Through interviews of five experienced caregivers in the field of aged care, this research aims to clarify the process of how care is actually provided in nursing homes and how workers attain clinical competence. In order to collect data for the research, a semi-structured, open response questionnaire based on simulated hypothetical care scenes was used to interview the care-givers. The research indicated that throughout the care-giving process, the knowledge and value on which caregivers’ practices would be grounded were checked repeatedly, and care recipients’ individual needs and support situations were evaluated. In the end, the intervention method was decided and care was provided in accordance with such evaluations. This kind of procedure for care-work practices can be categorized as a type of behavioral science. The research also found that the type of communication within the workplace significantly affects the continuation of caregivers’ clinical skills and knowledge, and improvements in their attitudes towards work.
This study examines the differences in supply of long term care insurance services in cities, towns, and villages in one prefecture. The effects of community factors (e.g., service supply level) and the individual factors on individual service use were examined, using HGLM (Hierarchical Generalized Linear Model) analysis. The data used was a combination of receipt data of long term care insurance for disabled elderly and community data, including the number of service providers in each community. Results show that there are differences in service supply levels among cities, towns, and villages, which are especially evident in relatively popular services. For some services (e.g., institutional, home-support, day care, home-visit nursing care services), the effects of service supply levels on the service use of disabled elderly remain significant even after controlling for individual factors, such as age and level of disability.
In the present study, we implemented an educational program for providing excretion care through collaboration between care workers and nursing staff, and elucidated changes in the awareness of care worker regarding work, collaboration, and excretion with the objective of determining the effects of the program. The program consisted of lectures on basic knowledge of excretion and collaboration as well as a 12-week conference on excretion. Subjects were 26 care workers who provided valid responses among the 52 care workers working at two long-term care health facilities in Prefecture A. Subjects were divided into three groups based on 3 points in time, before intervention, after lectures, and after conferences, to make a comparison between groups. The results showed that in terms of beliefs in excretion care, participants’ beliefs in the potentiality of lessening the usage of diapers through care became significantly higher through time. However, no significant changes were found in job satisfaction or sense of control over work. These findings suggest that the present program is effective for enhancing excretion care, and clarifying issues related to promoting collaboration.
The objective of this study is to explore what institutional factors are related to end of life care provided in nursing homes in Japan. Questionnaires were sent to head nurses in nursing homes in Japan. Data were obtained from 389 (32.4%) facilities. The nursing homes were divided into 3 groups: no deaths in the facility (n＝79: group 1), a small number of expected deaths in the facility (n＝231: group 2), and a large number of expected deaths in the facility (n＝79 : group 3). In nursing homes in group 3, end-of-life decisions of residents and their family members were more supported, and there were more night visits by physicians, compared to the other 2 groups. The results suggest that it is important to organize an end of life care system based on care skill improvement of staff and communication with family members.