Care Managers' Attitudes Toward Death and Caring for Dying Community-Dwelling Adults

Thursday, July 14, 2011

Miho Matsui, RN, PhD1
Megumi Shimanuki, RN, BS2
Ayami Mori, RN, BS2
(1)Department of Gerontological Nursing, Nara Medical University, Kashihara, Japan
(2)School of Health Sciences, Nagasaki University, Nagasaki, Japan

Learning Objective 1: The leaner will be able to understand care managers’ attitude toward caring for cancer patients at terminal stage.

Learning Objective 2: The leaner will be able to provide better care management for dying community-dwelling adults.

Background: Public long-term care insurance covers not only geriatric diseases but also end-stage of cancer in Japan. Care managers are expected to coordinate care services for cancer patients, however, it is little known about their attitudes toward death and caring for dying community-dwelling adults. Objective: The purpose of this study was to examine care managers’ attitudes toward death and caring for dying community-dwelling adults. Method: A self-administered questionnaire that included demographics, experience with death or dying patients, seminar attendance about end-of-life care, and attitudes toward caring for dying patients measured by Japanese version of Frommelt Attitude Toward Care of the Dying (FATCOD), was provided to care managers belonging to home care support office in Nagasaki, Japan. The questionnaire was distributed to 218 adults. Of these, 140 returned (64.2%), and 136 (62.4%) fully completed the questionnaire. Results: The mean age was 43.0, and 102 (75.0%) were female. Of the 136 care managers, 69.4% experienced terminal care in their care management process, average number of  carding for dying adults were 2.9 (SD=5.3), and 95.4% felt difficulty in that care management. Nearly 60% attended seminar about end-of-life care. The average score of FATCOD was 111.9 (SD=10.3, range=90-140), positive attitude toward caring for the dying patient 58.9 (SD=6.8), and perception pf patient- and family-centered care 49.0 (SD=5.1), which means a slight higher score compared to previous survey in institutional setting. Conclusions: Most care manager in this study felt difficulty in their management of dying patients. Although 60% attended seminar regarding end-of-life care, education is needed for providing better management for dying community-dwelling adults.Conclusions: Most care manager in this study felt difficulty in their management of dying patients. Although 60% attended seminar regarding end-of-life care, education is needed for providing better management for dying community-dwelling adults.