The aim of this study was to give an account of the content of interviews with experts regarding the characteristics, care methods, and outcomes for elderly individuals with dementia in order to create a conceptual framework for support that elicits voluntary feeding behavior. Subjects were clinical nurses with professional quali.cations or more than 6 years'experience in the .eld of dementia nursing, and nursing university faculty from the .eld of gerontology. Semi-structured interviews were held and data obtained underwent content analysis and structuring. Results revealed that the characteristics of the elderly individuals were an indicator of their state resulting from the core symptoms of dementia, such as amnesia. Care methods involved daily examination of the causes of not being able to eat and support to adjust the elderly individuals'environment and emotions, to respond to their state, followed by individually tailored support to directly encourage meals, and support tailored to each individual's state as it changes with the progression of dementia. Care outcomes extracted were the primary outcome of eliciting voluntary feeding behavior, and secondary outcomes included improving nutritional status and gaining family satisfaction, which were obtained by continuing to achieve the primary outcome.

The aims of this study were to ascertain the experiences of individuals with severe motor and intellectual disabilities (SMID) who resided in the Tokyo area when the Great East Japan Earthquake struck and to determine the proportion of individuals with SMID who had those experiences. Family members of individuals with SMID who resided in the Tokyo area and who were seen by medical facilities for individuals with SMID in the Tokyo area completed a self-administered anonymous questionnaire. The questionnaire was returned by mail, and responses were received from 116 respondents. Analysis of those responses indicated that experiences soon after the massive earthquake were most often being"Con.ned indoors because residential elevators were out of service due to a power outage"(15.4%) and being"Unable to travel to a school or facility since public transportation was out of service and gasoline was in short supply"(15.4%). The most frequent experience 1 to 6 months after the earthquake was being "Unable to bring order to everyday life since authorities didn't clearly specify whether rolling blackouts would occur or not"(22.4%), followed by "There was a shortage of food or formula for a disabled child"(17.8%). Individuals with SMID are more susceptible to a disaster than the general population. The current results have revealed that there are 4 societal reasons for this. The first is that individuals with SMID have a tenuous link to regular society. The second reason why individuals with SMID are more susceptible to a disaster is because they must depend on others for the items that they need to survive. The third reason why individuals with SMID are more susceptible to a disaster is because their schools and care facilities are not part of a close community. The fourth and .nal reason why individuals with SMID are more susceptible to a disaster is because of the time taken to travel to and from care facilities where individuals with SMID can receive the multi-tiered care they need.