Original Article
What’s Needed in at-home Services?
—An Analysis of Family Care Burden—
2007 Volume 19 Issue 1 Pages 21-35
Details
2007 Volume 19 Issue 1 Pages 21-35
Objective : The aim of this paper is to estimate family care burden that is not lessened by the present at-home services to clarify at-home services to be supplied in the future and to get the impartial standard of nursing home placement.
Methods : Our subjects are 725 families that include the impaired elderly and at least another person in two cities in Chugoku Prefecture. There could be many causes for care burden. However, if the family can use enough care services to meet each burden cause，the causes won’t result in care burden. For example, if a family，including an impaired elderly person who needs night care，can use enough service to meet night care, there should be no difference in the care burden between caregivers whose impaired relatives need night care and those whose impaired relatives do not. So, we regressed the measure of care burden on various care burden causes. We used the Japanese version of the Zarit Caregiver Burden Interview（ZBI）as the measure of care burden.
Results : The following numbers are ZBI scores. The care burden causes that is not lessened enough by the present at-home services were restricted usage of short-stay in the cases where behavioral problem was severe（14.9）, night care（7.1）, bad relationships between the caregivers and the impaired elderly（5.4 - 15.8）, caregiver’s self-symptoms（2.3 per one）, housekeeping（4.6）. Those who very likely get worse suddenly increased the ZBI score by 9.4 points. Bur if the preparation for a doctor’s visit for such emergencies was completed, the score was 1.8. The scores were higher in the cases where either dementia or physical disability was severe. Sub caregivers decreased the scores by 1.7 per person.
Conclusion : The care burden causes that couldn't be dealt with the present at-home services were various. The new services that could deal with those causes are needed. We can calculate family care burdens by each status and use them as the impartial standard of nursing home placement.
