End-of-Life Care Patchy for Nation’s Elderly

The Yomiuri Shimbun

Japan

October 28, 2007

About 30 percent of the nation's 9,777 home care providers for the elderly were not present for the death of a single patient in the year to July, indicating that they may be failing to deliver on their mission to provide care for old people until the time of their death, according to a Yomiuri Shimbun survey. 

Home care clinics for the elderly handled the deaths of about 27,000 old people over a yearlong period beginning July last year, according to the survey--the first to tally the number of deaths handled by such care providers. 
It also discovered that there were regional differences in the number of deaths that the providers handled. 

Clinics specialized in home care services were introduced last April. They are expected to play a central role in upgrading care for the elderly, including end-of-life care. 

The clinics provide residential care facilities, and also 24-hour on-call medical services for patients living in their own homes. They get additional fees for services provided to patients in their homes. 

The care providers are required to report the number of deaths that their staff were present for to the regional social insurance bureaus. 

The Yomiuri Shimbun obtained the data reported over a yearlong period from July 2006 by the 9,777 home-care providers through requests to the regional social insurance bureaus across the nation. 

According to the data, 27,072 people were being attended by home-care providers at the time of their death. While 5,348 people died in various types of nursing care facilities, 21,724 died at home. 

Of the 27,072, 4,514 deaths occurred in Tokyo. Outside the capital, the largest number of deaths occurred in major urban regions, such as Osaka Prefecture with 2,345 people and Kanagawa Prefecture with 1,844. 

Home care providers in prefectures like Kochi and Toyama rarely were present when a patient died. 

In Tokyo, 787 deaths per 10,000 deaths of those aged 75 or older were attended by clinic staff. 

Tokyo was followed by Osaka Prefecture with 587 and Nara Prefecture with 559. 

The numbers were generally higher in urban areas such as the Kanto and Kinki regions. 

Concerning the number of deaths each home care provider was present for, 3,168, or 32 percent, reported that they had not been present for the death of a patient during the period. 

Experts say this indicates that some home care providers are failing in their mission to take care of elderly people until their death. 

Shinichi Oshima, president of the National Center for Geriatrics and Gerontology, said: "The number [of elderly people's deaths attended by home care providers] was much smaller than expected. These findings prove that many medical institutions that volunteered to register as a home care provider haven't adequately performed their function." 

Copyright © Global Action on Aging
Terms of Use  |  Privacy Policy  |  Contact Us