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Kashiwagi, Tetsuo. "Palliative Care in Japan". Palliative Medicine 5, n.º 2 (abril de 1991): 165–70. http://dx.doi.org/10.1177/026921639100500213.
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In 1990, palliative care services in Japan entered a new era when the national government authorized medical insurance cover for hospice care. Within the last decade, gradual yet remarkable progress has taken place in the perception of the need for palliative care services in Japan. The first Japanese hospice opened in 1981, followed by three other hospices over a nine-year period. These have been well received both by the public and medical professionals, although many difficulties have been encountered in establishing them. It is hoped that further development will include an increase in the number of hospices, a growing awareness within general hospitals of a hospice-style approach to care and an expansion in home care services.
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Nakanishi, Miharu, Asao Ogawa e Atsushi Nishida. "Availability of home palliative care services and dying at home in conditions needing palliative care: A population-based death certificate study". Palliative Medicine 34, n.º 4 (23 de janeiro de 2020): 504–12. http://dx.doi.org/10.1177/0269216319896517.
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Background: Avoiding inappropriate care transition and enabling people with chronic diseases to die at home have become important health policy issues. Availability of palliative home care services may be related to dying at home. Aim: After controlling for the presence of hospital beds and primary care physicians, we examined the association between availability of home palliative care services and dying at home in conditions requiring such services. Design: Death certificate data in Japan in 2016 were linked with regional healthcare statistics. Setting/participants: All adults (18 years or older) who died from conditions needing palliative care in 2016 in Japan were included. Results: There were 922,756 persons included for analysis. Malignant neoplasm (37.4%) accounted for most decedents, followed by heart disease including cerebrovascular disease (31.4%), respiratory disease (14.7%) and dementia/Alzheimer’s disease/senility (11.5%). Of decedents, 20.8% died at home or in a nursing home and 79.2% died outside home (hospital/geriatric intermediate care facility). Death at home was more likely in health regions with fewer hospital beds and more primary care physicians, in total and per condition needing palliative care. Number of home palliative care services was negatively associated with death at home. The adjustment for home palliative care services disappeared in heart disease including cerebrovascular disease and reversed in respiratory disease. Conclusion: Specialised home palliative care services may be suboptimal, and primary care services may serve as a key access point in providing baseline palliative care to people with conditions needing palliative care. Therefore, primary care services should aim to enhance their palliative care workforce.
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Matsumoto, Hiroshige, Masahiro Kawagoe e Satoko Hotta. "Older Adults Used Fewer Home Care Services during the COVID-19 Pandemic: Findings from a Secondary Analysis of an Urgent Survey in Japan". Annals of Geriatric Medicine and Research 25, n.º 4 (31 de dezembro de 2021): 286–93. http://dx.doi.org/10.4235/agmr.21.0108.
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Background: This study aimed to identify reduced home care use among older people and its impact on user numbers and service provider revenues during the coronavirus disease 2019 (COVID-19) pandemic.Methods: We conducted this secondary analysis of cross-sectional data from long-term care providers in Japan and estimated the probability of client cancellations and service contraction for institutional and home care services adjusted for the service type, area, size, infection occurrence, and staff employment impacts. We then estimated the rate of change in user numbers and revenue related to reduced usage.Results: Seventy-two percent of home care providers experienced client cancellations and 42.1% experienced service contraction, both of which were more prevalent in home care than in institutional care (adjusted odds ratio [AOR]=11.09 and 1.60). Home-visit (AOR=0.70) and short-term stay (AOR=0.38) services were less likely to experience client cancellations compared with adult day services. Service contraction was less likely in home-visit services (AOR=0.60) but were more likely in short-stay services (AOR=1.49) compared to adult day services. The estimated reductions in user numbers and revenue related to service contraction for adult day services were 9.1% and 7.1%, respectively. Home-visiting services decreased by an estimated 3.4% owing to service contraction. Conclusion: The secondary effects of the COVID-19 pandemic include reduced use of home care services, especially adult day services that include social contact. These secondary effects of the COVID-19 pandemic may cause functional deterioration in non-infected clients and financially impact service providers.
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Ogata, Yasuko, Yasuki Kobayashi, Takashi Fukuda, Katsumi Mori, Michio Hashimoto e Kayo Otosaka. "Measuring Relative Work Values for Home Care Nursing Services in Japan". Nursing Research 53, n.º 3 (maio de 2004): 145–53. http://dx.doi.org/10.1097/00006199-200405000-00001.
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Traphagan, John W. "Independence, Security, and the Intergenerational Social Contract: Home-Helper Services and Elder Care in Rural Japan". Care Management Journals 4, n.º 4 (dezembro de 2003): 216–22. http://dx.doi.org/10.1891/cmaj.4.4.216.63697.
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For several years, demographic trends and changing ideas about responsibilities for elder care in Japan have contributed to the desire, or need, for families to seek out new care approaches. This article focuses on one alternative to traditional approaches to caring for elder family members—the home-helper program that is available through the Japanese long-term care insurance program. Using ethnographic data collected in northern Japan, it will be argued that the home-helper program forms a compensatory elder care system that is intended to augment family-provided care and social support, rather than to promote independent living. This compensatory approach to elder care is based upon an intergenerational social contract in which it is assumed that some degree of dependence on family members is both an expected and preferred outcome of growing old.
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Matsushige, Takuya, Takako Tsuisui e Masaaki Otaga. "‘Mutual aid’ beyond formal institutions: Integrated home care in Japan". Current Sociology 60, n.º 4 (22 de junho de 2012): 538–50. http://dx.doi.org/10.1177/0011392112438336.
