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Author: Aki Morita, Psy.D.

森田　亜紀, Psy.D. 臨床心理学博士・グリーフケアスペシャリスト 兵庫県出身。大阪の一部上場企業で３年勤めた後、1990年渡米。日本語教師を経て、2000年ニューヨーク州コロンビア大学・ティーチャーズカレッジカウンセリング学科修士、2007年ロングアイランド大学臨床心理学科博士過程修了。同州ベルビュー病院で２年のエクスターン修了、ロングアイランド・ジューイッシュ・メディカルセンタ（現：ノースショア・ロングアイランド・ジューイッシュ・ヘルスシステム）にてインターン修了。2007年から２年間ノースキャロライナ州、カリフォルニア州で全寮制の教育施設で行動療法コーチ、クリニカルディレクターを務める。2009年にハワイに移住し、ハワイ東海インターナショナルカレッジのカウンセラーを経て、2012年から2019年までホスピスハワイにて遺族ケアコーディネーターとして終末期医療のグリーフケアに関わる、2019年夏帰国。現在横浜を拠点に国内外で講演・教育・執筆活動を精力的にこなす。 Aki Morita, Psy.D. Clinical Psychologist Grief Care Specialist Dr. Morita was born and raised in Hyogo, Japan. After having to work at an international corporation in Osaka for three years, she relocated to the United States in 1990. For years, she has taught multiple levels of Japanese language courses for business executives and others. She received a Masters Degree (M.A.) from Columbia University, Teachers College (New York) in Counseling in 2000 and a Doctoral Degree (Ph.D.) from Long Island University (New York) in Clinical Psychology in 2007. She successfully completed a two-year externship from Bellevue Hospital and an internship at Long Island Medical Jewish Center. Between 2007-2009 she worked with children with behavioral and health issues in North Carolina and California. She moved to Hawaii in 2010 and worked at Hawaii Tokai International College as a counselor. In 2012 she assumed a position as a Bereavement Coordinator at Hospice Hawaii and provided grief care for patients and families as well as those who were bereaved in the community. She returned to Japan on 2019. She is currently completing her manuscript for her first book entitled “The Miracle of Saying Goodbye” while publishing, teaching and lecturing in the United States, Europe and Japan.
December 21, 2019 ~ Dr. Junji B. Machi’s “Junior-Senior Christmas Celebration” (Tokyo, Japan)

December 21, 2019 ~ Dr. Junji B. Machi’s “Junior-Senior Christmas Celebration” (Tokyo, Japan)

JrSrは国際水準の日本の医学教育を目指して日米で教育活動をされています。ハワイ大学のDr.町が中心となり、ハワイ・日本でのサポーターが１２月２１日都内のイタリアンレストランに集まりました。私も微力ながら、２０２０年は医学生のOpen Cross Classの講師を努めさせていただきます。

Dr. Junji B. Machi’s “Junior-Senior Christmas Celebration” gathered on December 21, 2019 at a restaurant in Tokyo, Japan. Everyone in attendance cheered enthusiastically in support of plans to grow the “Hawaii Medical Education Program” begun by Dr. Machi at the University of Hawaii. Dr. Machi was recognized as the driving force for bringing American medical training and experience to Japanese medical students and schools. Dr. Machi has tirelessly dedicated his time and energy to expand his reach for more Japanese Medical Schools to join his program.

Dr. Morita has been asked and has graciously accepted the honor and privilege of lecturing to his medical students in Japan in 2020.

December 21, 2019 ~ Co-Presented Class with Professor Noriko Satoh at Jikei University School of Nursing (Tokyo, Japan)

December 21, 2019 ~ Co-Presented Class with Professor Noriko Satoh at Jikei University School of Nursing (Tokyo, Japan)

  

東京慈恵会医科大学看護学科の佐藤紀子先生の大学院生の方々のシンポジアムにお邪魔しました。佐藤先生の教え子でもあり、ハワイでも看護の臨床・教育で活躍されている飯室千恵子さんがシンポジアムでお話をするというのでついて行ったのですが、せっかくの機会だということで自己紹介も兼ねて私もアメリカのホスピスケアについてお話しさせていただきました。シンポジアムは看護の分野ではない私にでも興味深いもので、大変勉強になりました。日本の看護師さんたちはとても勉強熱心です！

