Characteristics of Support Cases for Single Elderly People in Daily Life, Medical Care, Long-term Care, and Death Situations

In Japan, the number of older persons who cannot be supported by family members in decisionmaking is increasing. Difficulties in making medical decisions due to dementia or deteriorated physical conditions are apparent. Considering the aging process, difficulties in maintaining the quality of daily living must exist beforehand, and support is required from earlier stages. We collected real cases from local government staff, care managers, social welfare personnel, and private support companies, according to five scenarios of supported decision making: (1) Difficulty with daily activities, (2) Receiving serious medical treatment, (3) Being discharged and rebuilding life, (4) Rearranging care services and residence according to functional decline, and (5) Dealing with death. Of the 134 collected cases, most were in Scenario 4 (n = 52) and involved men aged 75 to 84 years (n = 45). Even if it becomes difficult for a person to recognize problems and carry out solutions, expressing intentions, which is the basis of decision-making, plays an important role for the person and the most sustainable one. What is lost by the absence of family members is the “point of contact” between the individual and the outside world, which is related to the fact that issues cannot be discovered until Scenario 4 and that support at each stage is not continuous. In light of the decrease in the number of supporters and the increase in the number of people who need support, contact should be established in a way that requires less human involvement, such as through the use of information technology.