The present study examined whether or not varying methods of urinary support provided for elderly male patients with stroke-induced hemiplegia in the convalescent phase causes differences in the change in muscle mass on the non-paralyzed side. The subjects were fourteen patients aged 65 years or older with stroke-induced hemiplegia in the convalescent phase. A survey of urinary support and measurement of the muscle mass on the non-paralyzed side were conducted twice: two weeks and three months after hospitalization. The results suggested that when patients had an urge to urinate, they all went to the bathroom using a wheelchair. On the other hand, patients who had little or no urge to urinate used a diaper or indwelling bladder catheter, and did not go to the bathroom. The leg muscle mass on the non-paralyzed side (p=0.014) and its increase during hospitalization (p=0.094) were significantly larger in patients who used the bathroom (muscle mass: 4.30±1.02 kg, increase: 0.04±0.61 kg), compared to those who did not (muscle mass: 3.69±0.58 kg, increase: -0.14±0.86 kg). Urinary support for elderly males, which encourages male patients, including those requiring assistance, to stand erect, may help maintain and increase the leg muscle mass on the non-paralyzed side.

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The aims of this study were to reveal pain prevalence and the situation of pain which affects health- related QOL among community-dwelling frail elderly in the Long-Term Care Prevention Project for persons at risk of being in need of support. The subjects were 495 elderly people, with an average age of 84.7(±5.4). The pain prevalence of the past month was 73.1% in this study and the most usual location of pain was the lower back, with the average pain locations being 1.9(±1.0). In the SF-8 PCS (Physical component summary) with the pain group 44.3(±5.7) was significantly lower in the no pain group 52.1(±4.0). In the SF-8 MCS (Mental component summary) there was no significant difference between the pain group 51.9(±6.2) and the no pain group 51.0(±5.7). Multiple regression analysis was performed using the SF-8 PCS and the SF-8 MCS in the pain group as dependent variables. The factors of SF-8 which controlled the PCS were: the worst pain intensity; when the pain has interfered with your walking ability; the pain interfered with relations with other people; the neuropathic pain screening score; and the pain interfered with enjoyment of life. The factors of SF-8 which controlled the MCS were pain which interfered with mood and the pain which interfered with relations with other people.

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Study purpose: This study clarifies positive appraisal toward caregiving of family members who care for elderly people with dementia; specifically, factors that influence such aspects as a sense of coherence (SOC), subjective feeling of health, and social support were clarified. Method: We conducted a self-administered questionnaire survey with family members who were the primary caregivers for at-home elderly people with dementia, and analyzed the data of 188 persons with valid responses. In the questionnaire, we used scales, namely SOC-13 and SF-8, to measure the caregivers' positive appraisal toward caregiving; we also asked about social support, attributes, and the like. Results: The mean value of the positive appraisal toward caregiving was 36.5±7.9. As a result of a multiple regression analysis in which the positive appraisal toward care were the dependent variable, we understood that the factors influencing such appraisal were female gender (β=0.162, p=0.006), high MCS score in the SF-8 (β=0.218, p=0.001), high SOC score (β=0.133, p=0.043), and caregivers' understanding of appropriate care (β=0.410, p=0.000). These four kinds of variables could explain 35.7% in the 188 study subjects. Conclusions: It is suggested that social support and support that improves SOC and psychological QOL are important to increase the intention of family members to continue caring for elderly people with dementia at home, which is perceived as a positive appraisal of caregiving.

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The objective of this research is to shed light on the difficulties experienced by discharge nurses in acute hospitals when engaging in discharge planning for elderly patients. The results of qualitative analysis of the information gained in an interview survey conducted separately with 11 discharge nurses showed that the challenges they faced were attributable to: their inflexibility in responding appropriately to diverse requests from elderly patients and their families; insufficient coordination and collaboration between hospital staff members involved in the discharge planning process; limited availability of local resources in the community; and an inadequate organizational support structure. Furthermore, time constraints arising from the necessity to complete the discharge process in a short period also seemed likely to have added extra burden to the nurses. Through this research, the core concept underlying the sense of difficulty shared by the nurses in charge of discharge planning in acute hospitals when dealing with elderly patients whose conditions varied considerably from individual to individual was identified as "a feeling of uncertainty in what they were doing" that inevitably had grown from the complexly intertwined negative factors described above. The research suggests that, for these nurses to be able to continue pursuing better ways to care for elderly patients, it is important that they deepen their professional knowledge by acquiring more hands-on experience, as well as by clearly defining the efforts they have made in such work and evaluating how meaningful each of these efforts has been through a close review of past experiences.

