We conducted a survey of syllabuses of Japanese medical and nursing schools to develop a comprehensive educational program to teach undergraduates of Japanese medical and nursing schools about end-of-life care for the elderly.In addition to the program we developed with the present survey, teaching about ageism and the definition of the end of life of the elderly is necessary.The present survey suggested the importance of teaching about the quality of life of the elderly, including the items of comprehensive geriatric assessment.

1) We performed a pilot study using surveys before and after the completion of an education program we developed. The subjects of this study were the staff of a geriatric health services facility in Nagoya City.2) Although the degree of confidence in providing end-of-life care and attitudes towards death did not change significantly, the attitudes of staff towards providing end-of-life care did change significantly.3) This pilot study demonstrates that an educational program on end-of-life care at long-term care facilities can improve the attitudes of staff toward end-of-life care. This study constitutes an important step toward improving education in end-of-life care for the staff long-term care facilities.

AIM: gradual shift, from hospitals to long-term care facilities, in where elderly people spend their last years is expected in Japan.Therefore, we performed a questionnaire survey to assess the opinions of directors of long-term care facilities about end-of-life care and director education.
METHODS: In December 2006, data were collected through mailed, anonymous, and self-administered questionnaires. The subjects of this study were managing directors of 214 long-term care facilities in Nagoya City. Our questionnaire survey focused on the directors' attitudes about the following end-of-life issues: 1) requirements for implementing progressive policies for end-of-life care, and 2) educational training for end-of-life care. For data analysis, we divided the facilities into three groups: geriatric hospitals, geriatric health services facilities, and nursing homes.
RESULTS: Directors of 82 facilities returned completed questionnaires (response rate, 38.3%). They regarded staff education concerning end-of-life care, outside medical support, private rooms for end-of-life care, and 24-hour availability of physicians or nurse as requirements for quality end-of-life care at long-term care facilities. Nursing-home directors felt more strongly about the need for 24-hour medical services for end-of-life care than did directors of other types of facilities.Also, most directors wanted to receive additional training about clients' decision-making processes, communi-cation skills, and legal issues related to end-of-life care.
CONCLUSIONS: Our results suggest that staff education concerning end-of-life care and 24-hour medical services are required for quality end-of-life care at long-term care facilities for the elderly.

We conducted a questionnaire survey of attitudes about cancer disclosure, brain death, and organ transplantation among fifth-year medical students at Nagoya University from 2001 through 2003. Their attitudes about these topics did not change markedly during the period. Most students favored receiving information about their own diagnosis of cancer, but significantly fewer students favored informing their parents about their diagnosis. Students did not have a strong interest in brain death or organ transplantation. Less than 30% of students possessed donor cards. This survey indicates that attitudes about cancer disclosure, brain death, and organ transplantation among Japanese medical students remain different from those among Western medical students. Instruction designed to address these differences may be beneficial.