{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T07:42:19Z","timestamp":1786174939729,"version":"build-2736575974"},"reference-count":81,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This paper presents the official position statement of the Japan Geriatrics Society (JGS), updating the \u201c2012 JGS Position Statement\u201d regarding end\u2010of\u2010life (EOL) care for older adults. The \u201c2025 JGS Position Statement,\u201d which was recently published in Japanese, introduces an original definition of EOL, conceptualizing it in two stages: first, based on the individual's medical condition, and subsequently, from the perspective of the individual's life story. In this statement, EOL care refers to medical treatment and care provided at the end of life, grounded in appropriate medical judgment, respecting the individual's way of life, and safeguarding their dignity until death. To the best of our knowledge, no previous definitions have conceptualized EOL in this two\u2010stage manner. The best EOL care described in this statement centers on the principles and practices of palliative care and integrates not only medical knowledge and techniques for diagnosis and treatment but also the collective intellectual and cultural achievements from the natural sciences, humanities, and social sciences. Addressing the psychosocial needs of family members is also an essential component of EOL care. The \u201c2025 JGS Position Statement\u201d presents 10 positions to protect the human rights and dignity of older adults, beginning with opposition to ageism and further promoting palliative care, especially in the field of non\u2010cancer diseases.<\/jats:p>","DOI":"10.1111\/ggi.70228","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:34:57Z","timestamp":1760556897000},"page":"1681-1692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Japan Geriatrics Society 2025 Position Statement on End\u2010of\u2010Life Care for Older Adults: English Translation of the Japanese Article"],"prefix":"10.1111","volume":"25","author":[{"given":"Kaoruko","family":"Aita","sequence":"first","affiliation":[{"name":"Uehiro Division, Center for Death &amp; Life Studies and Practical Ethics, Graduate School of Humanities and Sociology The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Palliative Care National Center for Geriatrics and Gerontology  Aichi Japan"},{"name":"Aioi Geriatric Health Services Facility  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Hattori","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine The University of Tokyo Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Hirahara","sequence":"additional","affiliation":[{"name":"Training and Research Center Tokyo Fureai Medical &amp; Cooperative Union  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Hirakawa","sequence":"additional","affiliation":[{"name":"Department of Health Development and Innovation Aichi Comprehensive Health Science Center  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Nursing Kagawa Prefectural University of Health Sciences  Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Katsuya","sequence":"additional","affiliation":[{"name":"Katsuya Clinic  Amagasaki Hyogo Japan"},{"name":"Department of Geriatric and General Medicine The University of Osaka Graduate School of Medicine  Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Yanagawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology and Chemotherapy Nagoya University Hospital  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3345-2703","authenticated-orcid":false,"given":"Shinji","family":"Koba","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuko","family":"Aida","sequence":"additional","affiliation":[{"name":"Institute of Health Science, School of Medicine and Health Sciences Shinshu University  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Komiya","sequence":"additional","affiliation":[{"name":"Centre for Community Liaison and Patient Consultations Nagoya University Hospital  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Institute for Clinical Ethics  