Abstract
Purpose : The present study was undertaken to identify the types of intervention that would help the elderly and the family members improve their self-care agency and continue home care even under unfavorable circumstances to receive home care aid. To this end, factors of unfavorable circumstances and optimal methods of intervention under that circumstances were analyzed. Subjects and Methods : The subjects were 8 elderly clients receiving care under unfavorable circumstances, and their family members and caregiver (visiting nurses and home helper). Their cases were reported at the session from 2001 through 2003 in the visiting nurses' conference in K Prefecture. We extracted descriptions pertaining the unfavorable circumstances and the improvement of self-care agency and intervention, and made a qualitative analysis of them. Results and Discussion: Factors of unfavorable circumstances identified in this study were "deteriorated mental functioning," "deteriorated of family relationships," "disturbed rhythms of daily life," "difficulties of building the relationships necessary for receiving support," "the fragile basis of daily life" and "uncontrollable sickness." Also the interventions that gained the improved results of self-care agency were "building trust," "expressing emotions," "improvement of their organization's activities," "adjustment," "listening," "sympathy," "acceptance," "devotion," "guaranteeing patient peace of mind and safety," "getting involved," "remaining involved," "clinical judgment," "willingness to take chances," "keeping distance," "approving," "environmental adjustments." Improvement in self-care agency was seen in 7 of the 8 cases. One possible factor responsible for failure to make improvement in self-care agency was inadequate adjustment of family relationships. Improvement in self-care agency observed in this study was often difficult to recognize in terms of simple numerical improvements from the viewpoint of enhancing outcome. Detailed analyses as to the improvement of self-care agency and the methods of intervention by examining individual cases will be effective in identifying the optimal methods of provide support to the elderly and the family members who are under unfavorable circumstances to receive home care.
