[Age differences in decision-making factors on end-of-life care location for Musashino-city residents].

OBJECTIVES

Japan is predicted to continue its fast-aging trend, especially in urban areas. Therefore, promoting end-of-life services in urban areas is an urgent policy issue. In addition, the recognition of end-of-life care greatly varies by age. The aim of this study was thus to clarify the association by age between preferences regarding care location among people in urban communities and their experiences, knowledge, and perceptions related to end-of-life care.

METHODS

A total of 1,500 people aged 40 and older in Musashino-city participated in a cross-sectional nationwide survey. We asked about preferences regarding care location, demographic data, experiences, knowledge, and perceptions related to end-of-life care. We used logistic regression analyses.

RESULTS

A total of 769 (51.6%) responded. Of those over 65, 40.9% preferred homes and 59.1% preferred places other than homes as end-of-life care locations. For those aged 40-64, 54.1% preferred homes and 45.9% preferred places other than homes (P<0.001). Logistic regression analyses revealed that the following factors affect people's preferences regarding location of care for those over 65: not recognizing that medication use can lead to addiction (odds ratio: 1.90; 95% confidence interval: 1.17-3.08); taking precautions before taking medicine (1.97; 1.21-3.22); volunteering (2.38; 1.34-4.21) ; recognizing that home cost is cheaper than hospital cost (1.82; 1.10-3.03); recognizing that they have health care workers to consult (1.90; 1.06-3.41); and recognizing that end-of-life care at home provides enough treatment (2.30; 1.37-3.87). Factors for the 40-64 year old group were as follows: not wanting informal caregivers to care (2.80; 1.62-4.83); recognizing that they can respond to sudden changes at home (2.97; 1.15-7.66); and want to be free at the end of the life (4.57; 2.43-8.59).

CONCLUSION

These results suggest that changing people's thinking about the socialization of care is required to increase preferences of people over 65 for home death. For the 40-64 year old group, developing an awareness of death is required. For all generations, providing appropriate information and educating the people is required.