Medical decision making through end of life discussion

2014 Fiscal Year Final Research Report

• Project/Area Number: 24390135
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Partial Multi-year Fund
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
• Principal Investigator: TAKAHASHI Ryutaro 地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 副所長 (20150881)
• Co-Investigator(Kenkyū-buntansha): AITA Kaoruko 東京大学, 人文社会系研究科, 准教授 (40507810) ; TSURUWAKA Mari 聖路加国際大学, 看護学部, 准教授 (90386665)
• Co-Investigator(Renkei-kenkyūsha): SHIMADA Chiho 地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究員 (30383110) ; ISHIZAKI Tatsuro 地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究部長 (30246045) ; SHIMIZU Tetsuro 東京大学, 人文社会系研究科, 教授 (70117711)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Keywords: アドバンスケアプラニング / 終末期医療 / 患者主体

Outline of Final Research Achievements

Much attention is given to approaches to place proper regard on the wishes of the elderly care recipients. Of the patients enrolled in this research, 44% discussed their end-of-life care with families and friends, 12% articulated their wishes in writing, while 48% did neither. We conducted a practical intervention research by utilizing a tool named “Life Design Notebook”, which encourages the patients to envisage the end of their lives and also to communicate their advance medical directives. 114 local clinic patients were given this notebook, but only half documented their wishes with regard to the end-of-life care. We later interviewed the patients to investigate the psychosocial aspect to this outcome, and observed that they had the tendency to prioritize the circumstances of their families. They were reluctant to specify their living wills out of modesty, and the willingness to write them down in the Notebook reflected the relationship that they maintained with the families.

Free Research Field

老年医学