Japanese Americans' death attitudes and preferences for end-of-life care.

The purpose of this study was to explore death attitudes among Japanese American elders and to examine associations between death attitudes and other variables, including end-of-life preferences. We surveyed 123 community-dwelling Japanese Americans, 60 years or older, recruited from three senior centers in Hawaii. Survey items included those from the Death Attitude Profile-Revised as well as items regarding end-of-life preferences. Of the 112 participants providing complete data, the mean age was 74.7 years, and 71% were women. Regarding preferred place to receive end-of-life care, about 39% said home, 9% said hospital, 12% said nursing home, and 40% said hospice. More than half (about 53%) had discussed end-of-life issues with their physician and/or family. Correlating Death Attitude Profile-Revised dimensions with other variables, some significant associations were found. For example, healthier and less autonomous elders regarding decision making about life-sustaining treatments reported more fear of death. Elders who were more accepting of death had discussed end-of-life issues with others. Elders with lower scores on Escape Acceptance were more likely to have experienced death of a family member and prefer a hospital for end-of-life care. To better understand and support elders' end-of-life decisions, healthcare providers should assess elders' end-of-life preferences and death attitudes. [ABSTRACT FROM AUTHOR]