Dr. Morita visited with Professor Noriko Satoh at The Jikei University School of Nursing and joined a symposium with Professor Satoh’s graduate students on December 21, 2019. One of Dr. Morita’s friends, Chieko Iimuro, RN, works as a nurse in Hawaii. As one of Professor Satoh’s former students, Ms. Iimuro was asked to speak at the symposium on the topic of nursing education in the United States. She kindly invited Dr. Morita to join them and share Dr. Morita’s professional training and experience with hospice care in Honolulu, Hawaii. The content of the symposium was extremely informative and each student worked hard on their presentations. Dr. Morita sincerely thanks Professor Satoh, Chieko Iimuro, RN, and the graduate students for allowing her to participate in their class.

December 11, 2019 ~ Lecture Presentation and Workshop ~ Japanese Red Cross College of Nursing (Tokyo, Japan)

December 11, 2019 ~ Lecture Presentation and Workshop ~ Japanese Red Cross College of Nursing (Tokyo, Japan)

日本赤十字看護大学にお邪魔して大学院生の方々１０名ほど対象にグリーフケアについて講演・ワークショップを行ってきました。３月にロッテルダムのA C P学会でお会いした守田先生（現・学長）、吉田先生、住谷先生に久しぶりにお会いし、懐かしい思い出に花を咲かせました。１時間の講演と、２時間のワークショップは参加者の方に活発にご参加いただき、大変充実した１日となりました。

Dr. Morita presented a lecture and workshop to graduate nursing students at the Japanese Red Cross College of Nursing in Tokyo, Japan. Dr. Morita first met current President Morita, Professor Yoshida and Ms. Sumitani at the Advanced Care Planning (ACP) Conference in Rotterdam, The Netherlands in March 2019. She was delighted at the opportunity for a reunion with them in Japan. Dr. Morita’s the three-hour seminar (one-hour lecture followed by a two-hour workshop) opened up participants to a process of self-discovery, personal insights and suggestions regarding grief care at their workplace.

September 14 & 15, 2019 ~ Presentation at the 3rd Annual Conference of Japanese End-of-Life Care Association (Nagoya, Japan)

September 14 & 15, 2019 ~ Presentation at the 3rd Annual Conference of Japanese End-of-Life Care Association (Nagoya, Japan)

日本エンドオブライフケア学会で「エンドオブディスカッションから始まるQOD」という演題で事例を発表しました。様々な職種の方が約800名ほど集まり、研究・事例・ポスター発表などに取り組みました。日本で学会発表は初めてでしたが、現場や学術の場で活躍される方々から生のお話が聞けたことは大きな実となりました。

Dr. Morita presented a lecture entitled “QOD (Quality of Death”) Begins with End-of-Life Discussion” which included a case analysis. There were nearly 800 participants representing different disciplines who shared their experiences, research and challenges. Dr. Morita found it to be a wonderful opportunity to share her experience with Hospice care in the United States as well as learn about end-of-life care protocols in Japan. These cross-cultural programs are extremely important to Dr. Morita in demonstrating the need to introduce innovative End-of-Life protocols to Japan’s healthcare service providers.

August 25, 2019 ~ Advance Care Planning at End of Life in the United States and Japan (Japanese Medical Management Institute) (Tokyo, Japan

August 25, 2019 ~ Advance Care Planning at End of Life in the United States and Japan (Japanese Medical Management Institute) (Tokyo, Japan

日本医療経営研究所主催の総合診断能力養成塾にお招きいただきました。

様々なご専門のお医者様にお集まりいただき、日本と米国の意思決定支援事情についてお話ししました。こうした少人数の学びの場に伺うのは、お一人お一人の顔を見ながらご意見やご感想などを伺うことができるので、こちらが学ぶものも多くとても贅沢な時間を過ごさせていただきました。

In Tokyo Dr. Morita addressed a group of medical doctors of various specialties and disciplines to review the topic of Advance Care Planning (ACP) at end-of-life as it is approached in the United States compared to Japan. It was an afternoon filled with compassionate, interactive discussion and learning. Dr. Morita observed that the topic of end-of-life care is rarely addressed in the medical educational protocols in either the United States or Japan.  These doctors in attendance were especially interested in how this conversation can be approached with humanity and compassionate awareness into their daily practice.

