Aging in Place of Older People with Dementia：Realizing End-of-life Care through Community-based Services

Abstract

The places of death for older people are homes, social welfare facilities and medical institutions, with the latter accounting for almost 80% of deaths. Community-based-service（CBS）facilities are catering for rapidly increasing numbers of older people with dementia and there is a requirement for them to allow users to die a peaceful death without having the disruption of moving. However, there are a number of complexities in the provision of end-of-life care in CBS facilities outside medical institutions. This study presents an overview of the current status of end-of-life care in CBS, and explores the effectiveness of education programs for staff members, users’families, and community residents.

End-of-life care was not provided in the majority of CBS facilities in a city in western Japan mainly because of a lack of 24-hour medical cover and inadequate professional development for staff. We focused on upskilling staff and held two training sessions on end-of-life care；one for the city’s CBS staff and the other for all staff, families, and community residents.

Evaluation of the interventions suggests that obtaining knowledge on end-of-life care and sharing information with each other allays staff workers’anxieties and fear about end-of-life care and enable them to provide care of the dying in situ. The study indicates that educational programs could be a useful way to promote quality end-of-life care in CBS.