This was a study to: 1) review the literature on older adults with dementia who live alone and 2) summarize the findings.

The search terms were: ‘live alone’ or ‘living alone’ or ‘single person’ and dementia. Twenty-four English and nine Japanese research reports were selected for review.

Major findings from the combined studies were classified: 1) thinking-processes of single older adults with dementia, 2) demographic characteristics, 3) ADL/IADL abilities, 4) social services and networks, 5) harm/risks and 6) risk for incidence and diagnosis of dementia. Additionally, findings indicated the following valuable points for future consideration in suppor t of single older adults with dementia: establishment of earlier intervention with support network; health professionals’ correct diagnoses and assessments of cognitive symptoms and living abilities; evaluation for effectiveness of social service and understanding for thinking-processes and experiences of single older adults with dementia.

The purpose of this study is to clarify, among the caregivers and the visiting nurses, the caring behaviors of visiting nurses with reference to the caring decision for elders with dementia living in Grouphome.

Participant observation and interviews were conducted and the data were analyzed using a qualitative approach. As a result of the analysis, for the behaviors that the visiting nurses achieved in medical care of the GH, the following five components were extracted. [Building consensus on the necessity of caring including medical treatment with caregivers, family, and the cooperating doctor],[Discussing and deciding the caring method that corresponds to the resident’s condition], [Construction and the coordination of a care system to carry out better care for the residents, and their families], [Support for caregivers and families for them to carr y out medical treatment correctly without worry], [Judging the risk to the resident’s physical state and urging all caregivers to carry out continuous care to prevent deterioration]. The importance of the behaviors of the visiting nurse who promoted consensus building among the caregivers, the resident, his family, and the cooperating doctor was indicated.

The aim of the present study was to assess the health care needs of chronic obstructive pulmonary disease (COD) patients based on patient self-management, current state of everyday life and health-related QOL. A questionnaire survey was conducted of COPD patients receiving continuous outpatient care from medical institutions in region A. A total of 74 valid responses (96 % ; 71 men, 3 women; mean age, 73.9 years) were received. Mean treatment period was 79.3 months and 21 patients (28.4%) were undergoing domiciliary oxygen therapy.

Patients with severe shortness of breath were prone to increased exacerbation in the level of severity and were routinely careful regarding infection prophylaxis and healthy diet. However, they experienced difficulties in activities of daily life (ADL) and had a high level of informational needs regarding ‘strategies in ADL to relieve shortness of breath'. Half of all patients had informational needs regarding COPD. Mean SF-36 values showed low physical and role functioning but comparatively high mental health. These findings indicate the necessity of providing information regarding self-management to maintain stable periods and specific advice regarding movement strategies and environmental improvements tailored to the individual requirements of each patient in order to improve QOL.

PURPOSE: The purpose of this research is to clarify the actual situation of nursing delivery in a group home for the elderly with dementia (GH), its effect, and its tasks for the future.

METHOD: We conducted semi-structured interviews with eight administrators in group homes which employ nurses, and 7 administrators in group homes which contract with home-visit nursing stations in a prefecture from September 2007 through January 2010. Recorded interviews were transcribed verbatim and classified thematically.

RESULTS: Nursing delivery was effective in detecting and predicting the change of physical conditions of group home residents, caring for residents in an emergency or in a terminal phase, providing health management for residents, providing medical direction and advice to caregivers, improving the quality of nursing care, reassuring caregivers, smoothing coordination with medical institutions, and reassuring residents and their family members. However, nursing delivery also needs to address the tasks connected with economic costs, working hours of nurses, and coordination with residents’ family members and other employees in group homes.

DISCUSSION: Residents in group homes are the elderly who are associated with various diseases and have difficulty in describing their symptoms due to dementia, so that it is important to assess their words and deeds by associating them with their past illness and changes in their physical and mental health, predict the diseases from which they are likely to suffer and their physical and mental conditions, and link nursing care with medical care. There are also challenges of financial problems, expansion of medical services, and education of caregivers, making it necessary to strengthen official support of nursing delivery in group homes for the elderly with dementia.