Supportive Care in Cancer

, Volume 17, Issue 10, pp 1247–1254 | Cite as

Administrators’ perspectives on end-of-life care for cancer patients in Japanese long-term care facilities

  • Hiroki Fukahori
  • Mitsunori Miyashita
  • Tatsuya Morita
  • Takayuki Ichikawa
  • Nobuya Akizuki
  • Miki Akiyama
  • Yutaka Shirahige
  • Kenji Eguchi
Supportive Care International

Abstract

Purpose

The purpose of this study was to clarify administrators’ perspectives on availability of recommended strategies for end-of-life (EOL) care for cancer patients at long-term care (LTC) facilities in Japan.

Methods

A cross-sectional survey was conducted with administrators at Japanese LTC facilities. Participants were surveyed about their facilities, reasons for hospitalization of cancer patients, and their perspectives on availability of and strategies for EOL care.

Results

The 97 responses were divided into medical facility (n = 24) and non-medical facility (n = 73) groups according to physician availability. The most frequent reasons for hospitalization were a sudden change in patient’s condition (49.4%), lack of around-the-clock care (43.0%), and inability to palliate symptoms (41.0%). About 50% of administrators believed their facilities could provide EOL care if supported by palliative care experts. There was no significant difference between facility types (P = 0.635). Most administrators (81.2%) regarded unstable cancer patients as difficult to care for. However, many (68.4%) regarded opioids given orally as easy to administer, but regarded continuous subcutaneous infusion/central venous nutrition as difficult. Almost all administrators believed the most useful strategy was transferring patients to hospitals at the request of patients or family members (96.9%), followed by consultation with palliative care experts (88.5%).

Conclusion

Although LTC facilities in Japan currently do not provide adequate EOL care for cancer patients, improvement might be possible with support by palliative care teams. Appropriate models are necessary for achieving a good death for cancer patients. Interventions based on these models are necessary for EOL care for cancer patients in LTC facilities.

Keywords

Palliative care Administrators Long-term care facilities Cancer care 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Hiroki Fukahori
    • 1
  • Mitsunori Miyashita
    • 2
  • Tatsuya Morita
    • 3
  • Takayuki Ichikawa
    • 2
  • Nobuya Akizuki
    • 4
  • Miki Akiyama
    • 5
  • Yutaka Shirahige
    • 6
  • Kenji Eguchi
    • 7
  1. 1.Department of System Management in Nursing, Graduate School of Health Care SciencesTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of MedicineThe University of TokyoTokyoJapan
  3. 3.Department of Palliative and Supportive Care, Palliative Care Team, and Seirei HospiceSeirei Mikatahara General HospitalHamamatsuJapan
  4. 4.Psycho-Oncology Division, Research Center for Innovative OncologyNational Cancer Center Hospital EastKashiwaJapan
  5. 5.Faculty of Policy ManagementKeio UniversityFujisawaJapan
  6. 6.Shirahige ClinicNagasakiJapan
  7. 7.Department of Internal Medicine and Medical OncologyTeikyo University School of MedicineTokyoJapan

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