August 22, 2019 ~ Comparative Advance Care Planning (ACP) Between the United States and Japan (Shige Prefecture University Lecture and Workshop) (Hikone, Japan)

August 22, 2019 ~ Comparative Advance Care Planning (ACP) Between the United States and Japan (Shige Prefecture University Lecture and Workshop) (Hikone, Japan)

滋賀県立大学は彦根城に近い、穏やかな町の中にキャンパスがあります。駅からバスでキャンパスに向かうのも観光めぐり気分でした。たくさんの方々にお集まりいただき、米国と日本のエンドオブライフの意思決定支援についてお話しさせていただきました。その後のワークショップでは大学院生の方々中心に参加いただき、実際にロールプライなどを使ってACPを導入する会話を練習しました。時間が足りず急ぎ足で駆け抜けたのが残念でしたが、みなさん様々な気づきを持たれたようでした。

 

Shiga Prefecture University is located near the historic Hikone castle. The bus ride from Hikone station takes one through picturesque Jokamachi, a quiet castle town. Shige University faculty members, community nurses, and graduate students attended a workshop that discussed ACP practice in the United States as compared to Japan. In addition to Dr. Morita’s lecture, there was also a role play exercise which allowed participants to experience what it might be like to have ACP conversation with one of their patients. They were also required to experience the conversation from the patients’ point of view and how to approach these difficult but necessary conversations. The day concluded with many feeling that they finally understood the necessary yet emotional impact of such a patient-caregiver dialogue.

August 21, 2019 ~ Grief Care for Nurses (Osaka Prefecture University) (Osaka, Japan)

August 21, 2019 ~ Grief Care for Nurses (Osaka Prefecture University) (Osaka, Japan)

大阪府立大学からお招きを受け医療関係者・看護大学院生の方々向けにグリーフケアについての講義とワークショップをする機会をいただきました。グリーフケアという言葉は医療の場ではまだ馴染みがありませんが、大切な人が重篤な病気になるということは、患者ご本人、そのご家族、医療提供者までもが失うものに対するグリーフを体験しているといっても過言ではありません。ロールプレイなども交え、グリーフについての理解を深め、看護師としてのスキルアップを目指しました。みなさん熱心に取り組まれ、いい質問も飛び交い、有意義な1日となりました。

Dr. Morita’s lecture was sponsored by Osaka Prefecture University and focused on the topic of grief care for community nurses and graduate nursing students. Dr. Morita observed that most medical professionals in Japan as well as the United States are not trained in “grief care” and how grief can affect them as well as their patients and families. By the end of the day, all of the participants enjoyed an active learning process and acquired skills that could be translated into their workplace routines. Dr. Morita was overjoyed to work with such an enthusiastic and empathetic group of nurses!

June 17 -21, 2019 ~ Advanced Grief Care Training for Complicated Grief (Sponsored by the Portland Institute for Loss and Transition) (Portland, Oregon)

June 17 -21, 2019 ~ Advanced Grief Care Training for Complicated Grief (Sponsored by the Portland Institute for Loss and Transition) (Portland, Oregon)

Portland Summer Institute

6月17日から２１日までポートランドインスティチュート主催のワークショップがオレゴン州ポートランドで開催され、グリーフケアにおいては第一人者であるロバート・ニーマイヤー教授をはじめとし、エド・ライニアソン教授、ロリー・バーク教授、ダーシー・ハリス教授などがそれぞれの研究や臨床事例などを発表しました。約８０名の参加者は米国のみならず、ヨーロッパやアジアからも集まり、複雑性悲嘆、医療従事者のためのセルフケア、子供の悲嘆、終末期のケアにおける倫理、など幅の広いトピックが紹介されました。