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The Japanese government has promoted the development of a home care system that integrates the provision of health and social care services and links formal and informal care. Yet the coordination of different forms of care faces a number of challenges. This article introduces a micro-sociological approach focusing on the relevance of ‘mutual aid’ in local communities as a guide to practical action. The article explores interactions, communication and coordination in multidisciplinary care delivery using a qualitative approach focusing on a region of the country with advanced integrated home care as a case study. The findings highlight the relevance of ‘mutual aid’ for integrated home care. The article concludes that health policy needs to establish incentives that enable collaboration across the formal–informal division of care.
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Traphagan, John W. "Culture and Long-Term Care: The Bath as Social Service in Japan". Care Management Journals 5, n.º 1 (março de 2004): 53–60. http://dx.doi.org/10.1891/cmaj.5.1.53.61263.
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A central feature of Japan’s approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difficult task of bathing a frail or disabled elder—a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.
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Lawrence, Timothy L. "Health Care Facilities for the Elderly in Japan". International Journal of Health Services 15, n.º 4 (outubro de 1985): 677–97. http://dx.doi.org/10.2190/y409-deyj-8yg1-w2y8.
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North America and Europe have been struggling with increasing elderly populations needing medical and personal care. Japan also has suddenly found itself faced with a rapidly expanding population of sick and disabled old people. Japan, however, has witnessed this dramatic increase in its aged population proceed at a rate almost twice that of any other industrialized nation. The very suddenness of the emergence of such a top-heavy population and the equally sudden changes in the family structure have placed great stresses on both the medical and social welfare systems of Japan. This study is, then, of the present state of facilities for the care of the elderly in Japan. As the United States is now grappling with the sheer bulk of its own Social Security and Medicare plans, this article casts a light for comparison on the care of the elderly in Japan. In Japan, as in the United States, major concerns focus on the short supply of trained personnel and the mushrooming costs of care. Moreover, the dependence of the Japanese medical system on the hospital has made some hospitals into warehouses for sick or disabled elderly, while not providing enough support for the elderly to remain active at home. Japan should carefully consider, therefore, diverting some funds from medical and hospital care to social welfare facilities and home care services.
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Butler, Jenny, e Teresa Smith. "Community Care and Rehabilitation after Stroke in Japan". British Journal of Occupational Therapy 65, n.º 8 (agosto de 2002): 363–70. http://dx.doi.org/10.1177/030802260206500803.
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The purpose of the research project was to determine, from a cross-cultural perspective, the care services and rehabilitation for elderly people with stroke living in the community in Japan. A written questionnaire and a semi-structured interview were used. The participants were a purposive sample of 21 elderly people and family/carer living in the metropolitan area of Tokyo, Japan. There were 11 men and 10 women with an average age of 70 years (range 42–86 years). The mean age at onset of stroke was 66.5 years (range 42–81 years) and the mean time since stroke was 3.2 years (range 3 months to 8 years). Varying levels of dependency were found, with an average Barthel Index score of 9.32 (range 0–18). Varying experiences of rehabilitation services were also reported: six people received physiotherapy only, six received physiotherapy and occupational therapy, and nine received no formal rehabilitation service either in hospital or in the community. Many participants were living in multi-generational households. Women had frequently given up jobs to care for their elderly relative, but were assisted in the caring role by community care workers (mainly nurses and home helpers). Environmental changes and disability equipment were evident in the homes. The project concluded that elderly people in Japan were supported by good community health care, although rehabilitation resources were limited. Cultural understanding as a key factor in rehabilitation processes is explored in the paper.
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SUZUKI, WATARU, SEIRITSU OGURA e NOBUYUKI IZUMIDA. "BURDEN OF FAMILY CARE-GIVERS AND THE RATIONING IN THE LONG-TERM CARE INSURANCE BENEFITS OF JAPAN". Singapore Economic Review 53, n.º 01 (abril de 2008): 121–44. http://dx.doi.org/10.1142/s0217590808002872.
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Long-Term Care Insurance (LTCI), introduced in Japan in 2000, is rapidly turning into a system of rationed benefits due to financial difficulty. Based on our survey of 2,530 family care-givers and the Zarit Care-Giver Burden Index, we have examined how LTCI is affecting their subjective burden. We have found that, as Kishida and Tanigaki (2004) had shown, (i) insufficient provision of short-term stays, day services and home-helper services, as well as (ii) disruptive or antisocial behaviors of the elderly, increase the care-giver's burden. We then argue that (iii) these results establish the positive contribution of LTCI in the well-being of family care-givers, (iv) short-term stay is the most efficient service, followed by home-helper service, and day service is the least efficient, and we show that (v) J-ZBIC-8 works well enough for many practical purposes.
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Kubota, Rie, Junichi Mukai, Michiko Yamada, Yurika Yoshino e Nakaba Okamura. "Evaluation of a New Home Patient Services Practicum for Community Pharmacy Students in Japan". Pharmacy 9, n.º 3 (29 de junho de 2021): 120. http://dx.doi.org/10.3390/pharmacy9030120.
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This study aimed to evaluate the usefulness of the practicum as well as assess the knowledge, skills, and various specific realizations that the students gained from it. A total of 244 students role-played a scenario in which a pharmacist visited a patient at home and provided pharmaceutical management services. After completing the practicum, the students completed (i) a questionnaire survey consisting of six questions that assessed their level of understanding of the role of pharmacists in home medical care and (ii) a rubric survey that evaluated their learning achievement. In addition, they submitted practicum portfolios describing the patients’ living conditions, physical conditions, and background as well as the services that required consideration of said variables. Their responses to the portfolio item “What were noticed through the practicum” were analyzed using the grounded theory approach. After the practicum, 45% and 53% of the students reported having a full and partial understanding of a pharmacists’ role in home medical care. The students’ mean ± standard deviation rubric score was 3.0 ± 0.4. They classified monitoring drug use, support for improving medication adherence, and observation to identify side effects early as major service categories in home medical care. The practicum led the students to perceive the need for communication with patients and various healthcare professionals to improve their readiness for practical training.
