Factors Related to End-of-Life Care Discussions Among Community-Dwelling People in Japan

Context. End-of-life discussions regarding healthcare preferences are important to ensure a dignified end of life. Objectives. This study clarifies the factors associated with such discussions among community-dwelling people in Japan. Methods. We conducted a cross-sectional survey of 2400 randomly selected community-dwelling adults over the age of 40 in one urban and rural area each, in Japan. The survey investigated whether the respondents had engaged in discussions about their end-of-life care preferences. Logistic regression analyses were conducted to examine the physical, psychological, social, and demographic factors influencing end-of-life care discussions. Results. Of the final sample comprising 1172 respondents, 41.0% had engaged in end-of-life discussions. Of these, 95.2% had engaged in these discussions with family members, 11.0% with friends and acquaintances, and 4.4% with medical or long-term care personnel. Factors associated with end-of-life discussion engagement included requiring outpatient visits, long-term care requirements, availability of emotional support services, experience of the death of a relative within the past five years, living with a spouse, and being unemployed. Conclusion. The results showed that roughly 41% of the surveyed community-dwelling respondents had engaged in end-oflife discussions. The findings suggest that providing emotional support to relieve anxiety regarding one's health and the awareness of death, and having the opportunity to interact with others to discuss end-of-life issues, promote the engagement in such discussions in Japan. This study suggests that it is necessary to create an environment that provides social support and engenders awareness of the importance of end-of-life discussions while the community-dwelling people are still healthy. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.