Relationship between care managers’ discussion toward and involvement in end-of-life care

Abstract

  Advance care planning (ACP) plays an important role in supporting the end of life. A multidisciplinary care team understands clients’ values through ACP, which involves discussion with them and their families. This study aimed to ascertain the extent to which care managers are involved in end-of-life discussion with clients, and to clarify their involvement in end-of-life care. Survey participants were randomly selected from 3,000 care manager offices in Japan, and questionnaires were mailed to offices; they were handed to the care manager with the largest number of clients in their charge, and collected directly. The extent of end-of-life discussion in advance was ascertained from the percentage of respondents who had discussed with the clients where and how the latter would like to spend their final days in the future. Involvement in end-of-life care management was measured by whether or not they were in charge of end-of-life care cases. We confirmed that care managers who practice end-of-life discussion with many clients themselves are more likely to be in charge of end-of-life care cases, and that fewer cases are terminated by hospitalization or admission. End of life needs should be supported by a multidisciplinary collaborative team, of which care management is the core. It is necessary to clarify the skills required for end-of-life care management.