Department of Nursing, School of Nursing and Nutrition, Tenshi College
Department of Nursing, School of Nursing and Nutrition, Tenshi College
Department of Nursing, School of Nursing and Nutrition, Tenshi College
Department of Nursing, School of Nursing and Nutrition, Tenshi College
With the proportion of the elderly rising, the number of cancer patients and deaths continues to increase in Japan. While more than 320,000 people die of cancer every year, there are only 3,399 beds (2007) in palliative care units across Japan, and about 85% of cancer patients have little choice but to die in general hospitals. It is not common practice to prepare their own living will or advance directive in Japan, and even in the event of limited prognosis, if the patient's family asks for aggressive medical treatment, such treatment is often continued. As a result, terminal medical treatment accounts for a large proportion of overall medical expenditures, though medical costs are not a big problem for individual Japanese, who are protected under the universal health insurance system. As the rate of aging continues to rise over the next 30 years, an increase in terminal medical expenses cannot be avoided. For this reason, the government wants to promote home hospice care. However, because local governments are not ready to collaborate and visiting nurse service is not fully developed, home hospice care training has not yet been widely promoted. People in general feel anxious about dying at home, being concerned that they may become a burden on their families and that they may have trouble coping with sudden changes in their condition. As the number of elderly households continues to rise in the future, such anxieties are likely to escalate. In order to respect the patient's natural dying process, it is imperative to develop a medical system in which patients will be able to maintain consistent quality of life over the course of their treatment from the diagnosis of cancer to their death. This must include measures to strengthen the training system and to raise awareness about terminal care among the general public.