 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
John I. Takayama, MD, MPH, Interdisciplinary Medicine, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan, 81-3-3481-0999, haru@attglobal.net and Masahiko Saito, MD, PhD, Keiseikai Institute of Gerontology, Shinjuku 171 Bldg. 7F, 1-7-1 Shinjuku, Shinjuku-ku, Tokyo, 160-0022, Japan.
Background: Given a rapidly aging society in Japan with an increasing incidence of dementia, there is a critical need for standardized recommendations to families about decision making on behalf of patients with dementia. Such recommendations, however, require an understanding of caretaker preferences for disclosure and decision making. Objective: To understand caretaker preferences for disclosure about dementia to family members with dementia and for decision making about treatment and care. Method: Survey of 1,100 family caretakers of patients with dementia in Japan in 2002. Results: 47% of respondents preferred disclosure (D), a majority citing a mutual need to understand the illness and the importance of disclosure to treatment decisions. 53% preferred nondisclosure (ND), most expressing concern about the impact of the disclosure on the psychological well-being of the patient (e.g., he will be hurt, she will get depressed). 84% of D compared to 22% of ND reported that they would make treatment and care decisions by involving the patient to the extent possible; 57% of ND stated that family members should make decisions without informing the patient. Regarding care decisions within a geriatric facility, 51% felt that professionals (e.g., physicians, care managers) should make them, while 27% felt strongly that patient preferences should be considered. Regarding financial assets, 92% reported that family members should make decisions; however, 47% expressed a desire for a standardized legal procedure to permit proxy decisions. Conclusion: Only half of family caretakers prefers disclosure of illness to patients with dementia; regardless of their preferences, most envision a clear role for family members in making critical decisions with support from professionals and the legal system.
Learning Objectives:
Keywords: Dementia, International
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.