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The purpose of this study was to elucidate the significance of interactions with others for elderly women who live alone and need support, and who do not participate in group activities. Semi-structured interviews were conducted with five elderly women who had support need level 2, and their responses were analyzed using a qualitative synthesis method (KJ method). Interactions of these elderly women that were classified as 'interactions of approval' for a positive sense of self were as follows: "the pleasure of being able to do something for loved ones"; "the importance of an unaltered relationship with loved ones"; "the sense of security obtained from the comfortable and mutually-trusting relationship that has been created" "self-confidence in current interactions that reflect their past experiences". Conversely, interactions that were classified as "interactions to face death" for finding a way to confront death in one's own way were as follows: "spending time with friends to enjoy life to the fullest"; and "the conflicts and preparation for death realized through the aging process and the death of loved ones". It was considered that the elderly women requiring support were assimilating their own aging identities through interactions with the persons whom they selected. For future support, it was considered to be important to re-examine the current significance of the interactions and effectively maintain and develop it.

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Purpose : To conduct a concept analysis of 'life review for elderly' and to examine it's utility for enhancing aspects of nursing practice. Methods : Relevant literature was identified using the search terms: life review, elderly, and aged. Six databases, PubMed, CINAHL, PsycINFO, SocINDEX, medical central magazine, and Japan Medical Abstracts Society were searched for the years 1990 through 2012. Meeting the criteria were 28 articles, which were analyzed using Rodgers's concept analysis model. Results : Extracted attributes of life review included: elderly repeated recall, integrated looking back on entire life span, and talking to others increased facial expressions. Antecedents of life review extracted were: physical factors and characteristics of the elderly, decline in mental and cognitive function, decrease in social interchange and existence of an expert with the skill to listen. Consequences of life review extracted were: reception of one's stage in life as old age and impending death; promotion of mutual understanding with others; comparing traditions with other generations, and noticing self-awareness, and maintenance of self-esteem. Conclusion : Life review for the elderly is regarded as a concept that when enacted promotes self-awareness that could otherwise be easily lost in the advanced age period and which promotes mutual understanding with others.

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The purpose of this study is to clarify experiences of nurses who provide terminal care for unresponsive elderly patients. Semi-structured interviews were conducted with 10 nurses for qualitative and descriptive analysis. As a result, three categories were determined, including: "to support people to 'live' as they choose until the end," "to focus on terminal care while discovering values in the care they provide" and "to be distressed by conflicts surrounding the 'meaning of life." Nurses were providing support to help people to live as they choose as a human being, as long as their lives continue under any circumstances on the basis of care to "support the elderly to 'live on' as they choose to the last breath. Nurses "who aim at terminal care while discovering values in the care they provide" positively worked on care, thriving on small joy through involvement. On the other hand, nurses "who are distressed by conflicts surrounding the 'meaning of life' were in a situation of losing confidence, suggesting the need for support to alleviate psychological burdens.

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The objective of the present study was to elucidate factors supporting the continuous participation of elderly individuals in a "dementia awareness course", which has been conducted since fiscal year 2009. Semi-structured interviews and a qualitative, descriptive analysis using participant observation were conducted on 18 individuals who had been continuously participating in the present course for at least one and a half years. Based on the results, the following 7 categories were generated: "anyone can develop dementia", "enables me to have experiences that broaden my horizons", "realize the effects of the course through changes in self", "enables me to face up to life", "the course has become a source of support", "there are opportunities for independent participation", and "desire to continue is sometimes hindered". For the participants, who became increasingly aware with age that they too could develop dementia, the course served as an opportunity for independent participation as well as a source of support. On the other hand, factors hindering the desire to continue participation, specifically times at which participants felt they could not keep up with the course, were also identified. These findings indicate the need in the future to support the desire of elderly individuals to continue participation while respecting their independence.

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[in Japanese]

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