Palliative care in Japanese long-term care facilities

摘要

Background: Internationally, the demand for the provision of high-quality palliative care is increasing exponentially. Japan is a rapidly ageing society and it is therefore important to understand the current context to develop practice and inform future resource allocation in long-term care facilities (LTCFs). Aim: To describe the broad context of palliative care services, practice, education and policies in LTCFs in Japan. Methods: A process of expert elicitation and documentary review undertaken. The WHO palliative care model for public health was used as an analytical framework. Findings: Several deficits were identified regarding palliative care in Japanese LTCFs: a lack of palliative care strategy and standardised training for staff, and limited information on the use of palliative care medicines, quality improvement tools and frameworks. Conclusion: Such deficits need to be addressed to inform current nursing practice, future training needs for staff, quality care initiatives and decision making for advance care planning and resource allocation to respond to the ever-increasing demand for palliative care in these settings.