Abstract
Purpose
We investigated the activities of a facility (hereinafter referred to as Facility B) on Island A that provides support covered by long-term care insurance in order to elucidate the cultural traditions that underlie long-term care that respects traditional end-of-life care culture, thereby exploring the possibility of incorporating death as an aspect of everyday life and promoting community-based end-of-life care.
Method
Long-term care workers at Facility B who shared the prevailing view of life and death on the island participated in focus group interviews about the home-based end-of-life care activities they had provided and the reasons underlying those activities. In the analysis of end-of-life care activities, key sentences reflecting the cultural traditions of the care workers were prepared and their characteristics were identified. All participants provided consent after receiving an explanation about the voluntary nature of participation and the protection of personal information.
Results
Five long-term care activities that incorporate aspects of traditional end-of-life care culture were identified. These activities and their related cultural traditions (in quotation marks in parenthesis) are as follows: (1) maintaining oral feeding as long as possible (“respect for the longevity of the patient” and “hope at the end of life”); (2) connecting the patient with those they wished to see before dying (“fulfilling their wishes before their final departure” and “connecting lives”); (3) care that facilitates dying at peace with one’s memories (“confirming their connections” and “a pleasant transition from life to death”); (4) care not to neglect the deceased (“responsibility based on the island’s view of life and death” and “customs and sacrifice”); (5) care at the funeral (“death as an aspect of life”).
Discussion
Elderly islanders wished to receive end-of-life care that respects the island’s cultural traditions and view of death. Long-term care workers on the island fulfilled the elderly’s end-of-life wishes by playing the roles of both professional and islander in order to maintain their traditional society, thereby facilitating community-based end-of-life care.
