Purpose: This systematic review and meta-analysis evaluated the effects of individualized visits of a dietician along with multi-disciplinary team care for older adults living at home or in nursing homes.

Method: An extensive literature search of English and Japanese databases was conducted in January 2019. The inclusion criteria for the literature review comprised studies that were: i) randomized controlled trials, ii) interventions for older adults aged ≥65 living at home or at a nursing home, iii) interventions wherein dieticians visit individuals at home or in nursing homes along with multi-disciplinary team care, iv) comparisons of interventions without dieticians’ individualized visits.

Results: Six original articles were included in the review. Meta-analysis findings indicate that the intervention had a positive correlation with factors such as weight, dietary intake and quality of life (QOL) among older adults.

Conclusion: Individualized visits of a dietician in multi-disciplinary team care for older adults living at home or in nursing homes could improve nutritional status, dietary intake and QOL however, the evidence is limited.

Background: Caregivers play an important role in the continuation of home care for patients with heart failure, and support for caregivers has become an issue. Caregiving appraisal is included with negative aspects such as a sense of burden and positive aspects such as a sense of satisfaction, and the latter reduces the sense of burden associated with care; however, the current status of caregivers of patients with heart failure is unknown.

Objective: The objective of the study is to clarify the current status of caregiving appraisal and intervention studies of caregivers of patients with heart failure.

Method: A scoping review was performed on 142 original articles on caregivers of patients with heart failure.

Results: Caregivers experienced both negative and positive aspects, and the positive aspect improved their psychological condition. The negative aspect was influenced by the severity of heart failure and the number of hospitalizations, and the positive aspect was influenced by the lower number of acute exacerbations. Interventions that reduce the negative aspects have been reported; however, none of the studies have promoted the positive aspects.

Conclusion: Assessing the positive aspects of caregiving in addition to the negative aspects of caregiving, and providing nursing support to reinforce the positive aspects of caregiving evaluations, may help maintain and improve caregivers’ well-being and enable patients with heart failure to continue stable home care.

This study aimed to clarify the characteristics of the feelings of elderly people living in the community after being diagnosed with mild Alzheimer’s disease (hereinafter referred to as “mild AD”). Seven elderly people with mild AD were asked about their feelings in two rounds of semi-structured interviews: first, within a year of their diagnosis, and again a year later. The obtained narratives were qualitatively and descriptively analyzed to generate categories; first- and second-round categories were compared to assess their homogeneity and heterogeneity. Four categories of feelings experienced by elderly people after being diagnosed with mild AD were generated: distress toward knowing they have dementia; emotions of hope and despair toward their family; anxiety about socializing; and desire to live authentically in a familiar community. These results suggest that elderly people with mild AD wish to live in a familiar community a year later despite their distress about having developed dementia.

This study aimed to elucidate the perceptions of visiting nurses on specified medical acts. Semistructured interviews were conducted with 11 visiting nurses with ≥5 years of experience as visiting nurses. Obtained data was analyzed using the modified grounded theory approach, and eight categories were generated. The basis of visiting nurses’ perceptions of specified medical acts were characterized by pressures of being on duty alone and concerns about the effects on the patients and their families. Fundamentally, visiting nurses valued their pursuit for nursing with empathy for patients and families and confirming their primary roles as visiting nurses. Through their experiences involving their effort to save lives and troubles related to relationships with physicians, they demonstrated their expectations for specified medical acts and determination to fulfill their roles. Findings from this study suggest the need for improvements in relevant training programs and legal frameworks to develop a system that allows nurses to engage actively in specified medical acts.