Advance directives in Japanese nursing homes

Area of Science:

• Gerontology
• Healthcare Policy
• Bioethics

Background:

• Advance directives are underutilized in Japanese nursing homes.
• End-of-life care funding was introduced in Japan in April 2006.
• This funding was the first support for terminal care in Japanese nursing homes.

Purpose of the Study:

• To examine the adoption of advance directives in Japanese nursing homes.
• To assess the impact of new end-of-life care funding on directive use.
• To identify the types of advance directives utilized.

Main Methods:

• A national survey of 913 Japanese nursing homes was conducted.
• Data collected included advance directive prevalence and details.
• Demographic information of responders was also gathered.

Main Results:

• Advance directives are present in 58.4% of surveyed nursing homes.
• Funding for end-of-life care correlated with advance directive adoption.
• Instructional directives, focusing on explanation and informed consent, were most common.

Conclusions:

• Over half of Japanese nursing homes have implemented advance directives.
• Increased funding for end-of-life care is associated with higher adoption rates.
• Instructional directives are the preferred type, emphasizing informed consent for terminal care.