Background it remains unclear how family relationships could affect stability of end-of-life care preferences. Objective to describe change patterns of preferred place of death (POD) among older people and to examine associations between family social support and stability of preferences regarding POD. Methods this longitudinal study of 1,200 noninstitutionalized independent Japanese older people aged over 65 years used panel data between 2016 and 2019 from the Japan Gerontological Evaluation Study (JAGES). Preference stability was defined as the congruence of preferred POD based on questionnaires between baseline and follow-up. We performed multiple logistic regression analysis and gender-stratified analysis to examine associations between social support (spouse, children living together and children living apart) and preference stability. Results only 40.9% of participants had stable preferences. For a spouse, both receiving and providing social support was associated with less stable preferences (OR: 0.63, 95% CI: 0.43–0.93; OR: 0.55, 95% CI: 0.38–0.80, respectively), and providing social support to children living apart was associated with more stable preferences (OR: 1.35, 95% CI: 1.03–1.76). In gender-stratified analysis, significant associations between preference stability and providing social support to a spouse among women (OR: 0.53, 95% CI: 0.34–0.82) and providing social support to children living apart among men (OR: 1.72, 95% CI: 1.16–2.55) were observed. Conclusions family social support was associated with the stability of preferences, and the associations differed by support resources and gender. Incorporating family members in the process of end-of-life care discussion may be necessary for establishing stable preferences.

中文翻译：

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家庭社会支持和老年人死亡地点偏好的稳定性：来自日本老年学评估研究的 3 年纵向研究

背景 目前尚不清楚家庭关系如何影响临终关怀偏好的稳定性。目的是描述老年人偏好死亡地点 (POD) 的变化模式，并检验家庭社会支持与 POD 偏好稳定性之间的关联。方法 这项对 1,200 名 65 岁以上非住院独立日本老年人的纵向研究使用了 2016 年至 2019 年日本老年学评估研究 (JAGES) 的面板数据。偏好稳定性被定义为基于基线和后续调查问卷的首选 POD 的一致性。我们进行了多元逻辑回归分析和性别分层分析，以检验社会支持（配偶、同居子女和分居子女）与偏好稳定性之间的关联。结果只有 40.9% 的参与者有稳定的偏好。对于配偶，接受和提供社会支持都与不太稳定的偏好相关（OR：0.63，95% CI：0.43-0.93；OR：0.55，95% CI：0.38-0.80，分别），并为孩子提供社会支持分居与更稳定的偏好相关（OR：1.35，95% CI：1.03–1.76）。在性别分层分析中，偏好稳定性与为女性配偶提供社会支持（OR：0.53，95% CI：0.34–0.82）和为男性分居子女提供社会支持（OR：1.72，95%）之间存在显着关联CI：1.16-2.55）被观察到。结论 家庭社会支持与偏好的稳定性相关，并且这种关联因支持资源和性别而异。