2004 Volume 59 Issue 1 Pages 1-25
This paper examines the gap between the reality and ideal conditions when entering a nursing home by analyzing a questionnaire's results and explores the criterion of location in selecting a home. Recently, the aging of Japan's population has become a serious problem. In particular, the necessity to provide long-term care for the elderly has rapidly grown more urgent. This social change prompted the introduction of the "Long-term Care Insurance System" in April 2000. This new system of delivering various services to the elderly has increased the demand for institutional care rather than domiciliary care because of the pricing structure. According to previous studies, nursing homes, which represent a typical service of institutional care, have serious regional disparities in location among the municipalities. Furthermore, these studies showed that demand tends to concentrate on entering a nursing home located near one's original home. This paper aims to grasp the demand of residents and their families for nursing homes directly through a questionnaire distributed in the Tono planned area for the promotion of services, Gifu Prefecture, Japan. The results of the questionnaire are summarized as follows : About one third of the residents of nursing homes had lived with their on's family, while one third of them had lived alone or with only their elderly spouse who had less power to take care of hemselves at home. Many residents had utilized services for the elderly before entering a nursing home. About 80% of them utilized institutional care (other than the nursing home) and about 70% of them utilized domiciliary care. The residents who had no experience of using either of them were very exceptional. Children (and their spouses) of the residents are the dominant persons in selecting the nursing home where residents currently live. The reasons why residents had entered nursing homes tended to be passive ; for example, they included "accepting a suggestion by the administrative officers to enter the nursing home" and "being able to enter a nursing home as soon as possible". These reasons are caused by the strong demand to quickly enter a nursing home and the mental pressure imposed by the care by family at home, which can be very troublesome. Although there is the passive tendency, proximity to the home where a resident had lived previously was the dominant reason among various reasons for selecting an institution. In contrast, the ideal method of selecting a nursing home reported by the respondents of this questionnaire, imagining that they themselves were going to enter an institution, was to consider the factors related to quality of life in a nursing home. These factors include, for example, pleasant personalities of the care staff and a private room that can maintain one's privacy. Clearly there is a gap between the actual factors that influenced the residents who had already entered a nursing home and the ideal factors considered by the respondents of this questionnaire imagining if they were to enter a nursing home in the future. This gap is caused by the shortage of information about each nursing home and the number of beds, which results in a long waiting list. Although there is a gap between the reality and ideal conditions in entering a nursing home, the desire for proximity to one's original home is a common important factor for both actual residents the respondents who are just imaging a future ideal. Accordingly, these results of the questionnaire suggest that it is necessary for administration (central and local govemment) to be assiduous in building nursing homes such a way as in order to avoid regional disparities, especially among municipalities.