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Nakano, Ikuko, Y. Shimizu, K. Hiraoka, Y. Nakatani, J. Wake, A. Honma, T. Okamoto e Y. Izumo. "Measuring the Social-Care Service Needs of Impaired Elderly People in Japan". Ageing and Society 16, n.º 3 (maio de 1996): 315–32. http://dx.doi.org/10.1017/s0144686x00003445.
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ABSTRACTThis study aims to measure objectively and/or estimate the needs of impaired elderly persons and their families for social care services. The research was carried out in Maebashi, a medium size Japanese city. In our study, ‘impaired elderly persons’ included both physically and/or mentally impaired persons. In total, 693 impaired elderly persons and their families were classified according to 20 specific types of need: these ‘need types’ were cross-tabulated with two sets of factors: (1) Severity of impairments and (2) Difficulty of caregivers in providing the required care. A standard model of the service provision necessary for each ‘need type’ was established through group consultation with social care service professionals. Finally, the total amount of each service required in the city was calculated. Major findings are: (1) Our estimates indicate that 7.1 per cent of all persons 65 and over residing in Maebashi City were physically and/or mentally impaired to a certain degree. (2) Forty per cent of these elderly people were being cared for by caregivers who themselves had serious difficulties. (3) The demand for social care services in local Japanese cities is high. In order for this demand to be met a substantial expansion of both nursing home care and in-home care services is required.
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Hayasaka, Shinya, Masanobu Okayama, Shizukiyo Ishikawa, Yosikazu Nakamura e Eiji Kajii. "Accidents Associated with Bathing in Home Care Services for the Aged in Japan." Journal of Epidemiology 11, n.º 3 (2001): 139–42. http://dx.doi.org/10.2188/jea.11.139.
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Aoyama, Maho, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima e Mitsunori Miyashita. "The Japan HOspice and Palliative Care Evaluation Study 3: Study Design, Characteristics of Participants and Participating Institutions, and Response Rates". American Journal of Hospice and Palliative Medicine® 34, n.º 7 (2 de maio de 2016): 654–64. http://dx.doi.org/10.1177/1049909116646336.
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This article describes the whole picture of Japan HOspice and Palliative Care Evaluation Study 3 (J-HOPE3 Study) including study design and demographic data. The aims of the J-HOPE3 study were to (1) evaluate the process, structure, and outcome of palliative care in the following care settings: acute hospitals, inpatient hospice/palliative care units (PCUs), and home hospice services; (2) examine bereaved family members’ self-reported psychosocial conditions, such as grief and depression, as bereavement outcomes; (3) provide data to ensure and improve the quality of care provided by participating institutions through feedback concerning results for each institution; and (4) perform additional studies to explore specific clinical research questions. We conducted a cross-sectional, anonymous, self-report questionnaire survey involving patients’ bereaved family members in 20 acute hospitals, 133 PCUs, and 22 home hospice services between May and July 2014. Two types of questionnaires were used: main and specific studies questionnaires. The questionnaire was sent to totally 13 584, and 10 157 returned the questionnaire. The analysis included 9126 family members’ questionnaires from acute hospitals, PCUs, and home hospice services. Respondents’ average age was 61.6 years, 55% were women, and 40% had been married to the deceased. With respect to the characteristics of participating institutions, most institutions did not have religious affiliations, and most PCUs and home hospice services provided bereavement care. These results of the analysis of common and additional questionnaires could play an important role in clinical settings, quality improvement, research, and public accountability.
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Akishita, Masahiro, e Satoru Mochizuki. "Geriatrics Perspectives From Japan". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 382–83. http://dx.doi.org/10.1093/geroni/igab046.1485.
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Abstract In 2025, Japan’s baby boomers will cross the threshold of 75 years of age; a phenomenon that has been referred to as “the 2025 crisis”, resulting in a significant burden on the healthcare system. To address this issue, the Japanese government is establishing the Integrated Community Care System, to provide comprehensive medical and long-term care services in each community. In cooperation with government and affiliated organizations, the Japan Geriatrics Society (JGS) has been working to develop the Integrated Community Care System. As a result of this effort, geriatric medicine is being integrated into the health care system through incentives for practitioners. For instance, medical facilities can be reimbursed if they perform comprehensive geriatric assessments (CGA) and CGA-based management/care. Additionally, home care medicine and polypharmacy are emerging issues of interest to the government. In this symposium, I will discuss how JGS has been trying to achieve “Aging in Place” in Japan.
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Mine, Yuka, Masayuki Yokoi e Takao Tashiro. "Why Did the Policy to Convert Hospitals Into Facilities Not Work in Japan?" Global Journal of Health Science 11, n.º 10 (16 de agosto de 2019): 89. http://dx.doi.org/10.5539/gjhs.v11n10p89.
