Dying from Old Age (02:46)
A 93-year-old woman takes her last breath. New research explains physical changes that occur in the last months before death— scientists hope to ascertain whether people suffer. Quality of death is just as important as quality of life.
Roka Home (02:14)
The average age of residents is 90 and most suffer from dementia. Dr. Kozo Ishitobi witnessed over 200 resident deaths— feeding tubes and IVs are administered only at the request of family members. A caregiver moistens Haru's mouth with apple juice, because she stopped eating and drinking five days earlier.
Natural Death (02:03)
Haru died from the effects of old age and not a specific disease. In 2014, 75,000 deaths from old age were recorded. Dr. Ishitobi realized that the body has limits, and letting nature take its course is a better solution.
Adopting A New Policy (02:39)
Roka Home believes that death is part of the natural order. Eating habits change as death approaches; Ito Nakamura only eats pudding. Dr. Ishitobi does not believe in forcing patients to eat.
Pattern of Dying (04:12)
Studies find that the elderly stop eating one week before they die. Two years ago, Nakamura would eat everything on her plate, and still lose weight. Yoshiaki Kawakami found that despite a steady caloric intake, Body Mass Index (BMI) declines when individuals are close to death.
Physical Changes and Age (02:00)
At John Hopkins University, Neal Fedarko studies the mechanism of aging. When the villi in the small intestine shorten as a result of old age, the person becomes unable to absorb nutrition no matter how many calories they ingest.
Ito Nakamura's Health Declines (03:18)
Nakamura's family discusses whether they want life prolonging measures implemented. Takashi, her son, decides against treatment and spends time with his mother during her final days.
Nakamura's Death (02:33)
Nakamura starts taking large gasping breaths— a nurse tells Takashi she will be dying soon. Late in the afternoon, Nakamura passes away. Dr. Ishitobi comforts the family.
Processes of Dying Study Results (02:20)
In cancer victims, overall health stayed high until two months before death when there is a rapid decline. In people with organ failure, a decrease in overall health occurred each time the condition worsened. Death occurred slowly and gently in individuals who succumbed to old age.
Cellular Changes and Aging (02:35)
Fedarko studies how older cells divide less frequently than young cells and lose their shape. Older cells secrete cytokines which cause inflammation. Inflammaging is the rapid increase of inflammation as one approaches death.
American Geriatrics Society (02:35)
The society released a report stipulating that tube feeding should not be given to those afflicted with advanced dementia. Joseph Shega explains that feeding tubes do not impact how long a person lives. Shigeki Ikawa worries his mother Eiko feels pain.
Caring for Eiko (04:22)
Dr. Ishitobi explains that he can make adjustments to Eiko's care treatment at any time. Eiko began to require nursing care and moved in with Ikawa eight years ago. Eiko decided to cease life prolonging treatment and Ikawa moved her to Roka Home.
Consciousness of the Dying (02:46)
A recent study of 178 non-feeding tube patients determined that pain and discomfort decreases as death approaches. Alasdair MacLullich explains that this is a result of inflammation in the brain subduing its pain receptors.
Family Goodbyes (02:23)
A slow dying process gives family members time to prepare. Eiko receives a taste of ice cream and perks up at the sweetness. Her grandson Shinichi Ikawa returns from overseas and spends time with her.
Impending Death (02:55)
Ikawa remains at his mother's bedside. Her color has changed and her breathing is labored. Dr. Ishitobi prepares Ikawa for Eiko's death and explains that she is not in any pain.
Eiko's Death (02:48)
Eiko's blood pressure is low and Ikawa says goodbye to his mother. Eiko dies peacefully. Shinichi remembers his grandmother.
Accepting Death (03:28)
Keri Thomas explains that if individuals could acknowledge mortality, they would live better lives. At Roka Home, residents celebrate the Tanabata holiday. Ishitobi describes how his patients embrace death.
Credits: Seeking Quality of Death (00:54)
Credits: Seeking Quality of Death
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