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Asian Americans, dying, hospice, Japanese, older adults



  1. Matsui, Miho RN, PhD
  2. Braun, Kathryn L. DrPH


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.