To develop a checklist for welfare commissioners to identify early signs of abuse of community-dwelling elderly, a draft checklist was created with such signs extracted from the literature, and its content validity was confirmed by distributing it to 48 welfare commissioners. Subsequently, to confirm its reliability and validity, a mail questionnaire survey was conducted, involving 108 professionals belonging to community-based comprehensive support centers and public health centers in charge of abuse management. Through exploratory factor analysis, 4 factors were selected: [Declining family care], [Unnatural living behavior of the elderly], [elderly’s complaints], and [Uncertain location]. A high Cronbach α of 0.897 for the entire checklist was achieved, which confirmed sufficient reliability. Confirmatory factor analysis was also performed to examine construct validity, and the following values were obtained from the goodness-of-fit test: GFI=0.917, AGFI=0.884, CFI=0.934, and RMSEA=0.058. As a result, a 19-item elder abuse checklist for welfare commissioners was created, and it was shown to be applicable to identify early signs of elder abuse and to share such information with other professionals.

  The survey aimed to elucidate the relationship among workers’ ageism, stress, and emotion work to determine stress management measures to prevent elderly abuse. An anonymous self-administered questionnaire survey was conducted for nurses and nursing care workers in geriatric health services facilities. The Japanese version of the Abridged Fraboni Scale of Ageism, Negative Feeling toward Patient Frequency Scale, and the Emotion Work Inventory for Nurses were used to evaluate participants using a 5-point Likert scale, and a hierarchical multiple regression analysis was performed. The results revealed a strong link between the negative emotional expression of emotional labor and the stress of “negative emotions toward the selfishness and excessive complaints” of the elderly (β＝.515, p＜.01). Furthermore, a connection with ageism was not found. However, ageism avoidance had the strongest link to stress (β＝.373, p＜.01). The results suggest that it is important to improve the ability to regulate negative emotions such as irritation in order to reduce the negative emotional expression in the form of anger toward the elderly. Further, reducing avoidance could lead to the prevention of stress.

  The purpose of this research was to clarify the “fall behaviors” and real needs in the background of older people with cognitive impairment in an acute hospital by analysis of patients with and without the onset of delirium, focusing on the first week of admission when falls most frequently occur.

  The subjects were nine older people with cognitive impairment admitted to an acute hospital. The research was conducted via the participant observation method. The real needs found to influence the background of their behaviors were identified through a hearing investigation with those in whom the “fall behaviors” were observed, and their involvement with nurses when their behaviors were calm once again, as well as their other behaviors were each analyzed by content for meaning.

  As a result, seven “fall behaviors” were observed, and at the time of “non-delirium,” three categories, “physiological desire and custom,” “physical pain and discomfort,” and “mental stress”, were observed as the background needs of their behaviors. The subjects had clear intentions in the background of their behaviors and were stressed because their intentions were not reflected. At the time of delirium, five categories that could lead to fall behavior, and the needs of two further categories of “uneasiness caused by the difficulty of recognition of their current situation” and “physical pain and discomfort” were recognized. Individuals felt uneasy about being left alone and about several pains caused via disease and treatment.

  This suggested that livelihood support respecting intention, and early intervention to their physical pain, unpleasant feelings, and anxiety can possibly prevent such a fall behavior.

  The purpose of the study was to gain hints of nursing practice after clarifying changes of verbal behaviors of the old people with dementia influenced by duration of hemodialysis: blood-pressure lowering and degree of pain assessed from the behaviors. Participants were 11 old people with dementia (two males, nine females) receiving hemodialysis. Two researchers per one participant observed the participant once every three minutes from entering a dialysis room to the end of hemodialysis, and collected participant’s blood pressure value every thirty minutes. The degree of pain was assessed on the basis of the criteria made by the researchers and shown in the list along time proceeds. All participants showed pain that disrupted the continuance of hemodialysis more than one time, and the degree of the pain in four participants became higher between thirty minutes and one hour before hemodialysis. In needle insertion, 10 participants (91%) shouted “It hurts!” or stood silent without moving their forearm (shunt side) until the end of the insertion. From these results, it is necessary for nurses to set a time to focus on observation and care, and to explain to the old people with dementia by any means necessary at the time of needle insertion while believing their patience.

