{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T22:08:27Z","timestamp":1766441307160,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K10557"],"award-info":[{"award-number":["19K10557"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To clarify older adults' preferences for and actual situations of artificial hydration and nutrition (AHN) in end\u2010of\u2010life care in a care home.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were residents of a care home who had completed advance directives regarding preferred methods of AHN from 2009 to 2018. Advance directives alone were available from April 2009 to June 2016 (Wave 1), and advance care planning for AHN including advance directives was introduced in July 2016 (Wave 2). AHN preferences included (i) intensive methods (percutaneous endoscopic gastrostomy, nasogastric tube feeding and total parenteral nutrition), (ii) drip infusion, and (iii) oral intake only. Participants were followed until the end of 2020, and we checked whether decisions about AHN were based on older adults' preferences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 272 participants had completed advance directives. Most participants preferred \u201coral intake only\u201d (59.5%), followed by drip infusion (32.0%) and intensive methods (8.5%) in advance directives. Ninety of the 272 participants completed advance directives twice; 83.3% did not change their AHN preferences from Wave 1 to Wave 2. By the end of 2020, 93 of the 272 participants died in the care home. AHN was provided according to older adults' preferences in 48.9% (oral intake only), in 51.4% (drip infusion) and in 55.6% (intensive methods) of cases respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most participants preferred oral intake only, and their preferences were reflected in decisions about actual situations of AHN in end\u2010of\u2010life care. To prepare for advanced dementia and senility, early advance care planning for AHN should be promoted. <jats:bold>Geriatr Gerontol Int 2022; 22: 581\u2013587<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.14419","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T10:20:22Z","timestamp":1655547622000},"page":"581-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Older adults' preferences for and actual situations of artificial hydration and nutrition in end\u2010of\u2010life care: An 11\u2010year follow\u2010up study in a care home"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-858X","authenticated-orcid":false,"given":"Taizo","family":"Wada","sequence":"first","affiliation":[{"name":"Center for Southeast Asian Studies Kyoto University  Kyoto Japan"},{"name":"Osaka Home Healthcare Clinic  Suita 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