Abstract

Remarkable improvements in medical technology and system deployment have brought to Japan a level of life expectancy and a speed of aging unlike any mankind has experienced. As a result, the Japanese government has been seeking to realize a healthy society of longevity amidst its declining birthrate and super aging society. It has been developing strategies for achieving the target of extending a ‘healthy life expectancy’ and has been executing on those. The majority of patients in Japan are 65 or older. Supporting not only a complete cure but also maintaining their health are crucial to their daily Quality of Life. It will therefore be necessary to reduce their inconvenience and pain when unhealthy conditions exist and to offer concern. Working to achieve these goals is both the pleasure and responsibility of Gerontological Nursing. When focused on the last stage of life, we find that eighty per-cent of citizens die in medical institutes despite their wish to be at home. Consensus surveys report that people hope instead to spend their time at home. They do not wish to be forced to accept life-prolonging agents without justifiable cause, and the points used by the family to make the decisions regarding the prolonging of life seem to be different from those used by oneself. While around seventy percent of citizens support the idea of giving instructions for their terminal care, only three percent of them end up doing so. This indicates that the family’s opinion might not reflect that of the elderly. The major reason for why the hospital has become the place where most people die is the lack of infrastructure. Hereafter in Japan, it will be critical for Gerontological Nursing to not only develop a hard infrastructure but also to enhance the soft measures that reflect a person’s wish during the final days from the viewpoint of the Quality of Life.