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The government of Japan formulated measures to significantly reduce the number of hospital beds for long-term care in 2006. In particular, long-term care hospital beds covered by long-term care insurance (sanatorium medical facilities) were to be abolished in 2012, and existing sanatorium medical facilities were to be converted into long-term care insurance services such as geriatric health services facilities. However, the conversion did not progress in spite of various support measures, and the deadline for abolishment was extended. In order to clarify the reason for this, we selected 28 hospitals with 402 or more long-term care beds and 28 health services facilities with 158 or more beds and examined their management philosophies and analyzed the keywords included. The most popular keyword was “community” in both hospitals and facilities. Hospitals had a significantly higher rate of 60.7% (P< 0.05) of including “trust” or “feeling of relief” in their management philosophies. Facilities had higher rates of including any of the terms “return” or “independence” or “home” (32.1%, P= 0.051), and also of including either “service” or “care” (46.1%, P< 0.05). In conclusion, it is suggested that hospitals with long-term care beds differentiate themselves from neighboring facilities in that they are able to simply accept the situation and be responsible for terminal care whenever inpatients may have difficulty returning home. In addition, it seemed difficult for hospitals to convert into health service facilities, the aim of which is to enable residents to return home.
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Neill, Ruth D., Junko Wake, Mie Ohwa, Jill Manthorpe, Patricia Gillen e Paula McFadden. "Comparing the Mental Wellbeing and Quality of Working Life among Nurses and Social Care Workers in the UK and Japan in Older Adults’ Care Services during the COVID-19 Pandemic". Psych 4, n.º 4 (1 de novembro de 2022): 843–55. http://dx.doi.org/10.3390/psych4040062.
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This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults’ care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents’ psychological wellbeing was significantly lower in Japan compared to the UK (p ≤ 0.001). UK respondents had significantly higher personal burnout (p < 0.05) and work-related burnout (p < 0.05) while those in Japan had significantly higher client-related burnout (p < 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.
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Burton, Elissa, Gill Lewin e Duncan Boldy. "A Systematic Review of Physical Activity Programs for Older People Receiving Home Care Services". Journal of Aging and Physical Activity 23, n.º 3 (julho de 2015): 460–70. http://dx.doi.org/10.1123/japa.2014-0086.
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The proportion of older people living in our communities is rising and, to live independently, some require assistance from home care services. Physical activity can improve and maintain function, strength, and balance, which are important for those receiving home care. This study reviewed the evidence on physical activity/exercise interventions trialed with older people receiving a home care service. A systematic review of studies published from January 1982 to September 2012, from five databases, was undertaken. Inclusion criteria were: aged 65+ years; community dwelling; no dementia diagnosis; receiving home care services; and a physical activity/exercise program. Eight articles were included and results show there were few consistencies between intervention types, groups, outcome measures, and follow-up. Study quality was mixed. Future studies should include pragmatic randomized controlled trials involving home care practitioners and their clients to gain “real-world” knowledge of what interventions are effective and can be delivered within this setting.
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Goto, Yuko, e Hisayuki Miura. "Validation and Clinical Application of the Japanese Version of the Patient-Reported Experience Measures for Intermediate Care Services: A Cross-Sectional Study". Healthcare 12, n.º 7 (29 de março de 2024): 743. http://dx.doi.org/10.3390/healthcare12070743.
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Older adult patients account for 70% of all hospitalized patients in Japan, and intermediate care based on patient-centered care (PCC) that ensures continuity and quality of care at the interface between home services and acute care services and restores patient’s independence and confidence is necessary for them to continue living independently. At present, no concept of intermediate care is established in Japan, and the implementation of PCC has been delayed. Thus, in this study, a Japanese version of the intermediate care evaluation index (patient-reported experience measure (PREM)) was created on the basis of the original PREM developed in the UK, and data in wards with intermediate care functions in Japan were collected to confirm internal consistency and validity from 2020 to 2022. The Japanese version of PREM was found to have a factor structure with two potential factors. Given the clear correlation with the shared decision-making evaluation index, which is the pinnacle of PCC, the theoretical validity of the Japanese version of PREM, which is based on PCC as a theoretical basis, was confirmed.
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Ayabe, Takako, e Shinichi OKADA. "Research concerning the Care Planning by Care Managers in Home-Based Community Care Support Centers of Japan". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 950–51. http://dx.doi.org/10.1093/geroni/igab046.3432.
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Abstract The research was conducted between February 9 and 28, 2017. The care management centers were randomly selected from the national list of the centers. The data were collected by self-administered questionnaires mailed to the care managers at 500 care management centers in six prefectures in the Kinki area of Japan. The independent variables were gender, age, experience years of care managers and/or social workers, Clients’ Physical and Mental conditions (CPM), Client’s Lifestyle (CL), Physical and Mental conditions of the Caregivers (PMC), and Human and Financial resources for Clients and their Caregivers (HFCC). The dependent of variables were the categorized contents in the care planning. They included the Approach for exploring Client’s needs (AC), Coordination among Care services within the program in accordance with the needs of client (CC), Coordination among Formal services and informal supports without the program in accordance with the needs of clients (CF). We examined the relationships between the dependent and independent variables by using the Structural Equation Modeling. The results indicated that the goodness of the fit indices was acceptable, and we retained the models. In correlational analyses, AC was significantly correlated with PMC (p<.01), CPM (p<.05), and CL (p<.001). CC was significantly correlated with PMC (p<.001), CPM (p<.001), and CL (p<.01). CF was significantly correlated with PMC (p<.05), HFCC (p<.05), and CL (p<.05). In conclusion, our findings suggest that care managers should recognize that information concerning the clients’ and their caregivers’ conditions is significant in making appropriate care planning for the clients and their caregivers.
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Akiyama, Akiko, Hiroo Hanabusa e Hiroshi Mikami. "Factors Influencing Home Death in a Japanese Metropolitan Region". Journal of Aging Research 2011 (2011): 1–8. http://dx.doi.org/10.4061/2011/610520.
