Abstract

Background: Depopulated and aging areas in Japan, the proportion of older people who die at home tends to be lower than the national average. We investigated the trend regarding their preference for dying at home and associated factors among older residents living in a village.

Methods: We conducted a questionnaire-based cross-sectional study in February and June 2020, targeting residents of Mitsuse Village aged ≥ 65 years.We compared two groups for each factor, residents who preferred to die at home (Group H) and the remainder (Group O).

Results: In total, 223 (62%) residents responded to the survey. Participants' median age was 77 years, and 44% were men. Group H accounted for 47% of the total. Univariate analysis showed that Group H was older (p = 0.010) and included a smaller proportion who used a private vehicle (p = 0.036), compared with Group O. Multivariate analysis showed that male sex and not having a primary care physician were associated with a preference for dying at home (p = 0.031 and p = 0.041). Availability of transportation, social isolation, family economic status, or knowledge of long-term care were not independent associations with a preference for dying at home.

Conclusions: To fulfill the wishes of older people who prefer to die at home in depopulated areas of Japan, establishing better home medical, nursing, or long-term care systems with improved human and financial resources is essential. Further research on how to support individuals' preference for dying at
home is needed.