Objectives: This study clarified the structure of preferences of the elderly in an urban area of Japan concerning social supports and examined the relationships between the preferences and the demographic factors.

Methods: The research design was a cross-sectional survey with mailed questionnaire. The subjects （2,000 old individuals who were 65 years old and over） were randomly selected from the resident lists of the Osaka City. The response rate was 56.5%. Factor analysis with Varimax rotation was performed in order to clarify the structure of preferences. In addition, t-test and one-way ANOVA were performed to examine the relationships between the preferences and the demographic characteristics of the elderly.

Results: The results showed that the elderly were more likely to recognize family members as the most important support sources in their preferences about social supports. In addition, formal supports were the secondary sources for social supports of the elderly in their preferences. Another result from the factor analysis indicated that the elderly were more likely to view supports provided by volunteers as formal supports. The other results showed that old individuals who did not live with spouses and other family members or who recognized themselves as lower classes expected to receive instrumental supports from formal support services in their preferences and that their counterparts expected to receive them from their family members.

Conclusions : The primary sources for social supports of the elderly were family members in their preferences.The preferences were related to demographic factors such as living arrangements and social classes. Additionally, the interesting finding from this study was that the elderly tended to view supports provided by volunteers as formal supports. These findings imply that care managers working with the elderly should carefully assess their preferences about social supports and should consider their backgrounds in order to perform the care management practice.

With the development of aging society in Japan, need for in-home care has been increased. Quality of visiting home care provided by professionals must be evaluated.

The purpose of this study is to clarify issues of visiting nursing stations in order to raise quality of nursing care practice provided by them.

We asked nurses working for visiting nursing stations in S-Prefecture to evaluate performance grade of their own care they provided. Questionnaire was constructed from eight categories（assessment-planning-evaluation, daily living care, medical treatment-emergency, rehabilitation, infection control, terminal care, mental care-advocacy, family support）and forty items.

We got answers from thirty-eight visiting nursing stations and 202 nurses （respondent rate 86.0%）. Categories which performance grade was higher were terminal care and daily living care which are directly connected to basic nursing function. On the other hand, lowers were mental care-advocacy and infection control such as, collaboration with other professionals is needed.

As a result: it is to raise quality of nursing care.

1. It is make out a manual and it make to standard clear. Manuals can use of other professionals too.

2. We have found how to take opportunity to do the training for the nurses at visiting and it make a attend system for a small and work business.

We conducted 15 months trial of network formation among 14 frail elderly living at home through coordinators intervention and the use of videophones. The purpose of this trial was to support and improve the functional independence of the the frail elderly living at home who were out of use the long-term insurance system， and to widen the social network amongst them.

As the results， a network using videophones was helpful for the elderly in an improvement in functional independence and an increase in active communication for among them. A use of videophone as a support system in the day service contributed to improve the quality of the day service. We noted the following；（1）the important moment of coordinators intervention was one or two months after starting of the intervention；（2） to increase the coordinate function， it was necessary to understand well the situation of all subjects by coordinators；（3） Capacities as a care specialist in the coordinator worked on the home telecare service．

Objective：The purpose of this study was to investigate favorable factors in maintaining long-term care at home for persons with amyotrophic lateral sclerosis（ALS）who were introduced by the Patients’ Association and who had a positive outlook on life.

Methods：A survey conducted by interviews with patients and their family caregivers was carried out,and their attitudes toward long-term care were examined. The subjects comprised five patients（2 women, 3 men, aged from36 to 62）and their six caregivers （2 wives, 2 husbands, and one set parents）. Four patients had been continuing home mechanical ventilation for between 3 and 10 years.

Results：Most caregivers had accepted their own role as “an appointed task.” A positive relationship between the patients and member of their family was a crucial factor in continuing home care. It was of importance for ALS patients and their caregivers to be supported mentally by both informal networks and formal care services. After being physically and mentally stable for several years, patients and their families. started to consider their life “natural and normal” and not something special.

Conclusion：If patients and their families can accept their life as normal it will enhance their strength and enable them to continue stable home care.

The home care nurses often meet the patients who continue the treatment by prescription medication at home.

Some of the home care patients in secrecy from their physicians, are taking a non-prescription products that are similar to herbal medicine. In this kind of cases, an interaction of medications can be overlooked and impose danger to patients well being. The purpose of this research were to clarify the relation between the behaviors of taking prescription medicine and the non-prescription products use among outpatients.

There were 158 outpatients samples selected from two hospitals−74 male patients and 80 female patients. The average age was 70.0 years old. The number of daily medicines by prescription was six on the average for them and their mean of continued period was about 100 months.

The research result indicated that 20.3% of sample patients used non-prescription products of which 78.1% did not inform their use of non-prescription products to their physicians. The research result also indicated that when comparing among those patients “using” and “not using” non-prescription products, there were significant differences within each individual personal assessments for current prescription medication. The patients were following, “aware of the effectiveness of medicine” “the medication explanation was useful” “patients control the prescription medication on their own”. In logistic regression, the variables that clearly showed relationships were “the medication explanation was useful （p=. 004）”and“patients control the prescription medication on their own（p=. 007）”. Even between the distinction of sex women used more non-prescription products than men.

For the prevention of dehydration during the summer in elderly people with care needs, we carried out a survey on the present status of water intake/excretion in elderly people with care needs and water drinking support by care providers in 14 pairs. In the elderly people with care needs, the total water intake was 2.0±0.7l（drinking water,1.0l；from meals,0.9l；combustion water, 0.1l）, and the total water excretion was 2.0±177l（urinary excretion 1.2l；water evaporation, 0.8l）. These results suggested hydration that corresponds to daily water excretion is performed based on urinary excretion. All the car providers were aware of water drinking support for the elderly people with care needs. Eight care providers obtained information by receiving guidance in the necessary drinking water intake, and 6 had correct knowledge of the standard drinking water intake and encouraged elderly people to drink water using effective containers and types of drinks. As water drinking support, not only guidance in the standard drinking water intake but also detailed guidance according to the physique, drinking method. tastes, and the swallowing state of individuals is necessary, and the awareness of care providers should be also enhanced.

In this study， we provided visiting nursing specialty care in ALS patients who developed respiratory infection on life-support system and refused recommended hospitalization. The purpose of this case study was to identify effects of the care and decreasing the medical cost. We developed a care plan mainly for management of expectoration, and evaluated symptoms and examination data as outcomes. The medical cost was calculated by estimated amounts of hospitalization from length of stay, examinations and drugs. The medical cost in visiting nursing was calculated by actual visiting nursing cost and estimated amounts from the number of examinations and drugs. As a result, length of stay in case of hospitalization was 14 days at minimum while it took only 7 days by visiting nursing to easing symptoms and the examination results were normalized. Also, visiting nursing needed less examinations and treatments than hospitalization. Thus, the cost was relatively low. We need to enhance and study specialty of visiting nursing methods while length of stay is shorter and shorter．

Many chronic patients live in home, so health-care providers use the concept of Self-Care in home care situation. Also, the concept of Self-Care is considered, but this is not a clearly concept yet. Instruments relating to Self-Care developed worldwide. However, there is rarely useful instrument, because those instruments based on the concept of Self-Care, which is unclear and complex. We consider about the concept of Self-Care, furthermore discuss about some researches. This work is that we can clear problems on the concept of Self-Care and instruments.