{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:11:18Z","timestamp":1784628678952,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K20563"],"award-info":[{"award-number":["25K20563"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","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":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic disrupted end\u2010of\u2010life (EOL) care for patients with incurable non\u2010communicable diseases. This study evaluated the overall quality of EOL care and achievement of a good death in Japan during the pandemic, particularly focusing on hospital deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Questionnaires were mailed to 26\u2009969 bereaved family members of patients aged \u2265\u200920\u2009years who died in 2021 from the 10 leading causes of death in Japan. Causes were grouped into six categories: cancer, cardiovascular disease, renal failure, respiratory diseases, neurocognitive disorders, and senility. Outcomes were (1) perceived quality of EOL care, measured with the Care Evaluation Scale (CES), and (2) achievement of a good death, measured with the Good Death Inventory (GDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We received 10\u2009890 responses (50.9%); 3619 hospital deaths were analyzed. Perceived quality of EOL care was generally high during the pandemic (73.3%\u201392.9%). Within CES, \u201cfamily care\u201d was lowest across diseases, yet 73.3%\u201378.6% perceived care as good quality. For the GDI item \u201cbeing free from physical distress,\u201d achievement was 37.6% in cancer and 65.8% in senility. After adjusting for age and sex, achievement of a good death did not vary by disease, except for pathophysiology\u2010related symptom items (e.g., pain and cognitive function).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>During the pandemic, \u201cfamily care\u201d was rated lower, yet it became especially important under visiting restrictions. Approximately one in three people dying of senility experienced pain, indicating a need for closer attention from caregivers. Within good\u2010death outcomes, person\u2010centered items did not vary by disease\u2014an encouraging finding in universal EOL care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70347","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T07:54:51Z","timestamp":1768895691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Quality of End\u2010of\u2010Life Care in Japan in 2021: A Mortality Follow\u2010Back Study During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-1787","authenticated-orcid":false,"given":"Richi","family":"Takahashi","sequence":"first","affiliation":[{"name":"Division of Policy Evaluation Institute for Cancer Control, National Cancer Center  Tokyo Japan"},{"name":"Division of Quality Assurance Programs Institute for 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