Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study

Abstract

Aim Japan introduced dementia‐friendly initiatives into its national policies to help people with dementia remain involved in society for as long as possible. However, some people might choose to live in a nursing home to avoid care burden on family members. Understanding middle‐aged adults’ preferences for place of care and identifying factors that influence their preferences would help policy decision‐makers promote dementia‐friendly initiatives. The present study aimed to investigate the care preferences of middle‐aged adults if they acquired dementia in Japan and the USA. Methods We carried out a cross‐sectional observational study using an internet‐based questionnaire survey of Japanese residents with Japanese ethnicity, Japanese Americans, and non‐Asian Americans aged 40–70 years. A total of 301 participants, including 104 Japanese residents, 93 Japanese Americans and 104 non‐Asian Americans, completed the survey. Participants were asked to answer the items based on a hypothetical situation in which they had acquired dementia requiring regular care and supervision. Results Participants preferred nursing home care (29.9%), followed by professional home care (19.6%), family home care (17.6%) and hospital care (11.3%). Japanese residents had a significantly lower preference for professional home care than did Japanese or non‐Asian Americans (adjusted odds ratio 0.28, 95% confidence interval 0.10–0.75). Between‐ethnicity difference in care preferences was not observed. Conclusions A low preference for professional home care among the middle‐aged adults might be influenced by country‐specific long‐term and dementia care systems. Policy decision‐makers should develop professional home care services that are more available for families of people living with dementia. Geriatr Gerontol Int 2019; 19: 829–833.

The Revised Medical Care Act is associated with a decrease in hospital death for the total Japanese older adult population regardless of dementia status: An interrupted time series analysis

“…These results could be a consequence of Japanese persons regard home death as a burden to their families, and many family members prefer a transfer in the end of life to hospital as this is very common [ 35 ]. Moreover, evidence shows middle aged Japanese prefer hospital care over family and professional home care if acquired dementia later in life [ 36 ]. Yet, the main obstacle may be the lack of home services that support end-of-life care available to older adults and their family [ 11 , 37 ].…”

Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

“…The cross-sectional nature of our study is its major limitation. The large intra-patient variability of BPSD underscores the importance of longitudinal studies [24,25]. Previous studies suggested that the ABC-DS scale is useful for tracing chronological changes in dementia sever- ity.…”