The purpose of this study was to develop a self-care evaluation scale for older adults with chronic heart failure and to examine its reliability and validity. A questionnaire survey about the scale, which was created by the authors, was distributed to certified nurses in chronic heart failure nursing; subsequently, a pretest for the patients was conducted. Next, a questionnaire that included the scale was distributed to 340 older adults with chronic heart failure. The reliability and validity of the scale were verified. According to the analysis, this scale was constructed based on 4 factors with 30 items; the factors considered for constructing the scale were “necessary knowledge and practice,” “continual habits of management,” “recognition and correspondence pertaining to any changes in physical symptoms,” and “acquisition of support.” Cronbach’s α for the overall scale was 0.84; the corresponding values for the subscales ranged from 0.55 to 0.80. As expected, there was a significant correlation between this scale and SCAQ as well as Self-care confidence. These results suggest that the self-care evaluation scale for older adults with chronic heart failure has a fairly good reliability and validity. Furthermore, the possibility of it being used for self-care support was indicated.

  We investigated for one year the sleep-state of elderly people requiring long-term care in a special nursing home in the Hokuriku region of Japan, using mattress-type sleep monitors. A total of 15 participants were recruited and their data were recorded over one year and analyzed. The 15 participants comprised 4 males and 11 females, with a mean age of 85.4 ± 8.6 years. Their average length of stay in the nursing home was 4 years. In terms of level of required care, three participants required level-1 care, eight required level-2 care, and four required level-3 care.

  Throughout the year of data collection, the average sleep-onset time was 7:19 p.m., demonstrating that participants were likely to go to bed immediately after dinner. The average wake-up time was 6:23 a.m., and the average sleeping duration was 11 h and 5 min. The proportions of light, deep, and REM sleep were 66%, 4%, and 17% of the sleeping hours, respectively. In terms of seasonal differences in sleep-state, sleep-onset time was earlier and waking time was later in winter, compared with those in summer, resulting in longer sleeping hours in winter. However, because a longer interrupted sleep and a shorter REM sleep were recorded in winter, the quality of sleep in winter was lower than that in summer, despite the longer sleeping hours. In conclusion, results suggest that the residents would benefit from staying awake longer after dinner, resting in sunlight, and having a warmer bedroom in winter.

  The objective of the present study was to obtain suggestions for the activities of Community Comprehensive Support Centers (hereafter, Centers) concerning isolated death by classifying the cases of isolated death among elderly people living alone in the community documented by Centers. A questionnaire survey was conducted on one nursing staff each at all 249 Centers in Prefecture A between April and June 2014, and a total of 81 responses (response rate, 32.5%) were obtained. An interview survey was then conducted on 10 respondents who complied with the request. On the questionnaire survey, 51 Centers (63.0%) responded that they had received consultations regarding isolated death. These consultations were most often made by “social workers” (n=31; 60.8%), and were also made by “neighbors” (n=20; 39.2%) and “deliverymen for private delivery companies” (n=13; 25.5%), among others. A total of 27 cases of isolated death were obtained from the questionnaire and interview surveys, and they were classified as “death occurring at least a week earlier”, “death occurring after mimamori^*”, and “death occurring after end-of-life care”. These findings indicate that the activities performed by Centers must include gradual mimamori toward elderly people, promotion of awareness regarding initial responses at the time of encountering a case of isolated death, and the clarification of roles in mimamori toward elderly people as well as grief care and empowerment following death for the people involved.

^*mimamori : Maintaining distance by considering the feelings or circumstances of elderly people, confirming the safety of elderly people by observation and/or measurement, and understanding the needs of elderly people by cooperating with people and institutions in the community

  This study aimed to clarify the significance of life for the elderly with difficulty in walking independently, their purposes in life, and factors supporting their life-fulfillment. Semi-structured interviews were conducted with 6 long-term care health facility residents to extract their life stories, and create narrative records. The narrative records were qualitatively and functionally analyzed, and classified into 5 categories and 6 sub-categories: in addition to <satisfaction after efforts>, <past, present, and future interpersonal relationships>, and <life as a gift and an opportunity to learn its significance>, representing the spirituality of elderly community residents, <wishing to make my own decisions>, and <now is the best time of my life> were extracted. Listening to the elderly living in long-term care health facilities, focusing on the significance and purpose of life, as well as factors contributing to life-fulfillment, may enable them to develop self-insight, and improve the quality of nursing, and it may be necessary to provide care from such a perspective.

  This study aimed to clarify issues related to the transfer of post-acute elderly individuals to long-term care wards. Semi-structured interviews were conducted with four nurses working on long-term care wards. The nurses were interviewed regarding situations in which they experienced difficulties related to the transfer of post-acute elderly individuals and the solutions they currently use to address these difficulties. Interview data were subjected to qualitative descriptive analysis. The results of the analysis revealed the following six situational categories: “family’s discontent and lack of understanding regarding long-term care wards”, “lack of support to family for the future in acute-care wards and family’s discontent”, “transferring patients in a debilitated state of health”, “persistence of physical restrictions that seem unnecessary in acute-care wards”, “lack of communication with acute-care ward staff”, and “requirement of unexpected treatment due to lack of prior information”. Furthermore, the following four treatment categories were identified: “discovery of and coping with the family’s understanding and dissatisfaction during the early period of transition”, “supporting recovery in accordance with the patient’s condition at transfer”, “resourceful adjustment and conformity with the patient’s condition at transfer”, and “promotion of information sharing with acute care wards in cooperation with other professionals”.

  For continued care and to facilitate a smooth recuperation for post-acute elderly individuals, it is necessary to promote an understanding of long-term care beds, share information for continuing care, and examine care methods to support recovery.