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nakano","sequence":"additional","affiliation":[{"name":"Taiyo Clinic  Hokota Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Emergency and General Medicine, Geriatric Medicine Kyorin University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-9857","authenticated-orcid":false,"given":"Hisayuki","family":"Miura","sequence":"additional","affiliation":[{"name":"Clinical Research Center Yushoukai Medical Corporation  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Momose","sequence":"additional","affiliation":[{"name":"Japanese Red Cross Toyota College of Nursing  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tokiko","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Science, Medical and Lifestyle News Section The Asahi Shimbun  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Kozaki","sequence":"additional","affiliation":[{"name":"Geriatric Medicine Kyorin University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"e_1_2_17_2_1","unstructured":"World Medical Association \u201cWMA Declaration of Geneva \u201d 2017 https:\/\/www.wma.net\/policies\u2010post\/wma\u2010declaration\u2010of\u2010geneva\/."},{"key":"e_1_2_17_3_1","unstructured":"International Council of Nurses \u201cThe ICN Code of Ethics for Nurses \u201d 2021 https:\/\/www.nurse.or.jp\/nursing\/system\/files\/2021\u201010\/ICN_Code\u2010of\u2010Ethics_EN_Web_0.pdf."},{"key":"e_1_2_17_4_1","unstructured":"Japan Medical Association \u201cThe Code of Medical Ethics \u201d 2022 https:\/\/www.med.or.jp\/doctor\/rinri\/i_rinri\/000967.html."},{"key":"e_1_2_17_5_1","unstructured":"Japanese Nursing Association (JNA) \u201cJNA Codes of Ethics for Nurses \u201d 2021 https:\/\/www.nurse.or.jp\/nursing\/assets\/statistics_publication\/publication\/rinri\/code_of_ethics.pdf."},{"key":"e_1_2_17_6_1","unstructured":"Japan Pharmaceutical Association \u201cThe Code of Ethics and the Code of Conduct for Pharmacists \u201d 2018 https:\/\/www.nichiyaku.or.jp\/assets\/uploads\/about\/kouryo20180226.pdf."},{"key":"e_1_2_17_7_1","unstructured":"Japan Geriatrics Society (JGS) \u201c2001 JGS Position Statement on Tereminal Care \u201d 2001 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/old_v_jgs\u2010tachiba2001.pdf."},{"key":"e_1_2_17_8_1","unstructured":"Japan Geriatrics Society (JGS) \u201c2012 JGS Position Statement on Terminal Care \u201d 2012 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/jgs\u2010tachiba2012.pdf."},{"key":"e_1_2_17_9_1","unstructured":"Japan Gerontological Society \u201cWorking Group on Older Adults and Aging Society \u201d Report 2024 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/info\/important_info\/pdf\/20240614_01_01.pdf?20240624."},{"key":"e_1_2_17_10_1","unstructured":"Japan Geriatrics Society (JGS) \u201c2025 JGS Position Statement on End\u2010of\u2010Life Care \u201d 2025 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/tachiba2025.pdf."},{"key":"e_1_2_17_11_1","unstructured":"Statistics Bureau of Japan Ministry of Internal Affairs and Communications \u201cOlder Adults in Japan: A Statistical Perspective \u201d 2024 https:\/\/www.stat.go.jp\/data\/topics\/pdf\/topics138.pdf."},{"key":"e_1_2_17_12_1","unstructured":"Cabinet Office of Japan \u201cTrends in Mortality \u201d 2020 https:\/\/www.gender.go.jp\/about_danjo\/whitepaper\/r04\/zentai\/html\/zuhyo\/zuhyo07\u201003.html."},{"key":"e_1_2_17_13_1","unstructured":"WHO \u201cWorld Health Statistics 2022: Monitoring Health for the SDGs Sustainable Development Goals \u201d 2024 https:\/\/www.who.int\/publications\/i\/item\/9789240051157."},{"key":"e_1_2_17_14_1","unstructured":"United Nations \u201cRight of Older People. United Nations Principles for Older Persons Adopted by General Assembly Resolution 46\/91 of 16 December 1991 \u201dhttps:\/\/social.un.org\/ageing\u2010working\u2010group\/documents\/fourth\/AWAZUNprinciplesforolderpersons.pdf."},{"key":"e_1_2_17_15_1","unstructured":"Ministry of Health Labour and Welfare \u201cGuidelines on the Decision\u2010Making Process for End\u2010of\u2010Life Care: Commentary Edition \u201d 2015 https:\/\/www.mhlw.go.jp\/file\/04\u2010Houdouhappyou\u201010802000\u2010Iseikyoku\u2010Shidouka\/0000197702.pdf."