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To examine factors influencing home death, an anonymous survey was mailed to 998 home care supporting clinics (HCSCs) in the 23 wards of Tokyo, Japan. We classified the HCSCs into two types (single physician practice and multiple physician practice) and identified factors of each type of practice that predict home death. The factors associated with a greater probability of dying at home were as follows: in the multiple physician practices, collaboration with hospitals and teaching coping skills to the family members and, in the single physician practices, collaboration with clinics. Our findings suggest that home end-of-life care services are unlikely to be achieved without cooperation among service providers and without improvement of the family members' coping skills.
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Okamoto, Etsuji. "Japan’s Dental Care Facing Population Aging: How Universal Coverage Responds to the Changing Needs of the Elderly". International Journal of Environmental Research and Public Health 18, n.º 17 (4 de setembro de 2021): 9359. http://dx.doi.org/10.3390/ijerph18179359.
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Although universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care in their benefits. Japan, with its long-held tradition of UHC, covers dental care as an essential benefit, and the majority of dental care services are provided to all patients with minimal copayment. Being under UHC, the scope of services as well as prices are regulated by the uniform fee schedule, and dentists submit claims according to the uniform format and fee schedule. The author analyzed the publicly available dental health insurance claims data as well as a sampling survey on dental hygiene to illustrate how Japan’s dental care is responding to the challenges from population aging. A marked improvement was found in dental health status in the elderly population as measured by improved tooth-specific survival. The improvement may be attributable to the universal coverage of dental care, as evidenced by the steady increase in home visits by dentists/dental hygienists as well as home oral rehabilitation services.
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Yamazaki, Akemi, e Tae Kawahara. "The Structure of Family Practices in Multifunctional Long-Term Care in a Small Group Home in Japan". Home Health Care Management & Practice 30, n.º 1 (3 de outubro de 2017): 30–34. http://dx.doi.org/10.1177/1084822317734181.
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The aim of the present research was to extract the structure of family practices in multifunctional long-term care in a small group home by focusing on practices offered to families that are not present in conventional in-home support services. Semistructured interviews were conducted with 18 care providers and four users’ family members. Four categories and 16 subcategories were extracted. In multifunctional long-term care in a small group home, staff engaged in the practices of becoming a part of family life, drawing out the nursing care capabilities of family members, and constantly speaking about the future with office staff and family members so that elderly users with dementia could live while being respected as people.
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Ito, Tomoko, Sachiko Hirata-Mogi, Taeko Watanabe, Takehiro Sugiyama, Xueying Jin, Shu Kobayashi e Nanako Tamiya. "Change of Use in Community Services among Disabled Older Adults during COVID-19 in Japan". International Journal of Environmental Research and Public Health 18, n.º 3 (28 de janeiro de 2021): 1148. http://dx.doi.org/10.3390/ijerph18031148.
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During the COVID-19 pandemic, social interactions were restricted, including community services for disabled older adults. This study aimed to describe the change of use in community services related to long-term care insurance (LTCI) during the pandemic in Japan. A retrospective descriptive study was conducted using data collected via a cloud-based management support platform for older adult care provider “Kaipoke”, by a private-sector company “SMS Co., Ltd.”, in which care-managers of LTCI manage their office work. Data collection occurred from July 2019 to June 2020. Study subjects were LTCI service users aged 65 years and above. Subjects were living at home. We examined changes in the number of users of LTCI services before and after the COVID-19 pandemic began, using an interrupted time-series analysis. Results indicated that the use of outpatient services was reduced; however, home-visit services were maintained. The decrease in use was significant in the seven prefectures where the infection initially spread. There are concerns that older adults or surrounding caregivers can be affected by such changes in LTC service use. It is therefore necessary to implement sustainable measures from a long-term perspective and investigate their influence as part of future studies.
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Ohta, Ryuichi, Naoto Sakamoto e Tetsuhiro Maeno. "Home Care Workers’ Judgment of Acute Conditions in Home Care Patients: A Retrospective Cohort Study". Home Health Care Management & Practice 32, n.º 1 (4 de julho de 2019): 3–9. http://dx.doi.org/10.1177/1084822319861095.
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Home care workers are likely to detect acute conditions in home care patients. Obtaining data about home care workers’ detection of acute conditions is essential for improving the present quality of home care. This study investigates how home care workers approach the acute conditions of their patients. A retrospective cohort study was conducted with all home care patients who received services from home care workers in Unnan City, Shimane, Japan. The primary outcome was the frequency of acute conditions occurring in home care patients. We used logistic regression to model the acute conditions of the patients based on their age, gender, dependent condition, home-care-worker visit frequency, isolation, and number of chronic diseases. Of 445 participants, 74 had acute conditions (16.6%). The most common among the acute conditions was fever. There were no statistically significant relationships found between admission and the independent variables. The results of the logistic regression model demonstrated that visit frequency and isolation were statistically significant (odds ratio [OR] = 1.24, 95% confidence interval [CI] = [1.08, 1.43], p < .001; OR = 1.95, 95% CI = [1.09, 3.09], p = .001). This research shows that home care workers may be able to identify the early stages of acute diseases in their patients. The improvement of their detection skills may contribute to better health care for home care patients. The application of support systems such as information and communication technologies can promote the identification of acute conditions.
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Ono, Keiko. "HOME-BASED END-OF-LIFE CARE COOPERATION BETWEEN VISITING NURSES AND CARE MANAGERS IN JAPAN". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 1056. http://dx.doi.org/10.1093/geroni/igad104.3394.
