Background
In Japan, which is becoming a high-mortality society in addition to a super-aging society, the establishment of a suitable residence for older people to spend their last days is an urgent concern. In a home type hospice, which is a residence wherein home care services are provided and covered under nursing insurance, 5-6 individuals live together. Although home type hospices are expected to play an important role in the future as one of the residential options for patients to spend the terminal stage of their life, no study has assessed the actual living conditions and physical characteristics of home type hospices.
Reserch Objectives
By understanding the actual environment, such as resident attributes and nursing care provision system, this study aimed to clarify the characteristics of home hospices, which primarily utilize existing residences.
Research Methods
The target residences were 28 business establishments and 37 buildings in Japan, which were certified by the Japan Home Hospice Association. Surveys were conducted through interviews with the administrator of each business establishment.
Conclusion
1. There are age limitations for moving elderly people to facilities and residences providing home care services. However, home type hospices accept residents regardless of their age. While the majority of the residents are aged >80 years, there are some residents aged <60 years. 2. If we assess the reason and duration of occupancy of such facilities on the basis of disease type, cancer-centric home type hospices mostly accept patients in need of medical care, and most residents remain in the facility for a short duration, usually <1 year. These facilities provide hospice care for patients in the terminal stage of their life. Dementia-centric home hospices support patients with severe dementia. It is believed that these houses complement the insufficiency of facilities in different regions and the variety in the levels of care that is provided. Complex home hospices mostly accept patients in need of medical care and who could not live at their own residence. Thus, home hospices may accept residents regardless of the patient’s age and disease type, including older people and those with malignant diseases, respectively. In addition, these facilities function as a safety net for patients with severe conditions, who are difficult to deal with in the existing system . 3. Apart from home type hospices, there were 25 business establishments that were serving as home-visit nursing agencies, accounting for approximately 90% of the surveyed facilities. Cooperation between resident staff, which is responsible for providing daily living support, and home-visit nursing agencies is necessary to provide continuous support before moving patients. Therefore, in many cases, home-visit nursing was provided in the business establishments. 4. Renovation of buildings could be classified into four types, namely “improvement in building performance, ” “improvement in accessibility, ” “space expansion, ” and “barrier-free design.” Increase in the number of bathrooms/washrooms and toilets as well as renovation to accommodate wheelchairs were the most common. To utilize existing buildings as home type hospices, emphasis should be particularly given to the barrier-free design of plumbing fixtures. 5. Introduction through acquaintances was the most common method of property selection. It tended to reflect a higher level of connection and recognition with the local residents. This must be because of the owner’s connection with the region, which is shared with the new property owner.
