The aim of this study was to describe the development process of interdisciplinary delirium care teams in acute care hospitals. Semi-structured interviews were conducted with eight delirium care teams in general hospitals in the Kanto and Kansai areas of Japan. The interview data were then analyzed qualitatively and inductively.

  A total of 55 sub-categories in 17 categories related to the development process of delirium care teams were extracted and then classified as follows into four phases: initially, a “launching team” for delirium care brought about the “organization of team building,” which improved through mutual interaction and the “promotion of team activities”, thereby improving the “outcomes of the team activities”. This development process included the following components: the clinical staff had a clear need for a delirium care team; multiple key members understood this need and took appropriate actions; key members negotiated with and got support from hospital administrators; team members built the delirium care team through simultaneous organization both within and outside the team; and administrators examined possible options and resolved any issues regarding the costs of team activities. These findings suggest that systematizing the delirium care process and facilitating staff education contributes to the improvement of overall delirium care skills. Activities such as team rounds within the hospital are effective for improving collaboration and cooperation among hospital staff members.

  The purpose of the present study is to clarify the signs of exacerbation of heart failure detected by family caregivers of the heart failure elderly with dementia. Semi-structured interviews were conducted with 10 family caregivers living with demented elderly persons suffering from chronic heart failure. The details of the interviews were analyzed in a qualitative and descriptive manner. Consequently, as the signs of exacerbation of heart failure detected by the family caregivers, the following three categories were extracted: ‘presence of visible physical changes’, ‘having difficulty in speaking, dressing and moving’, and ‘appearance of physical disorder in the patient’s own manner’. Family caregivers living with patients who were having difficulty in recognizing and indicating their intentions could detect signs of exacerbation of heart failure. These signs were minor changes or subtle differences that only the family caregivers knowing the patients’ daily speech habits and living conditions could notice. Taking a collaborative approach with family caregivers, we should confirm the patient-specific signs of exacerbation of heart failure detected by family caregivers. In this manner, we should provide appropriate support that prompts patients to visit a hospital and prevent aggravation of heart failure.

  In this study, we examined how the nature of care affects sleep-state by comparing sleep-state data between elderly residents at a special nursing home who were independent pertaining to their excretion (independent group) and those who were receiving regular night excretion assistance (assistance group). We examined sleep-state data collected over one year using mattress-type sleep monitors. Fourteen subjects were analyzed: eight in the independent group and six in the assistance group. Average ages of subjects in the independent and assistance groups were 86.9 ±6.5 and 85.3±10.9, respectively. The means of transportation were walking (four subjects in the independent group and two in the assistance group) and by wheelchair without support (four subjects in each of the two groups).

  The rate of interrupted sleep was 13.9% (90.2 ± 38 min) and 11.1% (74.3 ± 20 min) in the independent and assistance groups, respectively. The assistance group had slightly fewer instances of interrupted sleep, but the difference was not significant. Furthermore, no significant differences were observed between the two groups in the sleep-onset time, wake-up time, sleep duration, rate of REM sleep, rate of light sleep, and rate of deep sleep. Regular night excretion assistance was not always found to deteriorate the sleep-state in elderly people requiring long-term care. One approach to preventing inhibited sleep-state in elderly people requiring long-term care is to reduce the number of times of night excretion care as much as possible; however, the results of our study suggest that it is necessary to examine the number of times and timing of night excretion care while observing quality of sleep and sleep patterns of elderly people individually.

  In this study, we implemented an anonymous self-reported questionnaire to clarify the differences between occupations in terms of awareness of multi-disciplinary cooperation and primary hindrances related to discharge planning at medical facilities with long-term care beds. Fisher’s exact test was used to analyze the variations in awareness among occupations. The results showed that although over 50% of respondents felt there was cooperation in their occupation, in regards to cooperation between doctors and other occupations, doctors felt cooperation had been achieved with other occupations, whereas the other occupations did not share the same opinion. Although the clerks felt they had achieved cooperation with the nurses/care workers and rehabilitation therapists, the other occupations did not feel this was the case. Rehabilitation therapists and nurses/care workers/social welfare workers experienced mutual difficultly in cooperation. A significant difference was observed between occupations outside of nurses/care workers (p < 0.05). The proportion of doctors and clerks who felt there were difficulties in achieving multi-disciplinary information sharing and participation in regular conferences was low, and the differences in values and activity among occupations was over 50% for all occupations. A significant difference was not observed between different occupations (p > 0.05).

  Older people need to be mobile as long as possible despite existing health conditions and poor physical function. The ability to travel is associated with freedom, activity, and choice, and lack of mobility in older people is associated with low mood. The purpose of this study was to evaluate the effect of group activities on older people using mobility scooters at a day-service facility and explore the impact this intervention had on their life.

  With the permission of the treating physical therapist and consent of the participants and family, a total of five users of the day service participated in the study. Following a year of group activities such as riding around the day center’s grounds and going out to stores and parks escorted by staff, participants were interviewed using semi-structured interviews about life changes and subjective life satisfaction. We evaluated the group activities based on the interview results in cooperation with facility staff.

  All participants showed positive life changes such as increased communication, increased life satisfaction, having a greater role within the family, and trying something new. In addition, they reported enjoying and being satisfied with the group activities. These findings indicate that older people with walking difficulties can obtain a new means of mobility using an electric scooter if they are provided with encouragement, support and opportunity to use this mobility device. The study suggests that group activities using mobility scooters would promote healthy lifestyle for older people.