[Assessment Items Emphasized by Visiting Nurses in How Older Patients Treated at Home and Their Families Decide the Place of Death].

Although 70% of people in Japan wish to die at home, only 13.6% do, and 72.9% die in hospitals. This study aimed to clarify, from the perspective of visiting nurses, the factors influencing patients and their families in deciding the place of death and their satisfaction with end-of-life care at the chosen place. We conducted a survey of 70 visiting nurses with over a year of home nursing experience. They responded to the key factors influencing the decisions of patients and their families regarding place of death, either hospital or home, and the satisfaction at each place of death on a 10-point scale. 67 nurses valued the following two items when the place of death was a hospital: "Less burden of care on the family" and "Specialized treatment to alleviate suffering." The following four items were emphasized in the home: "I can live my own life as I want," "I can have my family be there when I want them to be," "I can receive extensive nursing care," and "I can be seen by my family doctor." The nurses also rated the satisfaction of patients and their families much higher when they die at home than in a hospital. Therefore, improving the treatment environment based on the features of the place of death, and enhancing community-based end-of-life care support, would allow patients and their families to spend their own time in the hospital and get specialized treatment at home, resulting in greater satisfaction with end-of-life care.