Abstract
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.
