The study aimed to create an evaluation index for dementia care practiced by nurses and long-term care workers in nursing homes for the elderly, and to examine its reliability and validity. The original evaluation index consisted of 55 items that were created from a literature review and interviews. A questionnaire survey was conducted for 817 nurses and care workers at nursing homes for the elderly. Among the questionnaires collected, 653 response forms were analyzed. Based on the results of item analysis and exploratory factor analysis, 5 factors and 33 items were selected. A confirmation factor analysis was subsequently conducted with the following findings: GFI=0.844, AGFI=0.819, CFI=0.910, and RMSEA = 0.065. The total score of the dementia care evaluation index was significantly higher for those who participated in the dementia workshop (p = 0.003) and for those who performed care reflection with others (p <0.001). Cronbach’s alpha for the coefficient factors was 0.849–0.933 and was 0.961 overall. Although the goodness-of-fit index did not meet the recommended values for some items, it was interpreted as an acceptable range. The index that included 5 factors and 33 items was confirmed to have significant reliability and validity.

  We aimed to reveal ideal care-prevention activities that support the employment of older adults requiring assistance based on their caregivers' views and perspectives on support in the settings of “care prevention” and “employment”. We also aimed to provide suggestions for nurses when they are involved in employment support. Semi-structured interviews were conducted with 27 caregivers for 15 older adults requiring assistance, and the interview contents were analyzed qualitatively and descriptively. Ideal care prevention activities indicated in their views were [everybody has strengths and can be healthy, find purpose in life, and be employable by being helpful to others], [valuing older adults’ role and right to choose and establishing relationships with care recipients with an attitude of learning together while having fun], and [helping each other to continue living in the community]. Activities indicated in their perspectives on support were [converting older adults from community resources to employable resources], [utilizing contributions from families and involved individuals and mutually relying on each other], [preparing the environment to facilitate employment of older adults while maintaining connections with the community], and [helping older adults not give up on returning to work and reconnecting with society].To establish caring relationships with older adults requiring assistance that support their employment, the following are suggested: it is necessary to listen to and learn from individual older adults about their values on employment and way of life and thereby to strive to understand their residual social function, while remaining aware of influence of the time background and local culture.

  This study clarified the structure of the end-of-life care needs of residents in nursing homes, and obtained suggestions for the systematization of care based on care needs from the time of their admission to death. Focus group interviews were conducted with 36 expert nurses with nursing experience in nursing homes. A total of 118 cases were analyzed qualitatively and inductively. The end-of-life care needs of residents in nursing home were as follows: [inability to verbally express abnormal symptoms], [new health problems following the continued decline in physical functions], [difficulty moving as a result of pain and decreased motivation], [difficulty eating satisfactorily consequent to decreased swallowing function], [anxiety and restlessness] and [difficulty in spending time in a familiar place until the end of life]. The structure of care needs revealed that these six categories interacted with each other, and the lack of care that effectively met the needs of the residents expanded. At the root of this dilemma is the inevitable senility faced by most residents, which requires assistance based on an advanced predictive judgment to prevent the expansion of the care needs by avoiding sudden changes during their stay and reducing the total pain they experienced until death as a way of extending their lives.

  The purpose of this study was to clarify the experiences of elderly welfare officers supporting elderlies in their communities.

  The subjects were 10 local welfare officers aged from their late 60s to early 80s, five males and five females each, who had experience supporting elderlies in their communities. Semi-structured interviews focusing on how they felt and thought through their support work were conducted, and data were analyzed qualitatively and descriptively.

  Four categories were extracted from their experience in supporting elderlies in their communities: [being worried about how to respond to elderlies], [gaining benefits from being involved with elderlies], [empathizing with elderlies based on their own experiences], and [imagining their future selves at an older age].

  One of their strengths is that they can empathize with elderlies based on their own experiences when providing support. However, elderly welfare officers face their own issues, such as aging and declining physical strength. Therefore, organizations that support them need to consider their physical circumstances and provide support to them.

  This study conducted a questionnaire survey aimed at investigating the relationship between the role of nursing as perceived by nurses and the improvement of nurses’ work engagement in long-term care facilities.

  A self-administered questionnaire was distributed to 198 (valid response rate 97.5%) nurses employed at long-term care facilities in two prefectures in the Tohoku region. The content of the questionnaire included questions relating to nurses’ basic characteristics and work engagement, as well as role recognition by nurses working in long-term care facilities. Multiple regression analysis was performed on the collected data and work engagement was treated as the dependent variable. The following four factors were found to have a statistically significant relationship with work engagement: age (r=0.137, p=0.035), work continuation (r=0.238, p<0.001), attitude of nurses working in long-term care facilities (r=0.205, p=0.013), and protection of dignity of older adult residents by nurses (r=0.209, p=0.013) .

  Nurses working in long-term care facilities have the potential to improve their work engagement by respecting the dignity of older adults and providing nursing care that is relevant to their lives.

  This study aimed to reveal the conceptual structure of discomfort of elderly people receiving long-term medical care by conducting a literature review based on Walker and Avant’s concept analysis. For the analysis, 32 articles were selected from ICHUSHI Web, PubMed, CINAHL, etc. The results revealed six defining attributes “mixture of physical discomfort and distress” “diversity of experiences” “constant continuation” “underestimation by healthcare providers” “unlikelihood of manifestation” “threat to existence” and three antecedents “mental and physical functional impairment associated with disease progression and aging” “inappropriate responses from healthcare providers” “negative perception of elderly people”. A comparison with previous studies suggested that the discomfort of elderly people receiving long-term medical care is unlikely to be manifested; thus, it characteristically tends to be underestimated by healthcare providers and is affected by inappropriate healthcare response. The results of this study are useful for the development of care guidelines for relieving the discomfort of elderly people receiving long-term medical care. The findings highlight the need for nursing practices geared toward detecting signs of discomfort undisclosed by elderly people and to protecting their dignity, to prevent and relieve the discomfort of elderly people receiving long-term medical care.

  The purpose of this study is to clarify what kind of experiences elderly with higher brain dysfunction have in their home life. The subjects are 11 elderly people over 65 years old who developed higher brain dysfunction and lived at home after hospitalization. The semi-structured interviews were conducted with these subjects and the obtained data was analyzed qualitatively and descriptively. As a result, nine categories were extracted such as [I am frustrated that I can't do what I could do before] [I realize my body is weakening] [I have communication problems with the people around me] [I imagine my future and have anxiety] [I continue to keep records on my condition] [I cope with what I can do now] [I feel valued] [I rely on people close to me without hesitation] [I never give up on achieving my goals]Elderly with higher brain dysfunction who live at home tend to lose their self esteem because they cannot do what they could do before, and are more likely to fall into social and mental isolation. Nurses need to focus on what elderly with higher brain dysfunction can currently do and encourage them to utilize their skills.