},{"key":"e_1_2_17_16_1","unstructured":"Ministry of Health Labour and Welfare \u201cHave You Heard of the Guidelines on the Decision\u2010Making Process for End\u2010of\u2010Life Care? \u201d 2015."},{"key":"e_1_2_17_17_1","unstructured":"Science Council of Japan Clinical Medicine Committee Subcommittee on Terminal Care \u201cExternal Report on the Approach to Terminal Care: Terminal Care in the Subacute Phase \u201d 2008 https:\/\/www.scj.go.jp\/ja\/info\/kohyo\/pdf\/kohyo\u201020\u2010t51\u20102.pdf."},{"issue":"1","key":"e_1_2_17_18_1","first-page":"22","article-title":"White Paper on Standards and Norms for Hospice and Palliative Care in Europe: Part 1 Recommendations From the European Association for Palliative Care","volume":"17","author":"European Association for Palliative Care","year":"2010","journal-title":"European Journal of Palliative Care"},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211025457"},{"key":"e_1_2_17_20_1","first-page":"1","article-title":"Vita Biologica and Vita Biographica in Medicine\u2014Perspectives From Clinical Practice","volume":"53","author":"Shimizu T.","year":"2002","journal-title":"Philosophy"},{"key":"e_1_2_17_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13441"},{"key":"e_1_2_17_22_1","unstructured":"United Nations Economic and Social Council \u201cGeneral Comment No. 14 the Right to the Highest Attainable Standard of Health \u201d 2000 E\/C.12\/2000\/4."},{"key":"e_1_2_17_23_1","unstructured":"European Association for Palliative Care the International Association for Hospice and Palliative Care the Worldwide Palliative Care Alliance and Human Rights Watch \u201cThe Prague Charter\u2010Palliative Care is a Human Right \u201d 2012 https:\/\/ehospice.com\/international_posts\/the\u2010prague\u2010charter\u2010palliative\u2010care\u2010is\u2010a\u2010human\u2010right\/."},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14042"},{"key":"e_1_2_17_25_1","unstructured":"Health and Labour Sciences Research Grant Comprehensive Research on Aging and Health; Japan Geriatrics Society; Japan Association of Geriatric Health Facilities; Japan Association of Medical and Care Facilities \u201c2013 Guidelines for the Provision of Appropriate Medical Care for Older Adults \u201dhttps:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/geriatric_care_GL.pdf."},{"key":"e_1_2_17_26_1","volume-title":"Decision\u2010Making Process for Initiation or Withholding of Renal Replacement Therapy and the Establishment of Optimal Palliative Care for Older Adults With Renal Failure: Concepts and Practices of Conservative Kidney Management (CKM) for Older Adults With Renal Failure","author":"Japan Agency for Medical Research and Development (AMED), Program for Aging and Longevity Research and Development","year":"2022"},{"key":"e_1_2_17_27_1","volume-title":"Easy\u2010to\u2010Understand Textbook of Geriatric Oncology","author":"Japanese Association of Supportive Care in Cancer","year":"2023"},{"key":"e_1_2_17_28_1","unstructured":"Japan Geriatrics Society; Japan Agency for Medical Research and Development (AMED) Study Group on the Safety of Pharmacotherapy for Older Adults \u201cGuidelines for Safe Pharmacotherapy for Older Adults \u201d 2015 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/publications\/other\/pdf\/20170808_01.pdf."},{"key":"e_1_2_17_29_1","volume-title":"Clinical Practice and Care Guidelines Based on Comprehensive Geriatric Assessment (CGA)","author":"Longevity Medical Research Grant, Research Group on the Development of Guidelines for Comprehensive Geriatric Assessment (CGA); Japan Geriatrics Society; National Center for Geriatrics and Gerontology","year":"2024"},{"key":"e_1_2_17_30_1","unstructured":"WHO \u201cIntegrated Care for Older People. Guidelines on Community\u2010Level Interventions to Manage Declines in Intrinsic Capacity \u201d 2017 https:\/\/iris.who.int\/bitstream\/handle\/10665\/258981\/9789241550109\u2010eng.pdf?sequence=1."},{"key":"e_1_2_17_31_1","unstructured":"WHO Regional Office for Europe \u201cPalliative Care for Older People: Better Practices \u201d 2022 https:\/\/www.who.int\/europe\/publications\/i\/item\/9789289002240."