Are you communicating how you want to spend the final moments of your life? February 21st 16:05

Have you ever talked about how you or your loved ones would like your end to end? Where, with whom, and how do you want to spend your time? What about life-sustaining treatment?

I took a closer look at a nursing bed in a certain hospital and thought about how to write the last page of life. (Good Morning Japan Director Shoko Oda)

“Mitori is also prepared for the hospital…”

In January 2024, when snow was falling, an 80-year-old man was admitted to a hospital in Fukui Prefecture. Dementia had progressed and he was unable to swallow food due to pneumonia.

It was becoming difficult to communicate with his wife, but the hospital was considering future treatment plans based on the wishes of the man and his family.

As a result, it was difficult to provide nursing care at home due to family circumstances, and it was decided that the patient would continue receiving medical care at the hospital. However, in keeping with the patient's wishes, we confirmed that a gastric fistula would not be performed.

Man's Wife

: ``When my husband was around 70 years old, he started exhibiting dementia-like behavior, so we thought that we couldn't do anything until the symptoms had progressed, so we talked about it. I told my children, ``I don't want gastric fistula because it's hard for me to sleep with only nutrition.'' I also tell my children, ``I don't want gastric fistula if that happens to me, too.'' I have diabetes, and I'm prepared for complications to develop over time, so I don't think anything can be helped."

“Supporting life, supporting life”

The man was admitted to a hospital specializing in ``recuperation beds,'' where people with chronic illnesses, mainly the elderly, receive long-term treatment.

Medical care is provided from when the symptoms of the disease are stable to the end of life, and approximately 240,000 people are hospitalized in convalescent beds nationwide.

As the aging of the population is expected to reach its peak in 2040, the government is promoting the creation of a system that allows people to continue to live their own lives until the end of their lives, and the nature of nursing care beds is now being questioned once again.

At this hospital, the patients and their families' thoughts about how they want to spend their final moments of life are of the utmost importance when considering treatment strategies.

Director Ikebata

: ``The ultimate purpose is not only to support lives, but also to support livelihoods, and to support lives with dignity until the end.Recuperation beds are the ultimate goal of medical care that supports people in their final moments.'' In particular, I think we should continue to be reborn.”

One of the things that is required to fully respect the wishes of patients and their families is to make efforts to return patients to their preferred location, such as their home or facility, whenever possible.

Haruo Murakami (89), who was hospitalized in December last year, had a strong desire to return to his home, although his chronic heart disease had worsened and he had difficulty walking.

For this reason, Mr. Murakami worked on rehabilitation at home, such as incorporating movements necessary for daily life, such as ``walking while holding a bowl in one hand'' and ``climbing up steps.'' As a result of his efforts, Mr. Murakami was able to restore some of his body's functions and make his wishes come true.

Beyond the hospital

On the day of discharge, a ``pre-discharge conference'' was held to discuss Mr. Murakami's life after discharge. In addition to Mr. Murakami, his family, hospital staff, and other caregivers, they gathered to support Mr. Murakami in his life after being discharged from the hospital.

Since his son and his wife live far away, Murakami will be living alone after being discharged from the hospital. In light of these circumstances, we discussed how to support them in their future lives.

Participants exchanged opinions with nursing care helpers who provide daily support such as meals, pharmacists who deliver medicine, and shared important points to keep in mind in daily life.

My son and his wife also sought advice, and we talked until their concerns were resolved.

In this way, Murakami was able to return to his long-awaited home for the first time in two months. There were about three steps at the front door, but thanks to my rehabilitation, I was able to climb up on my own while holding on to his handrail.

Mr. Murakami

: ``I think my body is fine. (Now) I can finally start my normal daily life.It's not easy, though.''

He spoke with a relaxed attitude and a hearty laugh that belied his words.

To live a full life with dignity

Through my interviews at the hospital, I realized that it is important for the family and hospital to be as close as possible to the patient's wishes, in order for the patient to live a full and dignified life until the end.

A 95-year-old woman who was discharged from the hospital two years ago had a heart condition, but she was able to live at home by adjusting her diet to recover from her weakened nutritional status. She was looking forward to spending time doing puzzles, which has been her hobby for 20 years, and she said, ``I'm addicted to doing 1000-piece puzzles.''

In addition, a 72-year-old man with paralyzed legs due to respiratory disease and an incurable disease was discharged from the hospital two years ago and is now recuperating at home, receiving home visits and support from a care manager. Even as he continues to undergo treatment, his daily routine is to go outside in his electric wheelchair and look at the scenery of his hometown every day.

Of course, due to various circumstances, such wishes may not always come true. The director of the hospital we interviewed had the following to say:

Director Ikebata

: ``In order to create a situation that is as close to the patient's feelings as possible, we write a scenario and consult with everyone, including the family, the hospital, and the care manager, based on the scenario. I think the ideal would be for everyone to be able to rewrite it as their feelings change, produce it like a scenario, and have it end with applause and everyone come to pick them up.''

Strive to get as close to your ideal as possible. Such thoughts may make life more colorful.

A scenario for the last page of life. Why not talk about it with your loved ones?

(Broadcast on “Good Morning Japan” on February 14th)

Good Morning Japan Director

Shoko Oda Joined

in 2018

After working at the National Bureau, she currently belongs to the company