End-of-Life Planning Why Is It Necessary and What Deters You from Engaging in It?

Chiho Shimada, Ph.D.    Theme Leader (Exploring End-of-life care for the Elderly)
Ryo Hirayama, Ph.D.    Researcher (Exploring End-of-life care for the Elderly)

 

Despite advances in health and medical sciences that are aimed at keeping individuals healthy well into late life, no one can stay immune from functional declines accompanying aging. Yet, few attempt to become prepared for their end of life, when they should be incapacitated with limited physical and cognitive functioning.
One of our projects is designed to clarify what makes older adults motivated or hesitant to ponder their end of life and to make necessary decisions ahead of time. Such pre-arrangement, namely, advance care planning (ACP), has received increasing attention in Japan as well as other countries because, through ACP, older adults can share with others how they want to be cared for in the end of life, which makes it likely for them to spend their final days as they wish.
Our research on older adults' attitudes toward ACP revealed their strong concerns about their family relationship; they are afraid that they can be a burden to their families, which discourages them from talking with family members about end-of-life issues.
At the same time, our findings indicate that older adults' wishes regarding their end of life are not shaped in a vacuum. Rather, they appear to craft what they wish for in interactions with those who can and do participate in their end-of-life care arrangements and provision. Given these findings, we seek to identify how to facilitate the co-constructing process by which older adults clarify their end-of-life wishes through dialogues with family members and care and medical practitioners.

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