CENTER OF EXCELLENCE FOR END OF LIFE CARE
PUTTING THE CARE BACK INTO END-OF-LIFE CARE
――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 like Japan.
Research Keywords: Clinical Nursing Science, End of life care, Super-aged Death-ridden Era
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.
Members
Principal Investigator
| Name | Title, Affiliation | Research Themes |
|---|---|---|
| MASUJIMA Mariko | Associate Professor, Graduate School of Nursing | Oncology Nursing |
Co-Investigatior
| Name | Title, Affiliation | Research Themes |
|---|---|---|
| SAKAI Ikuko | Professor, Graduate School of Nursing | Long-Term Care Facilities, Nursing System Management |
| ISHIBASHI Miyuki | Associate Professor, Graduate School of Nursing | Gerontological Nursing |
| IKEZAKI Sumie | Associate Professor, Graduate School of Nursing | Health Administration in Nursing |
| ISHIMARU Mina | Associate Professor, Graduate School of Nursing | Community Health Nursing, Public Health Nursing |
| SATO Naho | Associate Professor, Graduate School of Nursing | Child Health Nursing |
| TSUJIMURA Mayuko | Associate Professor, Graduate School of Nursing | Visiting Nursing, Gerontological Nursing |
| WATANABE Miwa | Assistant Professor, Graduate School of Nursing | Oncology Nursing, Adult Nursing |
| TAKAHASHI Zaiya | Specially Appointed Associate Professor, Graduate School of Nursing | Education Philosophy |
| IDE Narumi | Specially Appointed Associate Professor, Graduate School of Nursing | Community Health Nursing |
| ISHIKAWA Takahiro | Specially Appointed Assistant Professor, Chiba University Hospital | Geriatrics Diabetes, Metabolism and Endocrinology |
| KOBAYASHI Mia | Specially Appointed Associate Professor, Chiba University Hospital | Health Economics, Policy Science, Nursing Management |
| KUROIWA Shingo | Professor, Graduate School of Engineering | Well-being Information Technology, Speech Information Processing |
| UMEZAWA Takeshi | Assistant Professor, Graduate School of Engineering | Intelligent Information Processing, Human Interface |
| AKITA Noriko | Associate Professor, Graduate School of Horticulture | Landscape Planning and Management, Landscape Use Management |
| SEKIYA Noboru | Professor, Graduate School of Humanities and Studies on Public Affairs | Politics |
| KAWASE Takayuki | Associate Professor, Graduate School of Humanities and Studies on Public Affairs | Philosophy of Law Bioethics |
| ISONO Shiro | Professor, Graduate School of Medicine | Anesthesiology Respiratory Physiology |
| TAGUCHI Natsuko | Associate Professor, Graduate School of Medicine | Palliative Medicine |
| AMEMIYA Ayumi | Assistant Professor, Graduate School of Nursing | Nursing Scinece and Engineering, Gait Science |
| SEKINE Yuko | Professor, Graduate School of Pharmaceutical Science | Pharmaceutical Health Care and Science |
Research report（2016〜2018）
The purpose of this research is to organize the Public and Professionals Cooperation-type Educational Research Center comprehensively deploying End-of-life Care (EOLC), not only for the elderly but also the whole community, looking ahead to the future in Japan as a super ageing society. Aiming at realizing EOLC supporting the elderly to live rich lives. To the end of the following four goals, we were divided into four groups called AGED.
i. Development of education for Public and Professional Corporation-type EOLC) ：Education and Learning Research group
ii. Establishment of EOLC International Education Research Center：Global Research group
iii. Development and implementation of EOL communication tool using ICTs centering on Advance Care Planning (ACP)：Advance Care Planning Research group
iv. Go back and forth between elucidation of the present state of EOLC for the elderly, and education research: Development of Practice Research group
１．Achievements from the aspect of academic research
＜A group＞ A prototype for a web-based education tool has developed to encourage the public awareness of ACP. To evaluate the education tool‘s usability and whether the tool encouraged the initiation of ACP for a sample of community-dwelling adults. We have redeveloped it more user friendly for the elderly in Japan.
＜G group＞As a result of a submission of the International report to European Association for Palliative Care, we had a media interview by ‘the Economist’ about the current status of EOLC in Japan and also we did the invited talks as the symposist at International Psycho-Oncologoy Society in Hong Kong in 2018.
＜E group＞We have planned four EOLC education and research projects as follows: (#1: Educational development in undergraduate and postgraduate courses based on research results, #2: Development of EOLC educational content and methods involving citizens (patients).
＜D group＞We have been investigating the progress of senility through the close tracking of vital signs monitored by Bed Sensor System (BSS) when an individual is admitted long term care facilities for the elderly and continuing until they pass away.
２．Achievements on building a research network among advanced research centre
We conducted 2 international collaborative studies. One study involves collaboration between researchers from Seoul National University, Korea and Khon Kaen University, Thailand. The other study involves collaboration seven researches from Chulalongkorn University in Thailand: three from our project and two from Washington State University in USA.
３．Achievements from the aspect of social implementation and innovation creation
In September 2017, the Chiba University Graduate School of Nursing was accredited as a Joanna Briggs Institute (JBI) affiliation group; we will be able to establish an affiliated centre with the JBI.
Regarding BSS, joint research and development activity have been officially started with funding from the Minebea Mitsumi Corporation. In D group, in the contexts of hospitals and facilities, a new bed-leave sensor, the ‘bed-leave wish detection sensor,’ which overcomes the problems (activation after bed-leave, false activation) common to the previous bed-leave sensors, which are used to prevent patient falls has been developed, and submitted for patent approval (patent number: application number 2017-177825).
４．Other achievements (Development of young researchers)
One PhD student and two graduate students were engaged in our research project. Around twenty members comprising assistant professors and graduates attended the Faculty Development for doctoral course curriculum to strengthen their information sharing capability on a global scale in November 2017. Six members, consisting of an assistant professor and graduate students, participated in Systematic Review Training Program.