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Abstract End-of-life care patients use home-visit nursing services under Japanese long-term care insurance; however, they require a care manager to implement the care plan. However, the cooperation procedure of home-based medical care between visiting nurses and care managers has not been adequately researched. Thus, this study aimed to clarify the presence of support between visiting nurses and care managers to be adapted to this situation. This study was conducted in March and April 2023 at home-visit nursing stations located in a prefecture in Japan. Self-administered questionnaires were mailed to 192 visiting nurses in Japan, and 136 response forms (70.8%) were received through postal mails. A total of 130 questionnaires (67.7%) were determined to be valid responses, which also included the participants’ written consent for research. The presence or absence of work experience and the importance of collaboration in the preparatory, introductory, stable, and near-death stages of end-of-life care were answered. The presence of work experience at each stage was over 53.1%. The importance of collaboration at each stage was over 76.9%. Query regarding collaborating well with care managers was answered on a scale from 0 to 100 %. Good collaboration with care managers had an average score of 75.4%. The presence or absence of experience and the importance of collaboration items were clarified at each stage. The research findings could contribute to the development of education and training. This work was supported by JSPS KAKENHI Grant Number JP21K02802.
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Sumikawa, Yuka, Sameh Eltaybani, Chie Fukui, Ayumi Igarashi e Noriko Yamamoto-Mitani. "WHAT IS THE DIFFERENCE BETWEEN OLDER PERSONS WHO CONTINUE HOME CARE AND THOSE WHO DO NOT?" Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 710. http://dx.doi.org/10.1093/geroni/igad104.2302.
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Abstract Enabling older people to remain in and return to their homes after hospitalization or institutionalization (i.e., admission to care institutions, such as nursing homes), if they wish so, is a key principle of aging-in-place worldwide. This prospective cohort study examined the characteristics of older people who returned to their homes after hospitalization or their stay at other care facilities. The study started with 1,450 older persons (≥75 years) receiving home care services at multiple places in Japan. Data were collected at the baseline and 6-month follow-ups. The study was approved by the Research Ethics Committee of the Graduate School of Medicine, The University of Tokyo (No. 2019087NI). At the 6-month follow-up, 256 clients (female: 152 clients, mean age: 85.1 ± 6.1) were hospitalized or institutionalized at least once, of which 54 clients (female: 38 clients, mean age: 83.6± 6.8) returned home afterward. A multivariate logistic regression showed that females (odds ratio [95% confidence interval]: 2.01 [1.06 to 4.09]), those with more care assistance (1.27 [1.03 to 1.55]) were more likely to return to their home, whereas older clients had a lower likelihood (0. 93 [0.88 to 0.98]). Based on this finding that younger females were more likely to return home if hospitalized or institutionalized, older males may have different needs than females, influencing the type and level of support they require. Further research might identify the support needed for older males with less care assistance.
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Dupraz, Julien, Karen Andersen-Ranberg, Stefan Fors, Marie Herr, Francois R. Herrmann, Tomoko Wakui, Bernard Jeune, Jean-Marie Robine, Yasuhiko Saito e Brigitte Santos-Eggimann. "Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international 5-COOP study". BMJ Open 10, n.º 3 (março de 2020): e034296. http://dx.doi.org/10.1136/bmjopen-2019-034296.
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ObjectivesTo measure the use of healthcare services and assistive devices by centenarians in five countries.DesignCross-sectional study using a survey questionnaire.SettingCommunity-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark.Participants1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions.Main outcome measuresRecent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries.ResultsThere was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark.ConclusionsOur findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences.
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Yamauchi, Yasuhiro. "Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan". Global Journal of Health Science 8, n.º 3 (12 de julho de 2015): 89. http://dx.doi.org/10.5539/gjhs.v8n3p89.
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<p>Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population’s longevity and low birth rate. In this study, we examine the efficiency of Japan’s regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care.</p>
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Abe, Kazuhiro, Yasuki Kobayashi, Akira Kawamura, Haruko Noguchi, Hideto Takahashi e Nanako Tamiya. "The Association between Continuation of Home Medical Care and Utilization of Other Home Care Services for Older People with Long-term Care Insurance in Japan". An Official Journal of the Japan Primary Care Association 41, n.º 1 (2018): 2–7. http://dx.doi.org/10.14442/generalist.41.2.
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Jang, Aeji, Yeonjung Lee e Young Choi. "SOCIALIZING CARE FOR OLDER PEOPLE ACROSS THE COUNTRIES: A COMPARATIVE STUDY OF THE LOCATION OF CARE". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 1154. http://dx.doi.org/10.1093/geroni/igad104.3704.
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Abstract As more people are likely to prefer to age in their own place, where and how the care in later life is provided become more important. This paper aims to compare the degree of socialization in care for older people among different countries, especially focusing on the location of care (i.e., home care and institutional care). We applied the Fuzzy-set Ideal Type Analysis to classify the countries depending on how the formal care is provided between home and institutional settings. Measures of socialization in home care include the national expenditure on home care and the number of formal care workers at home, whereas formal care workers and the number of beds in residential LTC facilities are indicators for socialization in institutional care. The four different types of formal care will be classified: HI where both home and institutional cares are highly socialized; Hi where home care is highly socialized but institutional care is not; hI where institutional care is highly socialized but not home care; and hi where neither are socialized. Results show that Denmark, Australia, and the Netherlands belongs to HI; Japan to Hi, New Zealand, Switzerland, and Germany to hI; and Korea and the United States to hi. Findings suggest that countries with high level of socialization of home care are likely to have a care management system for coordinating and monitoring services. This study provides implications for considering the unique cultural, institutional, and policy contexts among the countries in regards to the degree of socialization of care.
