The objective of the present study was to analyze the intervention methods in self-neglect cases, and the dilemmas and dif ficulties faced by professionals when managing such cases at a community comprehensive suppor t center (hereafter, suppor t center). This is the type of institution primarily responsible for handing cases of self-neglect. Focus group interviews were conducted with seven nurses and other professionals at a support center in a particular city. We divided the inter ventions into 7 categories, the dilemmas faced by professionals into 7 categories, and the difficulties into 6 categories. Professionals at the support center had the dilemma whether to respect the individual’s self-determinationwhen they worked toward a solution for self-neglect using watching intervention, emergent intervention, and preventive intervention methods. Furthermore, they met new dilemmas in the process - dilemmas between the local residents and the organizations concerned and on-the-job dilemmas. These dilemmas were associated with difficulties in professional awareness and a sense of duty, in support systems, and in undeveloped legal systems. Based on the features of self-neglect, they had difficulties regarding their ability as professionals.

We interviewed 13 families of deceased ALS patients who had refused treatment with tracheostomy invasive positive pressure ventilation (TPPV) in order to shed light on patient as well as family experiences.

Patients and family members experienced the process of finding meaning: meaning in living without TPPV for the patients themselves and families, and meaning in them having lived according to this decision for family members. The 11 categories for the process emerged over time. They experienced “the encounter with TPPV”. Regardless of coming to it with “shock or resistance” to TPPV, some patients and family members reached “the decision and expression relatively quickly after the encounter with TPPV”, some experienced “greater conflict and struggle surrounding the decision”. They reached “the final making-decision and confirmation”, and “lived to their fullest until death after reaching their decision”. Family members experienced “both regret and the condemnation of others” before “remembering their past experiences and serving for the dead patients”, “finding positive meaning” and “rebuilding their lives”. Fundamental factors affecting this process were “personality, worldview, and environment”.

Our interviews illustrate the need for greater information, education, and discussion in order for decision-making regarding this immensely dif ficult choice not to result in regret, while enhancing healthcare and nursing systems.

The purpose of this survey was to clarify the current states and challenges of disaster measures in nursing home-care agencies of Okayama prefecture. The subjects were the administrators of nursing homecare agencies. As a result, 61 administrators (58.7%) responded with valid answers. The current states of disaster measures were as follows : 1) Manual prevalence of disaster measures of this survey was 45.9%, lower than the national survey of Japan (69.0%); 2) High-priority users were persons who lived alone, highly depended on medical care, or elderly households; 3) Only 38.3% of the agencies cooperated with the local agencies of disaster measures. As future challenges of disaster measures, it is necessary 1) to create and review a standard manual of disaster measures and make simulation training among the station staff; 2) to consider concrete measures among the staff, high-priority users and their families; 3) to consider morecooperation with the local agencies of disaster measures.

The law concerning protection of personal information was enacted in 2003, and a further safety management measure came to be requested in the intelligence sharing of public health, healthcare, and social welfare in Japan. However, various problems in information management are feared. The objectives of this study were to investigate trends in research on the processing and management of personal information in the fields of public health, healthcare, and social welfare in Japan, and to provide basic information about the future of how to treat personal information, based on historical and social factors. Conducting a search on the Web Version 4 of Japana Centra Revuo Medicina (1983 -- 2010) using the keywords “personal information protection” we retrieved original articles only and reviewed their contents. We obtained 128 references, which were sorted into 6 categories and 9 subcategories based on the Japanese Ministry of Health, Labour, and Welfare’s “Guidelines for Personal Information Provision by Healthcare and Nursing Services Organizations.” Results suggested that while systems and processes concerning the use of personal information collected in health and nursing settings have gradually improved, several issues concerning education about the ethics of managing personal information and other specific measures remain to be addressed in home care etc.

This study aimed to evaluate visiting nursing care for terminal dying-at-home patients during the last 7 days of the patient’s life by comparing the causes of death (cancer and non-cancer) and the total duration and frequencies of the home visits. The managers of visiting nursing stations and the nurses who attended at the patients’ deathbed were surveyed using a postal questionnaire, followed by a comparative analysis of cancer and non-cancer patients. The average number of deaths per month that occurred in the presence of the visiting nurse was 1.6 (±1.2). On comparing cancer and non-cancer patients, significant differences were observed in patient age, total duration of visiting nursing care services, and duration of nurses’ visits on the day of death and the preceding 5 days. Our findings demonstrated differences in the duration of home visits by nurses when the patient was nearing death depending upon whether it was a cancer or non-cancer patient. Further investigation is necessary in order to clarify these patterns.