  The present study aimed to evaluate the effectiveness of a nursing intervention program to help individuals with early dementia (mild cognitive impairment [MCI] or early stage of dementia) gain life integrity, which is a developmental task of old age. Fifteen individuals with early dementia (MCI: n＝5, Alzheimer’s dementia: n＝9, and cerebrovascular dementia: n＝1; mean age: 80.7±7.0 years; mean Mini-Mental State Examination score: 25.3±2.8) participated in a six-session Support Program for Discussing the Present, Past, and Future and for Recording the Discussions in the Orange Notebook. Erikson’s Developmental Task Achievement scale scores were measured pre- and post-intervention. Based on their pre-intervention score (mean, 39.1±4.9), participants were divided into low- (＜40) or high- (≥40) score groups and compared. A significant post-intervention improvement was observed in the low-score group (P＝.007). No difference between pre- and post-intervention was observed in the high-score group. The present findings indicate the effectiveness of the present nursing intervention program for gaining life integrity, particularly for individuals with low developmental task achievement scores.

  The objective of this study was to reveal experiences of wives accompanying elderly patients with complications of delirium in a critical emergency ward. A qualitative and descriptive analysis was performed on the basis of the results of semi-structured interviews of six wives accompanying their elderly husbands with complications of delirium in a critical emergency ward. The results show that the experiences of the wives can be classified into the following six categories: being disturbed by delirium, interpreting their husband’s condition in their own way, taking care of their husband in consideration of the ward environment, feeling sorry for their husband under certain restrictions, restraining their husband from moving in order to prevent his condition from worsening, and worrying about their future life with their husband. The categories of the experiences suggest that the wives understand their husbands’ words and behaviors on the basis of their history of living together as a couple. The categories also suggest that the wives have a desire to assist their husbands as the one who can best understand them. Nurses should provide patients with necessary aid that can be shared with the wives and tell them that their actions contribute positively to their husbands’ recovery from delirium, which will result in support for the wives.

  The present study clarified the structure of nursing practice for elderly people with dementia in an open ward of an acute care hospital. Group interviews were conducted with four nurses working in an open ward. The interviews were recorded and transcribed verbatim, and then subjected to qualitative analysis. As a result, in addition to time, nursing for elderly people with dementia who were admitted to an open ward was classified into two fundamental and supporting categories, [Sharing of philosophy and mission for the early discharge of elderly people with dementia] and [Solid care system], and six practice categories, [Adjustment for adaptation to hospital life among elderly people with dementia], [Support for the independence of elderly people with dementia and the reduction of family care burdens], [Assessment of elderly people with dementia for home discharge], [Preparation of family for discharge], [Collaboration with other professionals and divisions and multiple institutions], and [Consensus between elderly people with dementia, family members, and professionals]. Nurses working in open wards regarded the elderly with dementia as living people by observing their progress as stable in solidarity with professionals inside and outside of the hospital. These findings suggest that information gathering and dialogue with multiple institutions having multiple specializations was carried out continuously, and that this promoted a good general condition and independence of the mind and body among the elderly with dementia.