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Jin, Xueying, Takahiro Mori, Mikiya Sato, Taeko Watanabe, Haruko Noguchi e Nanako Tamiya. "Individual and regional determinants of long-term care expenditure in Japan: evidence from national long-term care claims". European Journal of Public Health 30, n.º 5 (18 de junho de 2020): 873–78. http://dx.doi.org/10.1093/eurpub/ckaa065.
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Abstract Background Japan, with the oldest population in the world, faces a financial challenge caused by rising long-term care (LTC) expenditure. For policymakers to address this, it is important that we have a better understanding of how individual and regional characteristics affect LTC expenditure. Methods We linked national LTC insurance (LTCI) claim data, covering the entire population who used LTCI services in Japan, with municipality data on an individual level. Individuals 65 years and older (n=3 876 068) who had used LTCI benefits at least once in the fiscal year (FY) 2016 were included. We examined the associations of individual and municipality characteristics regarding supply and demand of healthcare with the LTC expenditures on facility care, home and community care, and total care (the sum of both types of care), after adjusting for regional differences in LTC extra charges. Results The following variables were associated with higher total expenditure; at the individual level: female, a higher care-need level, a lower income (0% co-payments) or a facility service user; at the municipality level: municipalities locating in metropolitan areas, with a higher proportion of single elderly households, more doctors per 1000 citizens, more nursing homes per 100 000 LTC benefit users or more outpatient medical spending per citizen ≥75 years old. Conclusions As we are able to identify several individual and municipality characteristics associated with higher LTC expenditure in Japan, the study offers insights into dealing with the rapidly growing LTC expenditure.
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Honda, Ayumi, Elizabeth Fauth, Yin Liu e Sumihisa Honda. "Predictors of Effort-Reward Imbalance Among Employees Providing Three Types of Long-Term Care Services in Japan". Innovation in Aging 4, Supplement_1 (1 de dezembro de 2020): 183–84. http://dx.doi.org/10.1093/geroni/igaa057.594.
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Abstract Increasingly, employees are leaving their jobs as long-term care workers in Japan. The purpose of this study was to identify predictive factors of effort-reward imbalance (ERI) among employees in long-term care, to better understand factors associated with excessive effort and reduced reward. This cross-sectional study included 944 participants providing three types of long-term care: home-based (n=201), community-based (n=128), and institutional (n=615). Multiple logistic regression analysis was used to identify factors associated with self-reported ERI, where higher ERI scores indicated greater work-related efforts and lower rewards. Key independent variables included type of occupation, employment status, position, daily working hours, job satisfaction, and annual income. Our results showed that low job satisfaction was the sole common factor associated with ERI in employees across all three types of long-term care. Other predictive factors for ERI differed by type of long-term care services. Working longer hours predicted ERI in community-based and institutional care employees, but not home-based care employees. For institutional care employees, being a care manager, holding a position of department head, having family-related stress were risk factors for ERI, suggesting that in this setting, the rewards of higher income and more prestige in leadership positions are offset by greater work-related demands. In conclusion, factors associated with ERI were both common and distinct among employees providing different types of long-term care services. Adjusting work demands and working hours, and identifying unique contributors to ERI within specific long-term care settings may help with job retention in these occupations.
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Kim, Sung-A., Akira Babazono, Aziz Jamal, Yunfei Li e Ning Liu. "Comparison of care utilisation and medical institutional death among older adults by home care facility type: a retrospective cohort study in Fukuoka, Japan". BMJ Open 11, n.º 4 (abril de 2021): e041964. http://dx.doi.org/10.1136/bmjopen-2020-041964.
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ObjectivesWe compared the care services use and medical institutional deaths among older adults across four home care facility types.DesignThis was a retrospective cohort study.SettingWe used administrative claims data from April 2014 to March 2017.ParticipantsWe included 18 347 residents of Fukuoka Prefecture, Japan, who received home care during the period, and aged ≥75 years with certified care needs of at least level 3. Participants were categorised based on home care facility use (ie, general clinics, Home Care Support Clinics/Hospitals (HCSCs), enhanced HCSCs with beds and enhanced HCSCs without beds).Primary and secondary outcome measuresWe used generalised linear models (GLMs) to estimate care utilisation and the incidence of medical institutional death, as well as the potential influence of sex, age, care needs level and Charlson comorbidity index as risk factors.ResultsThe results of GLMs showed the inpatient days were 54.3, 69.9, 64.7 and 75.0 for users of enhanced HCSCs with beds, enhanced HCSCs without beds, HCSCs and general clinics, respectively. Correspondingly, the numbers of home care days were 63.8, 51.0, 57.8 and 29.0. Our multivariable logistic regression model estimated medical institutional death rate among participants who died during the study period (n=9919) was 2.32 times higher (p<0.001) for general clinic users than enhanced HCSCs with beds users (relative risks=1.69, p<0.001).ConclusionsParticipants who used enhanced HCSCs with beds had a relatively low inpatient utilisation, medical institutional deaths, and a high utilisation of home care and home-based end-of-life care. Findings suggest enhanced HCSCs with beds could reduce hospitalisation days and medical institutional deaths. Our study warrants further investigations of home care as part of community-based integrated care.
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Chen, Xin, Tian Zheng e Yong Zhou. "New Trend in Facilities for the Elders in Japan - Small Multi-Care Facilities". Applied Mechanics and Materials 357-360 (agosto de 2013): 43–46. http://dx.doi.org/10.4028/www.scientific.net/amm.357-360.43.
