Purpose: This study was to investigate the ways to support Japanese caregivers of elderly people with dementia living at home through comparing the caregiver samples’ problems and support needs between Japan and England.

Method: Two questionnaire surveys were administered on the caregivers’ problems, the services they and elderly people with dementia used, and the supports they needed in Japan and England.

Results: ① There were 229 valid answers in Japan and 70 in England. ② There were proportional differences between the samples in caregivers’ gender, relations to elderly people with dementia, their health, number of family living together, and having sub-caregivers. ③ The Japanese sample had more problems and they were mainly on their fatigue and stress because of looking after their family. ④ When they were in trouble, the supports requested by the Japanese sample were a day service and a short stay service. As for the English sample, they were the skills to care their family and a consultation by professionals. To continue looking after their family at home, the most required support by the Japanese sample was a short stay service, and it was a consultation by professionals by the English one.

Conclusion: It is important to offer a day service and a short stay service to lessen physical and emotional burden of Japanese caregivers.

The purpose of this study is verifying prospectively about the influence of home visiting intervention performed by a physiotherapist accompanying on activities of daily living (ADL) and family relationship of a disabled person living at home in the area which is not blessed with rehabilitation resources. The subjects were disabled people living at home and the families’ main care workers in five towns and villages in Aomori Prefecture (intervention group: n=57, control group: n=27). Home visiting intervention was performed for about two and a half years. ADL and the family relationships were evaluated twice between the six and twenty four months.

As a result, a significant relation was identified between intervention and changes in ADL. Moreover, a tendency towards an improvement of the degree of ADL independence was indentified in the intervention group. The extent was 3.89 times greater compared with the control group. On the other hand, it was shown that it cannot be said that there is a significant relation between home visiting intervention and family relationships.

From the results, suggestions were made about the meaning of home visiting intervention in areas which are not blessed with rehabilitation resources.

The purpose of this study is to investigate perception of dietary life and dietary behavior of patients with home oxygen therapy (HOT) and to examine effective nursing intervention for the HOT patients to achieve an appropriate dietary life.

As a result of qualitative analysis on semi-structured interviews with 15 outpatients on HOT, the patients’ perception of dietary life and dietary behavior were classified into 7 categories. Correlation analysis among the categories indicates the overall structures of perception of dietary life and dietary behavior of HOT patients. The structure contained a core category: emphasizing the maintenance of regular diet and activity. It was found that patients coped with symptoms and difficult conditions by trial and error.

These findings indicated that the following nursing interventions would be necessary for HOT patients to achieve appropriate dietary life: (a) alleviating dietary problems to make up the differences between perception and actual behavior, (b) providing. appropriate knowledge on diet, and (c) modifying inaccurate perceptions. Nurses need to play a technical and continuous role to help patients see the correlations between their disease and dietary life so that they can behave adequately.

This study identified the obstacles to activities for toileting, bathing and cleaning and meal eating and caring situations, with those activities of the frail elderly in a community. The study used the data-base collected by the other research project team. The basic research design was a cross-sectional survey with interview of the frail elderly performed by well-trained care managers. The number of sample was 321, and the sample was widely collected from a variety of cities and towns in Japan. The results showed that (1) physiological and cognitive functioning were significant factors effecting the obstacles to activities, and physiological functioning and dementia-related problematic behaviors were significant factors effecting caring situations; and (2) the possibility of some other factors relating to caring situations as well as three factors mentioned in this study. This study implied in care management practice that (1) a care manager should carefully assess the physiological and cognitive functioning of the frail elderly; and (2) a care manager should carefully assess the dementia-related problematic behaviors and the environmental factors causing those problematic behaviors.

The purpose of the present study is to elucidate the effectiveness of foot grip strength exercise in preventing falls in the elderly disabled at home. Subjects consisted of 48 female elderly persons with disability who had been able to perform the exercise for 3 months (exercise group), and 16 female elderly persons with disability who did not (control group). After the exercise, exercise group indicated an improvement in foot grip strength, the time to keep single-limb standing, postural sway and gait rate, whereas control group showed no changes. One-year follow-up studies revealed that the number of persons who had experienced falls was significantly decreased in exercise group. These results suggest the effectiveness of foot grip strength exercise in preventing falls in the elderly disabled at home.

The current study clarified the contents of complaint from users of home help services and examined the relation between complaint and provider’s systems, cooperation with care managers. The research design was a cross-sectional survey with mailed questionnaire. The subjects were 832 administrators in home care services in Osaka City that selected from the lists in computer networks (WAM-NET). The response rate was 85.6％. we analyzed 366 replies from administrators in home help services.

The results indicated that the main complaint were (1) problems in matching with service users and home helpers, (2) fees for home help services. The other results showed that the factors increasing complaint were (1) heavy caseloads, (2) increase in number of service rejections, (3) poor cooperation with care managers, (4) decrease in the degree of reflection of user’s needs to a care plan.

The findings suggested that user-driven service systems and cooperation between home help service providers and care managers could be avoidable complaint in home help service as well as assure the quality of service. Additionally, it was concluded that the role of responsible helper for service was very important.

The purpose of this study was to identify by cluster analysis communication behaviors in the daily lives of aphasic people living in the community. A self-report questionnaire using CADL-FQ was distributed to 68 caregivers in the Self-help Group of Aphasic people.

Results:

1. These aphasic people were 65 years old on average and had been, suffering from aphasia for about 10 years. Ninety percent of diseases causing aphasia involved cerebrovascular disorders. Half of people were ADL independent.

2. The communicative ability sub-score for “Listening” was significantly higher than for “Talking” or “Daily Communication”.

3.Items that were inferred to be highly useful were “following the instructions of medical staff members” and “controlling the TV.”

4. Cluster analysis on “Daily Communication” formed three clusters: “communication accompanied by conventional behavior in daily life,” “communication accompanied by instrumental ADL,” and “communication by means of only language (gestures or expression were not used to impart meaning).

The purpose of this study was to clarify the structure of “the satisfaction level of caregivers” in caregivers who had just finished a period of caring for elderly patients. The subjects were the caregivers of 704 elderly patients aged over 65 years old who died after receiving home care by visiting nursing station. In this study, the statements that were made by the caregivers about “the satisfaction level of caregivers” were analyzed by the method of content analysis.

As a result, the structure of “the satisfaction level of caregivers” was categorized into ① the process from the beginning of home care to the time of death, ② “how to prepare for death,” and ③ how to appreciate the significance of separation by death and understand it. As constituents, “life-style of patients at home,” “evaluation of care,” and “evaluation of informal and formal support” were extracted for ①, “peaceful death,” “unexpected death,” “death surrounded by caregivers”. “remorse for their end-of-life care,” and “evaluation of the place for death” for ②, and “attaching a positive significance to death by caregivers” and “various thoughts about death” for ③.

The results of this study suggest that “the satisfaction level of caregivers” was comprised of factors that might reflect to some extent the satisfaction level of elderly patients themselves, and factors that were related to the evaluation of care and preparations for separation by death of caregivers themselves.