirmed when they move into such facilities providing end-of-life care and to review ideal ways for confirming their intention. We randomly selected 1000 welfare facilities for elderly requiring care (those providing end-of-life care) to conduct a mail survey in August 2008, and we obtained 336 valid responses. Out of them, 76.2% confirm elderly people's intention upon their entry, but the following were pointed out as reasons that make it difficult to confirm their intention: (i) some elderly people lack the ability to make decisions; (ii) it is considered taboo to talk about death; (iii) such talk may shock the elderly; and (iv) neither the users nor their family feel the need for such confirmation. Even in cases where the elderly have the ability to make decisions, 28.6% of those facilities only confirmed the intention of their family, and in most cases the intention was confirmed again only after the elderly were judged to be in their terminal phase. The survey suggested that further efforts should be necessary to establish proper procedures to confirm the intention of the elderly, focusing on the process from entry to a facility to the end of life, to clarify from whom or where the explanations on end-of-life care are available, and to standardize the contents of such explanations.

Journal

  • Bioethics

    Bioethics 20(1), 158-164, 2010

    Japan Association for Bioethics

References:  12

Codes

  • NII Article ID (NAID)
    110008762349
  • NII NACSIS-CAT ID (NCID)
    AN10355291
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    1343-4063
  • Data Source
    CJP  NII-ELS  J-STAGE 
Page Top