Abstract
Objectives : This study investigates current conditions and problems regarding health care provision for residents of group homes (GH) for elders with dementia, staff responses to changes in residents' medical conditions or accidents, and nursing systems. Methods : Survey questionnaires were mailed to 442 GH facilities in Kanagawa prefecture, Japan. Results : We collected survey questionnaires from 175 facilities (response rate, 39.6%). More than 70% of the facilities had residents who needed regular visits to physicians or physician home visits. Regarding daily medical treatments in GHs, 49.7% of the facilities provided dermatological treatments, and 19.4% of the facilities offered enema or stool extraction. In the previous three months, there were about 460 cases of changes in medical conditions or accidents, and 76 facilities (43.4%) requested ambulance transport. There were 65 facilities (37.2%) that had nursing staff, and 80 facilities (45.7%) used reimbursement for medical coordination systems. Facilities that used reimbursement for medical coordination systems to contract with visiting nurse stations comprised 14 facilities. The following were found as effects of visiting nurse services: improvement in responses to medical care needs, and availability for consultation when assessing symptoms. A problem to be addressed concerned the occasional differences between nurse and physicians judgments, which resulted in confusion. Discussion : While GH resident needs for medical and nursing care were assumed to be high, less than half of the facilities used reimbursement for medical coordination systems. This suggests that GHs should seek adequate nursing services through medical coordination systems.
