Abstract
To sort out the present state of end-of life care at special nursing homes for the aged (special home, hereafter) and clarifying issues for putting high-quality hospice services in practice, studies related to these issues were reviewed. People who face the end-of-life at special homes are a minority (about 2 %) at present. However, as people wishing to face the end outside home and special homes willing to offer hospice services increase in number, the services are expected to become prevalent in the future through necessary preparations such as "policy clarification by institutions". On the other hand, it is difficult to state that conditions for high-quality end-of-life care are satisfied at present because of weak medical treatment systems. Considering the above, issues were sorted out at the following three levels : policy, institution, and practice. To advance hospice services at special homes, measures need to be taken to position special homes as a place for hospice services at the policy level ; studies need to be gathered including preparations for four establishing conditions, document introduction for advance directive, and development of quality evaluation indices at the institution level ; and systematization of management know-how is deemed necessary at the level of implementation.
