{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:59:12Z","timestamp":1790405952718,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010298","name":"Yuumi Memorial Foundation for Home Health Care","doi-asserted-by":"publisher","award":["Y2024A104\u2010005"],"award-info":[{"award-number":["Y2024A104\u2010005"]}],"id":[{"id":"10.13039\/501100010298","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gen and Family Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Senility has become an increasingly common cause of death in aging societies such as Japan. However, many patients still die in hospitals, suggesting challenges in transitioning end\u2010of\u2010life care to community settings. This study examined hospital\u2010based geriatricians' perceived difficulty in discharging patients with senility and associated physician\u2010related factors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n I conducted a nationwide postal cross\u2010sectional survey of hospital\u2010based board\u2010certified geriatricians in Japan. Perceived difficulty in discharge and its reasons were assessed. A composite intervention frequency score was calculated based on four clinical practices used when patients were unable to maintain oral intake (hydration, central venous nutrition, nasogastric tube feeding, and percutaneous endoscopic gastrostomy). Ordinal logistic regression analyses were performed to examine the association between intervention frequency and perceived difficulty, adjusting for physician characteristics.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 409 respondents (response rate: 35.4%), 301 physicians with experience diagnosing senility were included. Most respondents reported experiencing difficulty in discharging patients with senility for end\u2010of\u2010life care to home (86.1% reported \u201calways\u201d or \u201coften\u201d) and to long\u2010term care facilities (72.5% reported \u201calways\u201d or \u201coften\u201d). Caregiver\u2010related factors were prominent barriers to home discharge, whereas facility\u2010related factors were more common for discharge to long\u2010term care facilities. Higher intervention frequency was associated with greater perceived difficulty in discharge to home (\n OR<\/jats:styled-content>\n 1.13, 95%\n CI<\/jats:styled-content>\n 1.01\u20131.26) and long\u2010term care facilities (\n OR<\/jats:styled-content>\n 1.14, 95%\n CI<\/jats:styled-content>\n 1.02\u20131.28).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Hospital\u2010based geriatricians frequently perceive difficulty in discharging patients with senility. Barriers differ by setting, and physicians' intervention tendencies may influence discharge planning.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jgf2.70181","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:17:11Z","timestamp":1789791431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived Difficulty in Discharging Older Patients With Senility to Home or Care Facilities for End\u2010of\u2010Life Care: A Nationwide Cross\u2010Sectional Study of Hospital\u2010Based Geriatricians in Japan"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6630-8284","authenticated-orcid":false,"given":"Teruhiko","family":"Imanaga","sequence":"first","affiliation":[{"name":"Kanade Clinic Hasuda Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Ministry of Health Labour and Welfare \u201cManual to Fill in a Death Certificate: 2025 \u201d accessed January 31 2026 https:\/\/www.mhlw.go.jp\/toukei\/manual\/dl\/manual_r07.pdf."},{"key":"e_1_2_13_3_1","unstructured":"Ministry of Health Labour and Welfare \u201cTrends in Leading Causes of Death (Summary of Vital Statics) \u201d (2023) https:\/\/www.mhlw.go.jp\/english\/database\/db\u2010hw\/populate\/dl\/E03.pdf."},{"key":"e_1_2_13_4_1","unstructured":"Ministry of Health Labour and Welfare \u201cVital Statistics: 2022 \u201d accessed January 31 2026 https:\/\/www.e\u2010stat.go.jp\/stat\u2010search\/files?page=1&layout=datalist&toukei=00450011&tstat=000001028897&year=20220&tclass1val=0."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-024-08458-7"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.13696"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3143\/geriatrics.44.641"},{"key":"e_1_2_13_8_1","first-page":"1","article-title":"Difficulties in Discharge Planning and Discharge Adjustment Faced by Nurses at Medical Institutions Involved and Countermeasures Therefor","volume":"17","author":"Fujimura S.","year":"2015","journal-title":"Journal of the Faculty of Nursing, Iwate Prefectural University"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.5116\/ijme.4dfb.8dfd"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216313511141"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2014-000794"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2022.28.1.28"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.2450"}],"container-title":["Journal of General and Family Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgf2.70181","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgf2.70181","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgf2.70181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:22:50Z","timestamp":1790403770000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgf2.70181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/jgf2.70181"],"URL":"https:\/\/doi.org\/10.1002\/jgf2.70181","archive":["Portico"],"relation":{},"ISSN":["2189-7948","2189-7948"],"issn-type":[{"value":"2189-7948","type":"print"},{"value":"2189-7948","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70181"}}