  There is a lack of empirical studies in the existing literature investigating families in Japan who chose hospice care in long-term care welfare facilities. Therefore, this study aimed to: (1) explore the aspects of the mental burden experienced by family members who chose hospice care for older adults with dementia residing in long-term care welfare facilities; and (2) identify the factors affecting family members’ emotions about surrogate decision-making. Data from semi-structured interviews with 16 family surrogate decision makers were analyzed using the modified grounded theory approach. Results regarding the aspects of mental burden indicated that: (1) at the time of surrogate decision-making, family members experienced indecision and felt great responsibility at having to make a choice where the wishes of the older adult or other relatives were unknown; and (2) subsequent to decision-making, the family experienced sadness at the older adult becoming progressively thinner, resulting in ambivalence about the decision, and felt sorrow over the older adult’s impending death. Results for the factors affecting emotions about surrogate decision-making indicated that family members’ emotions were influenced by the decision-making process as well as by satisfaction with hospice care at the facility. These findings suggest the need for continuous support even subsequent to surrogate decision-making.

  This study sought to clarify the persistence of the moisturizing effects of applying Vaseline for older adults immediately after bathing. Fifty-one hospitalized patients’ forearm and lower leg stratum corneum hydration were measured on the day before bathing and the first, second, and third day of bathing. The stratum corneum hydration was measured by Mobile Moisture HP10-N^®, in which 25 or more indicates sufficient water content. Changes were analyzed over 4 days, with a measured value of ≥25 for the non-dry group and <25 for the dry group. As a result, sufficient water content was maintained in the non-dry forearm and lower leg groups, but the moisturizing effects were unclear because there was no difference in the measured values before and after the Vaseline application. In the dry forearm group, water content increased significantly the first day and increased to a sufficient level the third day. In the dry lower leg group, the first and second days, stratum corneum hydration increased significantly, but water content was insufficient. Regarding Vaseline application to elderly persons immediately after bathing, these results indicate that the moisturizing effects on the non-dry forearm and lower leg groups were unclear. Moreover, the moisturizing effects persisted for 3 days in the dry forearm group but were insufficient for the dry lower leg group.

  In Japan, the percentage of cancer patients aged 75 years or over is currently over 40 percent and is increasing. This study aims to clarify the experiences related to medical treatment and life of cancer outpatients aged 75 years or over in local general hospitals in order to develop a compound outpatient nursing support model.

  Six patients who visit local general hospitals were included as participants of this study. We conducted semi-structured interviews and analyzed the data qualitatively. Using the patients’ interview transcripts, we codified the patients’ own sentences relevant to the study by topic. From 329 original codes, we were able to consolidate the data into 30 sub-categories, which could be arranged into 14 larger categories, which we eventually integrated into six main categories as follows : repeat decision-making to seek treatments that are safe and satisfying, living with the symptoms of cancer and its treatment, trust and a sense of security for a familiar hospital, awareness of changes in his/her body and responses to changes, preparation for the end of life and gratitude and care for people who take care of them.

  This study found that older cancer outpatients were initially surprised by their diagnosis. Then, they had to decide whether to receive the treatment or not and chose the best course of their treatment repeatedly. They were more fragile now than before they developed cancer but grew more satisfied with their pain-free independent lives and desired to continue on living. They also prepared for the end of their lives to avoid burdening their families.

  Objectives: The purpose of this study was to verify the effect of snowfall on self-efficacy among the elderly with the focus on homebound tendency.

  Method: We randomly selected 390 elderly residents in a cold snowy region. We mailed a questionnaire in both the snowy season and the non-snowy season. The survey content was their background (age, gender, whether there is a housemate), outing purpose up to 10 items, enjoyment for each selected outing purpose item, and self-efficacy for outing in general.

  Results: A total of 134 elderlies were analyzed (response rate 34.4%). The background factor affecting self-efficacy for outing was age in both seasons. Enjoyment of outing was positively related to self-efficacy only in the snowy season. The elderly with high self-efficacy reported they enjoyed “regular medical check-ups”, “visiting administrative or financial offices”, “role in the community” and “cleaning up the snow”.

  Conclusions: In order to raise self-efficacy for outing among elderly residents in cold snowy regions, it was suggested that they needed to be in good physical conditions and living environments. In addition, we found that the elderly with high self-efficacy include the enjoyment of their role and the enjoyment of interaction with others in addition to enjoyment of the purpose of outing.