In Japan, the number of the elderly who cannot be supported by family members in decision making is increasing. Difficulties in making medical decisions due to dementia or deteriorated physical condition are apparent. Considering the aging process, difficulties in maintaining the quality of daily living must exist beforehand and supports are required from earlier stages.We collected real cases from local government staff, care managers, social welfare personnel and private support companies, according to five scenes of supported decision making; (1) Difficulty in daily activities, (2) Receive serious medical treatment, (3) Discharge and rebuild life, (4) Rearrange care services and residence according to functional decline, (5) Deal with death.Of 134 collected cases, most were in the scene 3 (n=49), and involved men aged 75 to 84 years (n=45). The characteristics of five scenes were as follows;1) The person feels vaguely insecure about the future or has specific postmortem concerns. Arranging multiple solutions were necessary.2) Laboriousness in providing support differs depending on whether the person's will for medical treatment is clear.3) The burden of environmental coordination and procedures for returning home is too heavy for the person.4) The person cannot recognize the problem by him/herself, some serious problem was the first opportunity for outside intervention.s5) Necessity of support became apparent by knowing a limited life expectancy or by the person’s death.Measures for organizing information and establishing the support infrastructure before the deterioration, and a consistent channel for the person and the supporter are crucial.
Kanae Sawamura, The Japan Research Institute, Ltd., Japan
Makiko Okamoto, The Japan Research Institute, Ltd., Japan
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