Ethnographic study of a good death among elderly Japanese Americans.

Most humans desire a good death, but the nursing literature on culture-specific responses to older life, especially on issues of death and dying among Japanese Americans, is still limited. The pattern of beliefs about a good death held by elderly Japanese Americans living in Hawaii was explored. A qualitative study using ethnography and in-depth interviewing was employed. Eighteen healthy and active elderly participants were interviewed, and data analyzed using ethnography to extract categories and themes, and four supplementary interviews with experts were held for triangulation of the data. Four themes emerged, however, in this paper, the predominate one, not being a burden to family, was discussed. The participants believed burdening someone in their culture has an extremely negative implication. Sufficient preparation for older life and death, family support, friends support, and finance were their strategies to avoid being a burden. Nurses need to understand that the concept of good death is unique to every culture. Such knowledge will help them to plan and provide appropriate end-of-life care, and will reduce the risk of living wills being ignored.

Concept analysis of good death in the Japanese community.

PURPOSE: To describe the meaning of a good death in the Japanese community. ORGANIZING FRAMEWORK: Rogers's (2000) concept analysis strategy. METHODS: A review of the literature was done in March 2004, with a focus on older adults' experiences of good death in the Japanese community; "good death" was the subject heading or key words; and literature was published in English or Japanese. FINDINGS: Attributes of a good death include sociocultural norms, personal experiences, and continuous process. The person's experience of dying, the social context, the patient's autonomy and control over the dying process, and quality of end-of-life health care are the consequences of the concept. When good death occurs, it leads to family satisfaction, positive bereavement process, and work satisfaction for healthcare professionals. CONCLUSIONS: Integration of findings from the concept analysis and field research results in more accurate understanding of good death. Knowing the individual concept of good death enables nurses to provide culturally competent care to achieve an optimum death experience for both patients and families.