As post-war baby boomers reach old age, Japan is becoming a super aged society. Under these circumstances, the country's policy on welfare for the elderly has shifted toward the support of home- and community-based alternatives to nursing-home placement. Improving the home care environment is very important for family caregivers in order to lighten their burden.
The condition of a home environment affects its residents' quality of living. This study focused on the odors of elder care environments, as odors are one of the most important issues in long-term care environments. However, in home care for elderly people, insufficient data exists on evaluations of long-term care environments. The aim of this report is to clarify the actual condition of home care and how caregivers evaluate the care environment.
From December 2010 to January 2011, we conducted a questionnaire survey of caregivers living together with elderly who use long-term care insurance. Participants were 343 caregivers. The questionnaire was constructed with the basic attributes of the elderly and caregiver, care level and activities of daily living of the elderly person, care burden, odorous environments of the house, condition of the house, subjective evaluations of odors in the home care environment, and so forth.
The results were as follows;
1) Nearly 40% of the caregivers were daughters of the elderly; 30% were daughters-in-law. More than 70% of the elderly were over 80years old, and 28% were certified as care level 4 or 5, which means they require substantial care or support in daily life. A total of 52% of the caregivers cared for the elderly without any support from other family members. Despite various services being available, most elderly people used only day services.
2) Irrespective of the care level, home care for the elderly was a burden to the caregiver. Over 60% of the caregivers thought that it was difficult to contact their friends, maintain their social life, and invite people home.
3) Among “the evaluation of residence as the care environment, ” the items caregivers were the most dissatisfied with were, in order, “many steps within the house, ” “ease of using bath, ” and, fourth, “the odors in the home.” Regarding the state of the elderly individual's room for the caregiver, the rate of dissatisfaction with the odor in the room was the highest.
4) Excreta had the strongest and most unpleasant odor of all odors emitted in the home. A higher level of odor discomfort came from, in order, garbage, drainage, mold, and the body odor of the elderly (including hair, sweat, and bad breath). The odor intensity of excreta is related to the levels of certified care needed.
5) Caregivers considered that urine, feces, and body odors were problematic in the care environment. The higher the care level became, the stronger the odors. Persons with higher care levels have low independence in excreta; this means that they have incontinence or use more portable toilets or diapers. A caregiver's consciousness of odor in the home was influenced by way of excreta.
This work was supported by JSPS KAKENHI Grant Number 22360244