2009 Volume 31 Issue 3 Pages 331-341
The purpose of this study was to examine the effects of objective and subjective indicators in the implementation of end-of-life care in welfare facilities for the elderly requiring care (WFERC) for frail elderly. The study sampled directors of WFERC throughout Japan (N ＝ 4,678) with a total of 1,637 answering the questionnaire (35% response rate). They were requested to complete a questionnaire administered though a postal survey in August 2007. Logistic regression analysis was used to estimate the factors for implementation of end-of-life care for frail elderly in WFERC. 1) The study found that objective indicators revealed that: being in facilities with more than 15 private rooms had a significant negative effect on implementation of end-of-life care in WFERC. On average, those certified as on the care level of between 3.61-3.80 in facilities experienced a significant negative effect on implementation of end-of-life care in the WFERC. The being within facilities with a 7-14 inhabitants per year average mortality rate in the WFERC had a significant negative effect on implementation of end-of-life care. 2) As for medical care: offering death certificate by doctors and providing 24 hours nursing care had a significant negative association with implementation of end-of-life care in the WFERC. 3) Subjective indicators showed: recognition of maintaining the high standards and ongoing training among careworkers, and recognition that end-of-life care should be done by family and hospitals was significant positive association with implementation of end-of-life care in the WFERC.
