A survey of multiple medical care requirements for persons with severe motor and intellectual disabilities in day-care service centers:

important problems and their solutions.

Abstract

We conducted a survey on the actual situation of multiple medical care requirements in persons suffering from severe motor and intellectual disabilities (SMID) in the day-care service centers of five Japanese hospitals or institutes consisting of four type A centers (15 beds with transportation) and one type B center (five beds without transportation) in 2009 and 2010. In the type A centers, more than 90% of SMID persons had markedly severe disabilities with Oshima scores of 1–4. Twenty percent of these persons required extremely intensive (or extensive) medical care; this included tube feeding assistance and/or frequent body position changes in approximately 70%, and ventilator care through tracheal tubes or the nasal airway in 12%. Disabled persons who were cared for in type B centers had less severe disabilities compared with type A centers. All the centers expressed difficulties in coordinating transportation of disabled persons to and from the centers as well as in manpower and facility equipment for accepting more SMID persons requiring extremely extensive medical care. It was also highlighted how a newly devised score for assessing the extremely intensive (or extensive) medical care group among SMID persons may not precisely reflect the level of dependence on care and assistance. These medical day-care services are very important for the welfare of SMID persons living at home, and therefore the government should prioritize the establishment of legislation to facilitate reliable and comprehensive day-care services.