},{"key":"e_1_2_17_32_1","volume-title":"JRS Guidelines for the Management of Pneumonia in Adults","author":"Japanese Respiratory Society (JRS). Committee for the Development of the JRS Guidelines for the Management of Pneumonia in Adults","year":"2024"},{"key":"e_1_2_17_33_1","unstructured":"Science Council of Japan Clinical Medicine Committee Subcommittee on Aging \u201cProposal: Toward the Realization of a Vigorous Super\u2010Aged Society\u2014The Future of Medicine Healthcare and Society in Japan \u201d 2020 https:\/\/www.scj.go.jp\/ja\/info\/kohyo\/pdf\/kohyo\u201024\u2010t295\u20105.pdf."},{"key":"e_1_2_17_34_1","volume-title":"Dignity: Its History and Meaning","author":"Rosen M.","year":"2021"},{"key":"e_1_2_17_35_1","first-page":"34","volume-title":"Concepts of Dignity in East Asia","author":"Kato Y.","year":"2021"},{"key":"e_1_2_17_36_1","unstructured":"Collins Online Dictionary Definition of \u201cDignity\u201d https:\/\/www.collinsdictionary.com\/dictionary\/english\/dignity."},{"key":"e_1_2_17_37_1","volume-title":"Medical Treatment and Care in the Era of Longevity: The Logic and Ethics of End of Life","author":"Aita K.","year":"2019"},{"key":"e_1_2_17_38_1","volume-title":"Theory and Practice of Clinical Ethics. Conference Methods for Healthcare Teams","author":"Shimizu T.","year":"2022"},{"key":"e_1_2_17_39_1","unstructured":"Japan Gerontological Society; Japan Geriatrics Society \u201cProposal From the Working Group on the Definition of Older Adults \u201d 2017 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/definition_01.pdf."},{"key":"e_1_2_17_40_1","unstructured":"Ministry of Health Labour and Welfare \u201cGuidelines on the Decision\u2010Making Process for Medical Treatment and Care at the Final Stage of Life: Commentary Edition \u201d 2018 https:\/\/www.mhlw.go.jp\/file\/04\u2010Houdouhappyou\u201010802000\u2010Iseikyoku\u2010Shidouka\/0000197702.pdf."},{"key":"e_1_2_17_41_1","unstructured":"United Nations \u201cOvercoming Ageism and Supporting the Human Rights of Seniors \u201d 2011 https:\/\/www.un.org\/en\/chronicle\/article\/overcoming\u2010ageism\u2010and\u2010supporting\u2010human\u2010rights\u2010seniors."},{"key":"e_1_2_17_42_1","unstructured":"World Health Organization \u201cCombatting Ageism \u201d 2024 https:\/\/www.who.int\/teams\/social\u2010determinants\u2010of\u2010health\/demographic\u2010change\u2010and\u2010healthy\u2010ageing\/combatting\u2010ageism."},{"key":"e_1_2_17_43_1","unstructured":"National Institute of Health \u201cLeading the Charge Against Ageism \u201d 2024 https:\/\/www.edi.nih.gov\/blog\/communities\/leading\u2010charge\u2010against\u2010ageism."},{"key":"e_1_2_17_44_1","unstructured":"OECD \u201cHealth Policy Studies \u201cTime for Better Care at the End of Life\u201d \u201d 2023 https:\/\/www.oecd.org\/health\/time\u2010for\u2010better\u2010care\u2010at\u2010the\u2010end\u2010of\u2010life\u2010722b927a\u2010en.htm."},{"key":"e_1_2_17_45_1","unstructured":"WHO \u201cPalliative Care \u201d 2020 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/palliative\u2010care."},{"key":"e_1_2_17_46_1","unstructured":"NHS \u201cWhat End of Life Care Involves \u201d 2024 https:\/\/www.nhs.uk\/conditions\/end\u2010of\u2010life\u2010care\/what\u2010it\u2010involves\u2010and\u2010when\u2010it\u2010starts\/."},{"key":"e_1_2_17_47_1","unstructured":"World Health Assembly \u201cStrengthening of Palliative Care as a Component of Comprehensive Care Throughout the Life Course. WHA67.19 \u201d 2014 https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA67\/A67_R19\u2010en.pdf."