Study on Factors Affecting Prolonged Stay for The Aged Accommodated in Long-term Care Facilities from the Standpoint of Coordinating Relationship among the Family

Abstract

　　In Japan, long-term care facilities for the aged are general hospitals, hospitals for the aged, geriatric intermediate care facilities (GICFs), special nursing homes (for those needing activities of daily living assistance) and so on. GICFs were introduced for the hospitalized disable elderly to be adapted to the home-care program by rehabilitation and activity programs.

　　Recently, in spite of the original institutional object, a number of cases with prolonged stay in general hospitals, hospitals for the aged and GICFs has increased. In this paper, 72 males and 216 females in 3 GICFs, and 175 males and 346 females in 3 hospitals for the aged, staying more than 3 months were investigated to analyze the factors affecting the prolonged stay.

　　Conclusion are as follows;

　　1. Care-givers not having desires to take care of the aged prolonged stay at GICFs increased more than those at hospitals, because of tiredness for home-care. For supporting home-care, it is very necessary readily to re-enter in GICFs for the aged, and to coordinate psychological assistance for care-givers.

　　2. For adequate home-care management, coordinators in GICFs are expected to arranged the social resources according to the situation of each family for quality assurance, in the long-term care services.

　　3. Many care-givers could be characterized as displeased to take care of the inmate with “hopeless condition to get better”. Reasons to prolong stay in hospitals are not only to feel anxiety to relapse and to be disability for care-giving in home-care, but also not to enter easily in special nursing homes, to bear the expenses in special nursing homes more than in hospitals according to circumstances, and to keep up appearances for each family.

　　4. As analyzed by the type of facility, coordinators in hospitals tended to advise to enter in special nursing homes more, and the inmate and their family wanted to stay at hospitals more.

　　In order to fulfill the faculty of GICF, a function of coordinating the human relationship among the family, and providing psychological assistance for the care-giver is very important. Still more it is necessary to evaluate and to improve home care management, and functionally parts in long-term care facilities.