The objectives of this study were to propose the usefulness of the elderly age-adjusted certification proportion for long-term care need (divided into mild long－term care need and severe long-term care need) for long-term care insurance, weighted disability prevalence (WDP), and disability-adjusted life expectancy (DALE) as health indicators for the elderly, to confirm the convergent validity of these indicators, and to clarify factors associated with these indicators as an example of practical use. The convergent validity was investigated by Spearman rank correlation coefficient between certification proportion for mild long－term care need, certification proportion for severe long-term care need, age-adjusted WDP, DALE at age 65, and disability-free life expectancy. The relationships of health indicators, socioeconomic, and demographic factors with the health indicators for the elderly were examined by the Spearman rank correlation coefficient. The convergent validity of certification proportion for mild long－term care need, certification proportion for severe long-term care need, WDP, and DALE was confirmed, and the male and female certification proportions for mild long-term care need were correlated with many socioeconomic indicators. In conclusion, our proposal that these terms should be used as health indicators for the elderly is appropriate, and these indicators are considered to be useful indicators for planning, evaluation, and decision-making in health and welfare policy for the elderly at local and regional levels.
In order to develop a reliable and validated user satisfaction scale to evaluate the quality of home help services, a model to measure the qualitative dimension, which is influenced by the working practice of home help organizers, was created and tested. 1831 elderly home help users were targeted and 1347 responses were obtained (response rate:70%) and 650 elderly clients’ responses without missing values were analyzed. The exploratory factor analysis was based on a model of five factors construct (client interview with explanation of service provision, scope of home helpers’ work, gap with actual needs, continuity of service and variability), and the factors predicted by the hypothesis were extracted. The confirmatory factor analysis for assessing the model showed a fit index of CFI=0.965, TLI=0.983 and RMSEA=0.079, confirming the construct’s validity. Sufficient reliability was confirmed with Cronbach’s α=0.88. The next step is to confirm cross validity by applying the proposed scale in other regions.
The purpose of this study is to elucidate the experience of elderly people who were not allowed to take part in the decision-making process for their own post-hospitalization life, which resulted in their relocation to a nursing home.
The participants in this research were three elderly women in hospital “A.” The average age was eighty years old. I conducted unstructured interviews with them six times on average during the period till their discharge. I tape-recorded these interviews with their permission and transcribed the recording for use as data for analysis.
The analysis revealed the situation where these elderly women were not allowed to take part in the process for deciding the course of their own life after leaving the hospital. They were left out of the process, causing them to have “crisis of loss of individuality,” “suffering from not having their present role,” and “pain of not having stability or a place to be.” It also became clear that the elderly women who were asked to relocate to a nursing home would, after all, accept it only “for the sake of their family” after all.
The objective of the present study is to clarify the characteristics of caregivers’ awareness by their family relationship to the elderly persons needing care in the practice of home care. The subjects were 376 caregivers who are caring for over 65-year-old elders requiring long-term home care while utilizing services provided by visiting nurse stations in one prefecture in August 2005. A factor analysis showed that home care awareness consisted of five factors, “self-growth”, “personal conflict”, “fulfillment”, “restriction” and “economic burden”. When average scores of each factor were compared by ANCOVA among wives, husbands, daughters, sons and daughters-in-law, the “fulfillment” score of the daughters-in-law was the lowest among the families and significantly lower than that of daughters. As for the “economic burden”, sons’ score was the highest and significantly higher than those of husbands, daughters and daughters-in-law. No significant differences were shown in the scores of the remaining 3 factors among the families. These findings suggest that the awareness of caregivers differs depending on the family relationship to the elderly persons needing care and thereby consideration of family relationship might be recommended in the making of care plans.