Purpose：This study clarifies the skill which is first contacting on outreach for the older adults living alone with suspected dementia by nurses working in the community comprehensive care center. According to the New Orange Plan, every municipality in Japan is required to implement Initial-phase Intensive Support Team.

Method：The nine nurses who belong to the community comprehensive care center and are members of the team of multi-disciplinary experts in dementia were interviewed. These interviews were analyzed inductively.

Results：Individual and organizational supportive skills for the older adults with dementia have been clarified. The individual skill represents the characteristics to give consideration to their world view and subjectivity. The organizational skill represents characteristics to avoid risk and reduce the psychological burden on the nurses and support members.

Conclusion：A comprehensive outreach skills that include individualized and organizationalised scheme for the older adults are thought to prevent the aggravation and institutionalization. Furthermore, these skills are thought to lead to a comfortable environment in which the people can continue to live in the community.

Objective：The purpose of this study was to clarify the decision-making process of visiting nurses caring the elderly people living alone who have sequelae of stroke.

Method：Semi-structured qualitative interviews were conducted with nine visiting nurses with more than five years of experience as a visiting nurse for the elderly people living alone with stroke sequelae, and thematic coding of qualitative data was used to compose the decision-making process.

Results：The decision-making process of visiting nurses caring the elderly people living alone with stroke sequelae is composed of 7 phases, 125 categories, and 1490 codes. The visiting nurses have the decision-making process: [Predict the risk of health deterioration], [Understand human functions with environmental/personal factors], [Extract the issues/needs for continuing to live alone], [Discuss the care plans with the team] while [Monitor the vital signs, the physical conditions, and the living conditions], [Support the self-care behaviors while living alone], [Evaluate the continuation of living alone and the self-care behaviors].

Conclusion：It was suggested that visiting nurses support elderly people living alone with stroke sequelae in teams and carry out decision-making processes that lead to the prediction of new risks.

Aim：To investigate what experienced home visiting nurses notice in their patients when they have a gut feeling as well as what kind of clinical decisions they make in such a situation.

Methods：Semi-structured interviews were conducted with seven experienced home visiting nurses. A qualitative, descriptive study design developed by Hiroko Yatsu was used in analyzing interview data.

Results：Eight categories were generated for the gut feeling of nurses for their patients, including: different appearance from usual and slower response/reaction and fewer utterances than usual. For clinical decisions, nine representative categories were generated, including: making intuitive decisions based on observation and immediately making an analytical assumption about the patient’s current condition and taking action based on the patient’s current and past history.

Conclusion：It was found that the gut feeling of nurses is mostly derived from intuitive thinking. Results suggest that the relationship between the nurse and the patient is key for early detection of abnormal changes in the patient. Experienced home visiting nurses in this study made decisions based on quick assumptions on which they acted straight away. Findings suggest that, for nurses to improve their clinical decision-making skills, they should self-reflect on their actions.

Purpose：To clarify the feeling of difficulties of son-caregivers who care for their mothers with dementia.

Method：We conducted a qualitative descriptive analysis using a semi-structured interview method for 13 son-caregivers who are living with their mother.

Results：As feelings of difficulties for offering care 1. The [difficulties of caring for a mother with dementia] includes the difficulty of accepting the changing parent such as the distress of seeing the parent unable to perform normal things, and the sadness the gradual loss of the relationship with the parent, and the stress overly influenced by the unpredictable behavior of the parent. 2. Regarding [Feelings of difficulties in dealing with mothers with dementia], there were difficulty of physical care for a parent of the opposite sex and, when he is out for work, Worries about safety and comfort when I am not with her. 3. In [Feelings of difficulties in caregiving as a social issue], there were restriction of work due to unpredictable behavior of a parent and financial concerns due to living in his parent's pension.

Conclusion：Three categories were found in terms of difficulties regarding caregiving found in sons who are caregivers for their mothers with dementia

Objective：The aim of this study is to clarify the differences between occupations and years of experience in communication with patients among four types of specialists: visiting nurses, clinical nurses, care takers, and rehabilitation therapists.

Methods：A questionnaire survey was administered to specialists regarding their communication methods with patients. The questionnaire items covered questions asked to patients (15 items), information conveyed to patients (13 items) and communication attitude (14 items), ranked using a 5-point scale.

Results：The factors extracted in contents to be heard are information directly linked to living and information on living ability; and information conveyed: care needed to live and nursing care and life information. In regard to all factors, visiting nurses asked more questions and conveyed more information than other specialists regardless of years of experience. Communication attitude had a four-factor structure, and visiting nurses scored higher on the whole.

Conclusion：These results suggest that visiting nurses inquire more about and convey more to patients than clinical nurses, care takers and rehabilitation therapists.

Purpose：The purpose of this study was to clarify the competencies of new graduate, as identified by home care nursing office managers, from a training perspective.

Methods：Based on a quantitative descriptive study design, we conducted a random self-administered questionnaire survey of 650 nursing office nationwide, randomly selected by prefecture stratification according to the number of home care nursing office . The survey form was prepared with reference to the competency dictionary of Spencer & Spencer (1993/2011), with survey items relating to competencies of new graduate nurses to be emphasized, as well as their degree of importance, at the time of hiring and one year after hiring.

Results：Responses were obtained from 109 participants (recovery rate 16.8%), and the main competencies of new graduate nurses that managers emphasized at the time of hiring were [customer service orientation] [interpersonal understanding] [teamwork and cooperation] and [relationship building].Furthermore, one year after hiring, [conceptual thinking] [flexibility] [organizational commitment] and [self-control] were emphasized.

Conclusion：The competencies, as identified by managers, were suggested as both the characteristics necessary for home care nursing and the educational content to be emphasized during training.