International trends and directions of human sciences for health-social services were reviewed along with 4 mainstream. First is "consumer directed care", which was developed with the consideration to consumer's empowerment after the diffusion of managed care. Second is "evaluation of care management", which mentions several new models of evaluation. Third is "group living as a new life style", for expanding the opportunity to live in a community even for frail elderly. Forth is "new model of health-social information system", which includes evaluation system by itself. All trends are deeply related to the actual problem which has to be solved in this aging society. The role of human science of health-social services become more and more important to develop new concept or new methods with the futuristic outstanding.

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The Kaigo index composed of the involvement, difficulty, and necessity of the care given to the elderly and disabled was created for the evaluation of the actual care given. The health and social care workers at health and welfare institutions or communities in West Japan were surveyed with mail questionnaires with regard to the evaluation of 80 care works given to 1,208 disabled aged. We devised the Kaigo index to multiply the arithmetical average of involvement and necessity by the difficulty value of the care work calculated by the statistical analysis. It may be an available index in assessing, managing or planning the care to practice for the elderly and disabled. Various changes in score on the Kaigo index resulted from the occupational specialty of the care workers to the surroundings of the institute or community. The index of the care workers in special geriatric nursing homes was higher than that in geriatric convalescent hospitals. That of the care worker in special geriatric nursing homes bears a most striking correlation coefficient to that in geriatric convalescent hospitals and mainly indicate the support of care and housekeeping are main interventions. That of social workers was higher in the support of the information and in part was concerned in the care and housekeeping. That of the home helper was lower for the categories of housework and body care. It could demonstrated the correlation and specialty of the care works given by health and welfare workers. As the Kaigo index could be applied to the family care similarly, the assessment of the care was established by comparison of institute and home care with the Kaigo index in the same manner. The Kaigo index can be more available than the care categories for the care management and care planning for the individual lives of the elderly and disabled.

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The purpose of this study was to obtain basic data to determine the best ways of providing information on home welfare services to the elderly. For this purpose, we divided the individual levels of awareness among the elderly (over 65 years old) concerning home welfare services into two groups of "amount of available information" and "desire for gathering information", and we investigated the correlation between these types of awareness and individual attributes. The subjects were selected from 2,200 elderly (over 65 years old) living at home in five districts of Hokkaido. Valid responses were obtained from 1,611 people (57.5% men and 42.5% women; mean age, 72.8 years). The items of the survey were : gender, age, educational background, family composition, income, history of treatment at medical institutions, and availability of and desire for gathering information concerning home welfare services for the elderly. The X2-test and residual analysis were used for the statistical analysis. The results of analysis showed that the individual attributes of gender, age, family composition, educational background, income, and history of treatment at medical institutions were related to the awareness by the elderly of home welfare services. This indicates that reliance on only mass media is not sufficient for providing the elderly with information concerning home welfare services. A more individually oriented system for conveying information, based on demograhic factors, is needed.

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With a view to maintaining and improving QOL of those who receive treatment at home, a national medical plan for the disabled is to be established to promote health care services such as home help for patients with incurable disease. For the purpose of providing some help to such patients, our study attempted to identify medical and welfare problems facing them by analyzing a survey of 143 patients with Parkinson's disease in Japan. The result revealed that many of them suffer the progress of the disease as well as incidents of other ailments. It also became clear thet while a growing number of patients employ home helpers with progress of disease, the number of patients who desire visiting nurses shows a sharp rise at Stage 3 of the Hohen & Yahr severity scale. This study suggests that the following approaches be taken to cope with these problems : 1) Constructing at extensive, long-term health care management system for individual patients. 2) Enhancing expertise of home care assistants such as home helpers in health care and welfare so as to provide improved daily assistance through early detection of disease and adequate rehabilitation. 3) Reinforcing coopration among specialist sectors and promotiong social networks.

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The purpose of this study was to clarify the relations of psychosocial factors to the maintenance of physical functions by the length (2 years or 4 years) of the longitudinal research interval. The research was done in 1992, 1994, and 1996. The subjects were 586 elderly. They were living in the community, and had ability to walk independently. The elderly who had had more social curiosity (such as Reading newspapers, Reading books, or Having a hobby, etc.), or who had lived with independence (such as Improvement their life style, or Taking active attitude) had higher probability to maintain their physical functions significantly after controlled age, sex, and diseases. The number of psychosocial factors related to physical functions after 4-year interval was more than that after 2-year interval. However, the Hosmer-Lemeshow Goodness-of-Fit Test suggested that it was necessary to consider about selection of explanatory variables and their mutual interactions, and to add 'dependence' level of physical functions as a response variable in order to predict the maintenance of physical functions.

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Due to the increasing potential of health-social services, requirement of comprehensive information services have been stronger than before. Each managed care stages, to plan community health-social services and to make its decision to realize their own strategy by professional specialists, effectively and efficiently, strategic information systems is one of most important resources. Internet, which is one of ideal cyber space as digital-networked society, has been progressed dramatically. The purpose of this study was to clarify the potential of information assistivity as the fourth health-social services and to discuss its factors to improve for expanding to all the people in the community. To promote information services in the health-social supports, suitable systems must be designated for effective usage of services, that result from survey and analysis of that internet technologies, for instance world-wide-web.

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The purpose of this study is to inquire 1) what sorts of pleasures the elderly have, and to propose 2) a model of a volunteer system for them. Method : After getting consent and with a semistructured questionnaire, we interviewed 68 elderly living in the community and 68 elderly living in the nursing facility who are 65 years and above. We also sent questionnaires to 23 nursing facilities to assess their practice on recreational activities and volunteer system. Results and discussion : 1) The elderly living in the community indicated farming, karaoke, dance, travel as their plesures. 2) The elderly living in the nursing facility indicated meeting with family, conversation with friends as their pleasures, and 20.6% of them indicated having no pleasures. 3) 85.5% of the nursing facility offer a recreational programs. However the programs are planned without any input from the resident of the facility. 4) 66.9% of the volunteers had no contact such as talking or taking a walk with them with the resident. Subsequent to the results of the survey, we will propose a volunteer system model for the elderly living in the nursing facility.

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The purpose of this study is to develop the evaluation of perception of physical fitness for the elderly. The subjects were 706 persons over 60 living in a representative farming community near major urban centers. The perception of physical fitness was evaluated using questionnaires. The persons over 60 were asked about their perception of 'general physical fitness', 'leg strength', 'back strength', 'arm strength', 'to stand up', 'going up stairs', 'agility', 'fall', 'flexibility'. Each item was classified in 5 levels from 'I have enough' to 'I have not enough'. And, we analyzed the relation between the perception of physical fitness and actual levels using Spearman's rank correlation coefficient, for health conditions or physical functions, we used chi-square test. As a result, it was showed that the perception of physical fitness is not merely related to actual levels, but also health conditions and physical functions. For instance, the ratio that risk group of perception of 'general physical fitness' complained one or some kinds of ill conditions was over ninety percent, and significantly higher than normal group. Lots of similar relations that the rate of risk group was higher than normal group were shown on activities of daily living especially for persons over 80. For female over 80, the rate of 'difficulties in walking' that risk group complained was 83.3%, and significantly higher than 40.0% in normal group (p<0.01). For male, showing the rate of 'slowness in action' and 'poor eyesight' that risk group complained, the former was 88.9%, and the latter 77.8%. Both were significantly higher than each normal group (the former : 47.4%, the latter : 27.8%).

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