Guidelines from the Japan Geriatrics Society for the decision‐making processes in medical and long‐term care for the elderly: Focusing on the use of artificial hydration and nutrition

Abstract

Geriatr Gerontol Int 2018; 18: 823–827.

Factors associated with positive attitudes toward care of dying persons among staff of geriatric care facilities in Japan

“…In 2012, the Japan Geriatrics Society released guidelines for the decision‐making processes in medical and long‐term care for elderly people . This guideline encouraged workers involved in medical and long‐term care to enrich the narrated lives of persons in care, especially in the context of introduction, reduction or withdrawal of artificial hydration and nutrition.…”

“…In addition, one of the 12 authors of the Japan Geriatrics Society guidelines is a former chair of the Japanese Association for Religious Studies. The Japanese Geriatrics Society states that clinical decision‐making is influenced by the patient’s and their family’s view of death and life . More collaboration is required between mainstream medicine and mainstream religion to improve the lives of older persons in Japan’s super‐aged society.…”

Guidelines from the Japan Geriatrics Society for the decision‐making processes in medical and long‐term care for the elderly: Focusing on the use of artificial hydration and nutrition

“…(B) In cases where the introduction of a certain type of AHN is expected to prolong life, but it is doubtful whether the accompanying quality of life would be improved or maintained so as to enrich the cared-for person's own life (i.e. whether point JGS guidelines for the decision-making © 2018 Japan Geriatrics Society | 825 [1] mentioned above could be achieved), judge what is best for the cared-for person's own life. In other words, determine the goal and select the option based on the current thoughts of the caredfor person and their family about how the cared-for person should spend the remaining days of their life.…”

“…(C) In cases where the AHN would have little or no medical effect in prolonging life or the effect is doubtful, and where it slightly prolongs life and certainly cannot enrich the cared-for person's own life (i.e. point [1] stated above cannot be achieved), it would be appropriate to aim at making the cared-for person as comfortable as possible (i.e. point [2] stated above).…”

Percutaneous Endoscopic Gastrostomy Tube Removal for Patients With Advanced Dementia: Case Series Study

“…The Japanese Ministry of Health, Labour and Welfare assigned additional fee points for evaluation of swallowing function in 2014 and the Japan Geriatrics Society suggested thorough evaluation before insertion of PEG tubes in 2012. 8) However, the continued use of PEG tubes in dementia patients persists in Japan. The rate of PEG tube feeding is 8.3% among nursing homes, 6.0% among geriatric intermediate care facilities, and 26.2% among medical facilities.…”