Objective: This study aimed to investigate problems associated with aging of patients with higher brain dysfunction. Materials and Methods: This study investigated the role of age on the outcomes of patients with higher brain dysfunction who received in-hospital rehabilitation service at our hospital and were subsequently discharged, patient outcomes were assessed, by outpatient interview or questionnaire via mailed surveys. Results: Answers from 150 patients (115 males and 35 females; age 50-84, 10 years after onset) were obtained. Of the 59 patients having certified long-term care insurance, 50 patients were using long-term care insurance services. Moreover, 110 patients were certifiably mentally or physically disabled, and 34 patients were using the services of Services and Supports for Persons with Disabilities Act. 20 patients were working, 19 were using training and employment services, 7 were using visitation services (e.g., behavioral support and home care), and 4 were using daytime activities service (e.g., short-stay and life care). Of the 45 patients that were not using services, 15 progressed to dementia; their families ultimately wished to reduce their care burden. Conclusion: Long-term care insurance services were useful for aged patients; however, not available until the age of 65 except for cerebrovascular disease, so that not all patients with higher brain dysfunction had access to this insurance. Disability welfare services were essential for aged patients with higher brain disabilities to work and to reduce restrictions. Patients who were not using services had difficulties in daily life. The combined use of long-term care insurance services and disability welfare services, such as behavioral support and mobility support, is recommended. Review of the degree of care and disability classification is needed for patients who progress to dementia, to strengthen their support system.
https://ror.org/058s63h23 
