2021 Volume 21 Issue 2 Pages 9-18
Objective：To clarify factors that enable end-of-life home care for older adults, and establish systems to provide such care with community residents participating or mutually supporting in heavy snowfall areas, we performed a narrative analysis of main caregivers with experience in providing end-of-life home care for their families.
Methods：We con-ducted semi-structured interviews with 13 family caregivers who pro-vided end-of-life home care for older adults using home-visit medical/nursing services of a prefectural hospital after consenting to its end-of-life home care policy, and qualitatively and inductively analyzed the obtained data to clarify factors that enabled such care.
Results：From the perspective of these families, the following factors enabled end-of-life home care: care-receiver-related: 1) the desire to die at home and 2) painless home care; and caregiver/family-related: 1) a firm intention to provide end-of-life care for the care-receiver, 2) readiness to be in charge of such care, and 3) lower subjective caregiving burden. Regarding formal support, 24-hour home-visit medical/nursing services with: 1) doctors/visiting nurses who provide support at all times and 2) mental preparedness for end-of-life care; and seamless formal support systems based on: 1) end-of-life home care support through multi-institutional collaboration were identified. As for informal support, 1) the presence of other community residents/blood relatives who provide support in an informal manner; and 2) the presence of other community residents/blood relatives who are empathetic to the care-receiver were identified.
Discussion：Factors that enable end-of-life home care may also promote the QOL of families by reducing their caregiving burden and increasing their satisfaction/sense of accomplishment after end-of-life care, in addition to promoting the QOL of care-receivers and peaceful deaths.
