The purpose of the present study was to gather data to improve the quality of
terminal care by determining the concerns and opinions of nurses who provide terminal
care at specialized nursing homes for the elderly in Japan. This qualitatlve study was conducted by administering a questionnaire to 159 nurses to elicit their opinions and concerns regarding the provision of terminal care in specialized nursing homes for the elderly. The results identified six general areas that nurses felt were important, namely : 1) concerns with the restrictive manner in which the system is administered ; 2) difficulties
related to collaborating with other healthcare professionals;3)the need to provide terminal care that is centered around residents ; 4) concerns related to acceptable levels of workload and responsibility ; 5) concerns regarding the fact that the elderly were removed
from the decision-making process ; and, 6) difficulties associated with resolving emotions related to terminal care. These components are thought to reflect the complex problems associated with providing terminal care to the elderly. Consequently, in order to resolve these problems and improve the quality of terminal care, it will be necessary to improve facilities, increase the number of nurses, and strengthen working relationships among
nursing homes and other medical institutions.