This Inaugural Summer Institute sponsored by the Portland Institute for Loss and Transition was held June 17-21 in Portland, Oregon. Featured speakers included the noted expert in the field of complicated grief, Dr. Robert Neimeyer, as well as a distinguished panel of co-presenters including Dr. Ed Rynearson, Dr. Laurie Burke and Dr. Darcy Harris. Nearly 80 participants from across the United States, Europe and Asia attended thought provoking lectures and workshops such as Complicated Spiritual Grief, Healing the Healer Workshop, Child and Adolescent Bereavement, Loss Epicenters in Life, Ethical Imperative to Discuss End-of-Life, and many other topics related to grief, spiritual care, restorative retelling and attachment-informed interventions.

April 11-13, 2019 ~ ADEC (“Association for Death Education and Counseling”) Annual Conference (Atlanta, Georgia (USA)).

April 11-13, 2019 ~ ADEC (“Association for Death Education and Counseling”) Annual Conference (Atlanta, Georgia (USA)).

4月11日から13日まで米国ジョージア州アトランタ市にてAssociation for Death Education and Counseling (ADEC)の年次学会があり、ACP(人生会議)の重要性について、ホスピスでの事例と共に発表してきました。さまざまな理由で最期は病院で蘇生を望んでいた患者がカウンセリングを通じて、自分の中の、消化されていなかった過去の悲嘆と向き合い、家族との絆を深めたことで、最終的に本来望んでいた”蘇生はせず、自然の摂理にまかせて家で家族に囲まれて死ぬ”ということを叶えることができた例です。意思決定ではただ決めたことを記録しておくだけではなく、決定に至るまでの過程にどう寄り添うかということが大切であり、他のACP研究や、グリープ理論、家族への介入法などに焦点を当てて、発表しました。いい質問やコメントを頂き、さらにディスカッションが膨らみ、充実したプレゼンテーションとなりました。

 

Dr. Morita presented a lecture entitled “Whole Person Approach to EOL Discussion: What is Most Important to You?” Dr. Morita shared a case which represented a patient’s ambivalence in making end-of -life decisions. Through counseling, she worked through her multiple losses in her life, resolved family conflicts and reconnected with her sons. At the end, the patient and family engaged in a meaningful meeting and expressed affection and gratitude. It was the goal of the patient to make sure that her sons will continue family traditions together. End-of-life discussions are key elements in increasing QOL (“Quality of Life”) and QOD (“Quality of Death”) of patients and their families in the area of emotional and spiritual care.

March 13 – 16, 2019 “Who is in Control? Cultural and Institutional Barriers to EOL (“End of Life”) Decisions in Japan and the United States.” (7th Annual International Advance Care Planning Conference (ACP-I)) (Rotterdam, The Netherlands)

March 13 – 16, 2019 “Who is in Control? Cultural and Institutional Barriers to EOL (“End of Life”) Decisions in Japan and the United States.” (7th Annual International Advance Care Planning Conference (ACP-I)) (Rotterdam, The Netherlands)

  

第７回ACP―I（国際アドバンスケアプランニング）学会にて日本と米国における終末期の意思決定の課題について、文化、医療制度の観点から発表しました。日本・米国共に高度な医学の恩恵を受けていつつも、終末期のケアの質ということに関しては、様々な課題を抱えています。日本ではACPを記入している人が8.1%しかおらず、終末期においてもどのようなケアを希望しているのかという会話が医療現場で交わされていないというのが現実です。今後市民活動や医療従事者に対する情報の提供、研修のあり方を課題として挙げました。

Dr. Morita addressed an international body of physicians, scholars and researchers on how the healthcare systems in America and Japan manage or fail to manage adequately patients’ end-of-life issues. Her presentation identified an array of cross-cultural factors that may interject themselves into a patient’s end-of-life care and how those factors can impede and at times, even prevent, the patient from achieving their desired quality of end-of-life care. The interplay of cultural versus institutional factors in the vastly different American and Japanese societies oftentimes results in a terminal patient’s wishes going unheard or unacknowledged. Thus, Dr. Morita provided a framework for recognizing the importance of EOL (“End of Life”) discussions and how that conversation is an essential part of providing quality care to the dying patient.