2013 Volume 59 Issue 6 Pages 474-479
Aim: To develop a decision-making model for elderly end-of-life.
Methods: A semi-structured interview study was conducted with 12 physicians in Tokyo and other prefectures. The process of data collection and analysis followed the Modified Grounded Theory Approach and the Steps for Coding and Theorization. We set up the theme of data analysis as “diagnosis regarding the elderly end-of-life” and then drew practical instances from the data coded to establish categories.
Results: Fifteen categories emerged, of which five were main categories: Impossibility of end-of-life diagnosis, Decision-making at the end-of-life, Physician’s position in terminal care, Death with a feeling of achievement, and Culture of “Mitori” in the each community’s manner of staying together until death. Considering the connections between these categories, a practical model was developed.
Conclusions: The practical model is that diagnosis at the elderly end-of-life is not possible. However, decision-making is to be done as the starting point of asking how the patient wants to live at the end-of-life and thinking what doctors and care providers could do to support the patient and his/her family.
