Abstract
In this study, we investigate the approach regarding long-term nursing care adopted in Onomichi City, Hiroshima Prefecture, Japan. The approach is known as the "Onomichi Method" of geriatric care.
The Onomichi Method is based on the following premise: health care professionals including physicians have the common recognition that care conferences should be held to the extent possible, when an elderly person is judged to have a need for long-term care. Primary care physicians as well as hospital-based attending physicians in Onomichi are required not only to cooperate with the care manager in provision of information on the patient, but also to participate in care conferences with other professionals, if necessary. In order to make it easy for physicians to attend care conferences, care conferences are often held at the clinics or hospitals, rather than at care managers' offices.
In the process of diffusing the common recognition described above, workshops designed for educating people about the value of care conferences were carried out, and many professionals from various fields participated in these workshops. From early on, there was an awareness and sense of crisis regarding the rapidly growing percentage of the elderly population in the city. The percentage was forecasted to reach 25% when the Onomichi Medical Association created the Emergency Committee as early as in 1992.
To share the sense of crisis with other people, study sessions, lectures, and seminars on issues related to medical care and long-term nursing care have been held more than 60 times in the previous ten-year period. Thus care conference workshops have been able to attract many participants.
The Care Management Center belonging to the Onomichi Medical Association plays a central role in fostering care managers and hosting the workshops of care management. In addition, the Medical Association, four nursing care facilities for the elderly established by the Association, the local government, and various committees and councils support the system. As a result, this city has attained a high implementation rate of care conferences. The rate has exceeded 90%, which is difficult to find in other areas of Japan.
Furthermore, comprehensive elderly care practice is being pursued in the entire Onomichi area, which has come to be known as the "New Area Care" concept. We believe that this concept shows the future direction of elderly care in our country.
