Objective: Elderly preferences for end-of-life care have much attention. Nevertheless home care is important, differences of preferences due to place of care have not known. This study compared end-of-life preferences between inpatient and community adults among the elderly in Japan. Design: A cross-sectional study was conducted using a structured questionnaire. Sample: 313 community dwelling adults belonging to Senior Citizens’ Club and 52 inpatients in a university hospital, 65 years and over. Method: The survey items were demographic, health and medical status, end-of-life preferences such as place of terminal care, life-sustaining treatments, and advance directives. Results: Regarding place of terminal care, community dwelling adults preferred home (44.6%) to hospital (35.2%), whereas inpatients more likely chose hospital (52.1%). However, both were not many subjects to choose palliative care setting (20.2%, 14.6%).Life-sustaining treatments were significantly different attitudes, cardiopulmonary resuscitation (p=0.052), artificial ventilation (p=0.016), and artificial nutrition (p=0.003). Community dwelling adults tented to ask their physician, on the other hand, inpatients indicated refusal of these treatments. However, perspective on advance directives, more positive approval were shown community dwelling adults (72.8%) than inpatients (55.8%) (p=0.005). Conclusion: End-of-life preferences between inpatient and community dwelling adults were significantly deferent. Inpatients indicated refusal of life-sustaining treatments and less positive approval to advance directives. Implementation: Place of care shows the differences of end-of-life preferences. In hospital, elderly realized their own situation and preferred to make a decision by themselves, however, only half the inpatients approved advance directives. Therefore before admitted to hospital, it had better to discuss their preferences and execute advance directives. 

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