},{"key":"e_1_2_17_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30172-X"},{"key":"e_1_2_17_49_1","volume-title":"Guidelines for End\u2010of\u2010Life Care (EOLC) for Non\u2010Cancer Diseases","author":"Research Group on the Development of Guidelines for End\u2010of\u2010Life Care (EOLC) for Non\u2010Cancer Diseases","year":"2021"},{"key":"e_1_2_17_50_1","volume-title":"Guidelines for Home\u2010Based Management and Palliative Care of Pneumonia in Patients With End\u2010Stage Dementia","author":"Japan Agency for Medical Research and Development (AMED), Program for Research on Aging and Disability","year":"2022"},{"key":"e_1_2_17_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2016.05.016"},{"key":"e_1_2_17_52_1","volume-title":"Support Guide for People With Dementia: To Realize Care That Respects the Wishes and Preferences of the Person Until the End of Life","author":"Health and Labour Sciences Research, Research Group on Enhancing End\u2010of\u2010Life Care for People With Dementia According to Care Settings\u2014Considering the Impact of the COVID\u201019 Pandemic","year":"2024"},{"key":"e_1_2_17_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470757994"},{"key":"e_1_2_17_54_1","first-page":"10","article-title":"Concepts of DNAR (Do Not Attempt Resuscitation)","volume":"24","author":"Japanese Society of Intensive Care Medicine, Ethics Committee","year":"2017","journal-title":"Japanese Journal of the Society of Intensive Care Medicine"},{"key":"e_1_2_17_55_1","first-page":"82","article-title":"Unified Concepts of Terms Related to Geriatric Emergency Care","volume":"36","author":"Japanese Association for Acute Medicine, Committee on Geriatric Emergency Care","year":"2025","journal-title":"Journal of the Japanese Association for Acute Medicine"},{"key":"e_1_2_17_56_1","volume-title":"Guidelines for Decision\u2010Making Support in Daily Life and Social Life of People With Dementia","author":"Ministry of Health, Labor and Welfare","year":"2025"},{"key":"e_1_2_17_57_1","unstructured":"Japan \u201cBasic Act on Dementia to Promote an Inclusive Society \u201d 2024 https:\/\/www.japaneselawtranslation.go.jp\/outline\/92\/905R510.pdf."},{"key":"e_1_2_17_58_1","volume-title":"Global Action Plan on the Public Health Response to Dementia 2017\u20132025","author":"World Health Organization","year":"2017"},{"key":"e_1_2_17_59_1","unstructured":"Japan Medical Association \u201cEnd\u2010of\u2010Life Care: Perspectives From Advance Care Planning (ACP) \u201d 2018 https:\/\/www.med.or.jp\/dl\u2010med\/teireikaiken\/20180307_31.pdf."},{"key":"e_1_2_17_60_1","unstructured":"Ministry of Health Labour and Welfare \u201cGuidelines on the Decision\u2010Making Process for Medical Treatment and Care at the Final Stage of Life \u201d 2018 https:\/\/www.mhlw.go.jp\/file\/04\u2010Houdouhappyou\u201010802000\u2010Iseikyoku\u2010Shidouka\/0000197701.pdf."},{"key":"e_1_2_17_61_1","volume-title":"Handbook of Ethics Consultation","author":"Dozono T.","year":"2019"},{"key":"e_1_2_17_62_1","unstructured":"Japanese Geriatrics Society Japanese Society of Home Care Medicine National Center for Geriatrics and Gerontology \u201cGuidelines for Home Medical Care and Long\u2010Term Care Services for Older Adults 2019 \u201d 2019 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/publications\/other\/pdf\/care_service_guideline_2019.pdf."},{"key":"e_1_2_17_63_1","unstructured":"Yuumi Memorial Foundation \u201cHome Medical Care Textbook Chapter\u00a01 Section\u00a011: On Community\u2010Based Integrated Care \u201d 2024 https:\/\/www.yuumi.or.jp\/textbook\/pdf\/1\u201011.pdf."},{"key":"e_1_2_17_64_1","volume-title":"Practical Implementation and Challenges of Interprofessional Collaboration: The Role of ACP Facilitators","author":"Nishikawa M.","year":"2024"},{"key":"e_1_2_17_65_1","volume-title":"Live Well, Laugh Well, and Embrace a Good Death","author":"Deeken A.","year":"2003"},{"key":"e_1_2_17_66_1","unstructured":"Ministry of Health Labour and Welfare \u201cAnnual Health Labour and Welfare Report 2022: Securing Human Resources to Support Social Security \u201d 2022 https:\/\/www.mhlw.go.jp\/stf\/wp\/hakusyo\/kousei\/21\/index.html."},{"key":"e_1_2_17_67_1","unstructured":"Ministry of Health Labour and Welfare \u201cOverview of the 2022 National Livelihood Survey: Trends in Household Income and Expenditure \u201d 2022 https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/k\u2010tyosa\/k\u2010tyosa22\/index.html."},{"key":"e_1_2_17_68_1","unstructured":"Tokyo Metropolitan Institute of Gerontology \u201cCognitive Function in Advanced Old Age: From 100\u2009Years Old and Beyond \u201d 2017 https:\/\/www.tmghig.jp\/research\/topics\/201712\u2010539\/."