2019 Volume 84 Issue 766 Pages 2523-2533
Some nursing homes for the elderly provide a high level of nursing care for residents, and they are taking increased responsibilities as the places for end-of-life care. However, the actual state of facilities as the places for end-of-life care is not fully understood, and in particular, it has not been thoroughly discussed or analyzed from a spatial perspective. In this study, it is aimed to clarify the state of nursing homes for the elderly as ‘one’s final abode’ and problems in facility development plans. It is also aimed to further develop the concept of nursing homes for the elderly, which has presently changed from a simple ‘place of nursing care’ to a ‘place of living’ and to clarify the optimal state of nursing homes for the elderly when perceived as ‘one’s final abode’ from the viewpoint of architectural planning. The survey was performed by twice questionnaire survys at all nursing homes for the elderly in the Tohoku, Kanto, and Chugoku regions. Additionally, on-site interviews and supplementary questionnaires regarding facility room usage were conducted.
The main results are as follows:
(1) It is clarified the state of nursing homes for the elderly as the places for end-of-life care. Furthermore, we found differences in the approach to end-of-life care among the facilities and regional characteristics.
(2) It is found differences in responding to end-of-life care as well as room usage during the process between conventional-type nursing homes with two- or four-bed rooms and unit-type nursing homes with private rooms.
(3) Total average of the percentage of death in the facility was about 56%, an increase of about over 10% compared to 20 years ago own survey. The difference between the prefectures is also large, nearly 25%. In the conventional type and the unit type, the conventional type had about 57% death in the facility and the unit type about 52%. In other words, the percentage of died in facilities was high in conventional multi-bed type facilities.
(4) In addition to the fact that individual private rooms contribute to the protection of everyday privacy and improved lifestyle, they enable end-of-life care to take place as an extension of one’s life. In other words, there is no need to change rooms when end-of-life is approaching, and one can live in their own room until the end.
(5) The actual conditions of use of the rest room and the mortuary varied depending on the facilities. Also, it became clear that the residential private room also plays the role of a rest room and a morgue.
(6) It became clear that each facility is performing various devices and considerations on the environmental aspect in end-of-life care. There was a need to arrange space or room that could accommodate the family's attendants and staying.
(7) It became clear that active cooperation of a general medical doctor, awareness sharing of staff including nurses, and experience are very important in practice of end-of life care in a facility.
(8) It is clarified the optimal state of nursing homes for the elderly and the approach in preparing facility spaces based on their roles as the places for end-of-life care.
