JAPANESE

Next Generation Research Incubator

Center of Excellence for End of Life Care:Cooperation with the public and professionals in an aging society

A new research program recognizes that care for the dying is an important issue for both public and professionals alike in a rapidly aging society

Japan is teetering on the precipice of a demographic crisis. Already, people over the age of 65 make up more than one quarter of the country’s population. And the fraction of elderly people is only expected to rise in the years ahead — it is predicted that in 2060 two out of every five people in Japan will be senior citizens, putting huge logistical and financial strains on the country’s long-term care systems.

The Center of Excellence for End of Life Care is trying to ease the impact of this skewed demographic by fostering cooperation between the public and the professionals who assist the elderly. The goal, says Center Director Mariko Masujima, is to develop a coordinated research strategy that ensures all older Japanese people can live out their final years in a comfortable and dignified manner with their wishes and aims fulfilled.

“We have to encourage people in our society to talk more openly about their own end-of-life care,” she says. Only then will those facing imminent or distant death have the best quality of life in the time they have left — regardless of diagnosis, health condition or age.

The new center is housed within the Chiba Graduate School of Nursing, the oldest school of its kind in the country. It includes members from a wide range of interdisciplinary backgrounds, such as ethicists, engineers, health economists and doctors. These scientists are working together in four large research groups.

Preparing for later life

The first group is focusing on helping the elderly prepare for what lies ahead. In one project, they have developed a web-based education tool, which uses a range of animated scenarios to make users think about common end-of-life problems, such as a health emergency or the loss of cognitive functions. A prototype of the tool received favorable reviews in a small feasibility study and the team is now adding new features and functionality to make it more user-friendly.

A second group at the new Center of Excellence is developing a technological surveillance system that deploys remote sensors to detect physical activity among older residents in long-term care facilities.

“By tracking changes of vital signs and physical activity in the elderly, the sensors serve as a tool both for research and for end-of-life care,” explains Masujima. “They can help nurses and care workers pick up on discomfort that frail, older residents might not be able to express themselves.” The system will soon be deployed for pilot testing.

The third research group is focusing on global outreach and has already established links with researchers in Thailand, Taiwan, Korea, Northern Ireland and elsewhere in Japan, while the fourth group is developing educational materials — for both the public and for other health-care professionals.

“Students need a chance to think more about end-of-life issues,” Masujima says. “Unfortunately, our health-care education focuses almost entirely on treating the living, but we also need to care for the dying.” The new center hopes to make that a priority in the face of such a rapidly aging society.