Death education in home hospice care in Japan Hiromi Kawagoe Journal of Palliative Care: Autumn 2000; 16, 3: ProQuest Health and Medical Complete Death Education in Home Hospice Care in Ja apan MI KAWAGOE, Community Nursing, St. Luke's Nursing College, and KOH KAWAGOE, Home Care Clinic goe, Tokyo, Japan Abstract /In the practice of home hospice care, or one third of all deaths were due to cancer. In death education for both patient and family is ex- 1999, 92% of deaths from cancer occurred in the iremely important, although little information on its general hospital, 2% in an institutional hospice usefulness is available. In this study, the effects of or palliative care unit, and 6% at home. This death education under home hospice care were trend to having death take place in institutions analyzed for 16 patients who died at home. Death has meant that the general public has becom at least once in each phase of care, and at least four isolated from dying and ignorant of methods for times in total. The acceptance of death by the patients dealing with imminent death was judged according to the way they spent their Death education in home hospice care was es- emaining time, to their attitudes, and to their hope for tablished as a realistic and practical method for a life after death. Fourteen of 15 patients appeared to a patient and her /his family to live out their accept their own death. An autopsy was performed in remaining days in ways acceptable to 16 cases. In one case, the doctor recom- therefore involves not only medical care,but mended an autopsy to the family, in the other cases, also education. Using death expected in the it was performed in accordance with the patients or family's wish As the goal of death education in home short term as educational material results in hospice care is the acceptance of death by both pa- death education itself. However, the content tient and family, our methods of death education ap- must be practical and individualized, and the coals are different from those of death educatior n general. Although important, death educatio Resume Lorsqu'on dispense des soins palliatifs a in home hospice care has not been widely stud- domicile, il est extremement important que le patient et sa famille soient renseignes sur la mort et sur tous ied in Japan( 1 ). This is mainly due to doctors' peu de litterature sur I'utilite de le faire. Dans cette few home hospice care services, and the diffi etude nous analysons les resultats de cette formation culty of evaluating its effects objectively sur la mort aupres de 16 patients qui sont decides a In the present study, we examine 16 terminally la maison. Nous avons eu au moins quatre fois des ill cancer patients who received home hospice conversations sur la mort avec chaque patient durant care, and discuss the theory of death education les diverses phases de la maladie. C'est a partir de la While such studies tend to be subjective and liter- facon dont ils ont vecu leurs derniers jours, de leurs attitudes face a la mort, de leur espoir d'une autre vie ary, we have attempted an objective analysis avons juge s'ils acceptaient la mort. Des 15 based on accurate data. Conversations with the patients, 14 semblaient accepter leur tient or the family were recorded and evalu autopsies a ete pratique dans 5 des 216 cas Dans un ated In 10 out of 16 cases, death conferences with cas c'est le medecin qui l'avait recommandee a la the bereaved families were held to confirm famille, dans les 4 autres cas c'est a la demande de whether or not our assessments were correct Us la famille et selon les volontes exprimees par les g this information, the goals of death education patients qu'elles ont ete pratiquees. Dans le cadre in home hospice care in Japan are evaluated des soins a domicile, le but de notre formation sur la ort etait que le patient et sa famille puissant ac CASES AND METHODS cepter la mort; il semblerait donc que notre methode de preparer les patients et les familles a la mort soit Cases The subjects were 16 incurable cancer patients INTRODUCTION selected from registered home hospice care. The criterion of selection was that the death educa In Japan, cancer has been the leading cause of tion be delivered in certain ways, as will be de death since 1983. In 1999, about 270,000 people scribed. All the patients died at home Reproduced with permission of the copyright owner. Further reproduction prohibited without permissionReproduced with permission of the copyright owner. Further reproduction prohibited without permission. Death education in home hospice care in Japan Hiromi Kawagoe Journal of Palliative Care; Autumn 2000; 16, 3; ProQuest Health and Medical Complete pg. 37