Nursing home directors' attitude toward medical decision-making and medical care for elderly people with dementia

Hiroaki Miyata, Hiromi Shiraishi, Ichiro Kai, Yoshito Igarashi, Masaaki Matsushita

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Medical decision-making involving elderly people with dementia often troubles care providers in Japan. Meanwhile, little attention has been paid to the routine medical care of nondementia illnesses in such patients. To understand the current situation surrounding the issue, we conducted a postal survey with nursing home directors across the nation. A self-administered questionnaire was sent to 1,117 randomly selected nursing homes, one third of all such facilities in Japan, and 502 (44.9%) responded. Of the respondents, 291 (58.0%) said more than a half of their residents have difficulties in daily life because of dementia. Less than 20% of the facilities said that they routinely confirm residents' preferences in writing when they are admitted concerning each of the following items; terminal care, medical information disclosure, leaving a will, funerals and application for the guardian system. 206 (41.0%) facilities have difficulties in finding a hospital for the elderly with dementia when necessary. The Mann-Whitney U test showed no significant relation between facilities' characteristics and their difficulties in finding a hospital that would admit demented patients. At present, a number of nursing homes confirm their residents' preferences only some time after they are admitted. However, the way of confirming seems inappropriate under the circumstances in which more than a majority of residents have difficulties in daily life due to dementia. Though more than a half of nursing homes have difficulties in finding a hospital that would admit dementia patients, no significant relation was found between the difficulties and the facility-hospital relation. The problem seems to lie in the acceptance mechanism of hospitals.

Original languageEnglish
Pages (from-to)528-533
Number of pages6
JournalNippon Ronen Igakkai zasshi. Japanese journal of geriatrics
Volume41
Issue number5
Publication statusPublished - 2004 Sep
Externally publishedYes

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Nursing Homes
Dementia
Japan
Terminal Care
Disclosure
Nonparametric Statistics
Clinical Decision-Making
Surveys and Questionnaires

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nursing home directors' attitude toward medical decision-making and medical care for elderly people with dementia. / Miyata, Hiroaki; Shiraishi, Hiromi; Kai, Ichiro; Igarashi, Yoshito; Matsushita, Masaaki.

In: Nippon Ronen Igakkai zasshi. Japanese journal of geriatrics, Vol. 41, No. 5, 09.2004, p. 528-533.

Research output: Contribution to journalArticle

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