},{"key":"e_1_2_17_69_1","unstructured":"Fire and Disaster Management Agency Ministry of Internal Affairs and Communications \u201cPublication of Preliminary Figures on Ambulance Dispatches in 2024 \u201d 2025 https:\/\/www.fdma.go.jp\/pressrelease\/houdou\/items\/kyuki0328.pdf."},{"key":"e_1_2_17_70_1","first-page":"13","article-title":"Preliminary Figures on Ambulance Dispatches in 2019","volume":"591","author":"Emergency Planning Division, Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications","year":"2020","journal-title":"Fire Services Journal"},{"key":"e_1_2_17_71_1","unstructured":"Advisory Panel on Emergency Care Issues for Older Adults Japanese Association for Acute Medicine \u201cProposal on the Current Status and Countermeasures for Emergency Care Issues in Older Adults \u201d 2024 https:\/\/doi.org\/10.51094\/jxiv.998."},{"key":"e_1_2_17_72_1","unstructured":"Ministry of Health Labour and Welfare \u201cReference Materials for Acute Hospital Care for Older Adults Requiring Long\u2010Term Care \u201d 2023 https:\/\/www.mhlw.go.jp\/content\/12404000\/001079168.pdf."},{"key":"e_1_2_17_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2021.104398"},{"key":"e_1_2_17_74_1","unstructured":"Nikkei Shimbun \u201cPhysical Restraints Used in 45% of General Hospitals for Patients With Dementia; Some Practices Habitual National Cancer Center Survey \u201d 2018 https:\/\/www.nikkei.com\/article\/DGKKZO37913350Y8A111C1CR8000\/."},{"key":"e_1_2_17_75_1","unstructured":"Research Group on Understanding of the Adult Guardianship System and the Role of Hospitals for Patients Without Surrogates \u201cGuidelines for Supporting Decision\u2010Making for Hospitalized Patients Without Surrogates and Patients With Difficulty Making Medical Decisions \u201d 2019 https:\/\/www.mhlw.go.jp\/content\/000516181.pdf."},{"key":"e_1_2_17_76_1","unstructured":"Supreme Court of Japan Ministry of Health Labour and Welfare \u201cGuidelines on Guardianship Procedures Incorporating Decision\u2010Making Support \u201d 2020 https:\/\/www.mhlw.go.jp\/content\/000750502.pdf."},{"key":"e_1_2_17_77_1","unstructured":"Cabinet Secretariat Cabinet Office Financial Services Agency Consumer Affairs Agency Ministry of Internal Affairs and Communications Ministry of Justice Ministry of Health Labour and Welfare Ministry of Economy Trade and Industry Ministry of Land Infrastructure Transport and Tourism \u201cGuidelines for Lifelong Support Service Providers for Older Adults \u201d 2024 https:\/\/www.moj.go.jp\/content\/001420018.pdf."},{"key":"e_1_2_17_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.02.021"},{"key":"e_1_2_17_79_1","unstructured":"Japan Geriatrics Society Ethics Committee Subcommittee on End\u2010of\u2010Life Care and COVID\u201019 Task Force \u201cProposal From the Japan Geriatrics Society for Ensuring Optimal Medical Care and Support for Older Adults During the COVID\u201019 Pandemic: Considering the Timing of Advance Care Planning \u201d 2020 https:\/\/www.jpn\u2010geriat\u2010soc.or.jp\/proposal\/pdf\/covid_teigen.pdf."},{"key":"e_1_2_17_80_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202310-925ST"},{"key":"e_1_2_17_81_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198812223192504"},{"key":"e_1_2_17_82_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2004.10.1.12013"}],"container-title":["Geriatrics &amp; Gerontology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ggi.70228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T06:43:19Z","timestamp":1786171399000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ggi.70228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":81,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/ggi.70228"],"URL":"https:\/\/doi.org\/10.1111\/ggi.70228","archive":["Portico"],"relation":{},"ISSN":["1444-1586","1447-0594"],"issn-type":[{"value":"1444-1586","type":"print"},{"value":"1447-0594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]},"assertion":[{"value":"2025-10-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}