Providing Older Adults who Have Difficulty Self-Managing Insulin Therapy with Necessary Support to Continue Living at Home: Home-Visit Nurses’ Perspectives

Abstract

This study investigated home-visit nurses’ perceptions of the circumstances under which older adults undergoing insulin therapy have difficulty with self-management and the support they require. The respondents were also asked to suggest ideas for multidisciplinary cooperation in home care. A free-form questionnaire survey was conducted.

Home-visit nurses identified the following signs of difficulties with self-management: direct management problems, such as the inability to handle insulin injection; hypoglycemia; sick days; changes in sensory and cognitive functions due to aging; declines in fine motor skills; changes in health status and daily activities; and difficulties in establishing a support system. In addition, respondents reported difficulties in establishing support systems. In terms of necessary support, nurses advised the provision of extensive self-management support through home-visit nursing and the creation of further support through cooperation with physicians, family members, other medical institutions, and home care service personnel. The limitations of the current long-term care and medical insurance systems in supporting insulin therapy, the need to expand support, and expectations for the development of support tools and social resources are also discussed.