Ideal Environment for the End of Life on Remote Island with its High Home Death Rate in Japan: The Narratives of Nine Men

Among Japanese people, 51.0% hope for a home death, but 69.9% of people died in a medical institution in 2020. In the isolated island town of Yoron, the proportion of home deaths was 40.0%. This study aimed to clarify the hopes and social barriers for the final environment of men in Yoron Town and to consider the final support system at the time home-visit care services began. Interviews were conducted with nine men, and data were analyzed by the thematic analysis method. The findings indicated that all subjects from Yoron wanted home death because they took for granted that they would be taken care by family members—especially daughters-in-law—rather than using care services, and they wanted to be watched over by ancestors and relatives at home. Furthermore, they worried about financial strain on the town by using care services. However, this sense of value about family among these residents became a barrier to realizing their hope for home death because roles based on gender and blood relationships are changing. Yoron Town pays 12.5% of the total expenditure for long-term care insurance, with the remainder covered by national and prefectural governments. If residents use long-term care insurance services rather than relying on family care, expenditures from the national and prefectural governments will increase. Currently, a community-based integrated care system is functioning with families’ care and long-term care insurance services. To realize home death, awareness must be raised about the financial system of the long-term care insurance system.