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Recently, the Japanese government is actively advocating the form of facilities for the elders, the small multi-care facilities, which is in close relation with the residents in surrounding communities. It is to provide diverse services for the elders mainly by daytime caring, as well as the night accommodation, residence and home caring. This paper mainly introduces the background of these facilities, design concept and key points in design, to provide reference for designing and building of facilities in our country.
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Kanai, Hideaki, e Akinori Kumazawa. "An Information Sharing System for Multi-Professional Collaboration in the community-based integrated healthcare system". International Journal of Informatics, Information System and Computer Engineering (INJIISCOM) 2, n.º 1 (25 de junho de 2021): 1–14. http://dx.doi.org/10.34010/injiiscom.v2i1.4862.
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Currently, Japan is rapidly aging. Japanese government agencies report that the percentage of elderly people whose ages are at least 65 years will increase by up to about 30 percent in 2025. As one of the measures towards this situation, the community-based integrated healthcare system will be introduced in Japan. The system aims to provide elderly people living at home with appropriate health, medical, and welfare services. We focus on the burden of sharing information on the situation of the elderly at home among health, medical, welfare staffs, and neighbors. We have been developing a supporting system for sharing information on the situation of the elderly at home and conducted a field test around one year. We consider that various stakeholders involved in the community comprehensive health care system could recognize the importance of information sharing and collaboration with them through this kind of social implementation
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Shinohara, Masumi, Mariko Sakka, Taisuke Yasaka, Asa Inagaki, Chie Fukui, Maiko Noguchi-Watanabe, Ayumi Igarashi e Noriko Yamamoto-Mitani. "Association between Advance Care Planning for Older Adults and Family Caregivers’ Sense of Security in Home Care Settings: A Prospective Cohort Study". Health & Social Care in the Community 2023 (3 de abril de 2023): 1–11. http://dx.doi.org/10.1155/2023/4250408.
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Family caregivers’ sense of security benefits older adults who receive home care. Advance care planning (ACP) is reported to affect family caregivers’ experience positively, but it might differ depending on family caregivers’ kin relationships with the older adults. This study aimed to investigate whether ACP for older adults in home care settings is associated with family caregivers’ sense of security and whether such an association depends on the family caregivers’ status as spouses or adult children. Clarifying this association may offer practical support for implementing ACP while maintaining family caregivers’ sense of security. This study was part of a prospective cohort study in Japan. The participants were older adults who used home-visit nursing services, their family caregivers, and the nurses who cared for them, recruited through the professional associations of home care nurses across Japan. Family caregivers answered a sense of security questionnaire, and the nurses were asked whether ACP was conducted. Data were collected three times from nurses and twice from family caregivers over a three-month period from August 2019 to June 2020. Multivariate logistic regression analyses were performed to examine the association between ACP implementation and positive changes in the sense of security scores after three months. Data from 169 cases were analyzed; 28.1% of the family caregivers were men and 55.6% were spouses. ACP was performed in 53.8% of the cases. The multivariate analysis showed an interactive effect between ACP implementation and family caregivers’ kin relationships. For spouses, ACP was significantly associated with a positive change in their sense of security. For adult children, such an association was not found. Thus, ACP might have a positive effect on caregiving spouses’ sense of security. Adult child caregivers, who often have multiple responsibilities and have difficulties facing their parents’ physical decline, may need support in addition to ACP.
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Furukawa, Kazutoshi. "Development of a care management support system for preventing severe disease in elderly people requiring long-term care and enabling their continued living at home: Results of a questionnaire survey to identify assessment items". International Journal of Integrated Care 23, S1 (28 de dezembro de 2023): 044. http://dx.doi.org/10.5334/ijic.icic23021.
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In Japan, it is common for individual elderly patients requiring long-term care to use multiple home care services in order to continue living at home. However, the details of the services provided and patients’ conditions at the time of care are not shared among the service providers.
To address this issue, our research team aims to develop a website that collectively manages care information, predicts declines in activities of daily living (ADL) based on artificial intelligence (AI) analysis, and if necessary, automatically sends reports to service providers and the care manager in charge of the patient.
The target population of this study are elderly people with care needs living at home, their families, care managers, and home care service providers.
This research is being conducted with the cooperation of elderly individuals requiring care and their families, while always listening to the opinions of the parties involved. In developing the web system, we collaborated with a researcher specializing in care management and another researcher specializing in website development.
This report describes a questionnaire survey conducted to examine the assessment items to be used in a “care management support system for prevention of severe disease and continuation of living at home for elderly people requiring long-term care”, which our research team is working to develop. Firstly, the assessment items presented in “Appropriate care management techniques: Basic care and disease-specific care” published by the Japanese Ministry of Health, Labour and Welfare were discussed among the author, co-authors, and care managers who were not the subjects of this study, and 73 assessment items were extracted. For each of the 73 items, a questionnaire was developed asking “How important do you think it is for the elderly requiring care to continue living at home?” Each question was scored on a 5-point scale. Of the 30,631 home care support centers in Japan, 1,000 were randomly selected based on a population-proportional distribution by prefecture and government-designated city. Questionnaires were mailed to a total of 3,000 care managers, three to each center, and 642 valid responses were obtained (valid response rate: 21.4%).
Assessment items that the care managers selected as highly important (4.7 points or higher) were “presence or absence of falls”, “status of cognitive impairment if the patient has dementia”, “amount of food intake”, “changes in daily condition”, and “mental and physical statuses of a caregiver (family member)”.
For the international audience, the development of a “website that predicts declines in ADL based on AI analysis, and if necessary, sends reports to service providers and the care manager in charge of the patient” may provide useful information, as it could be modified to suit the situations in each country and be used effectively in many countries.
In the next steps, we plan to conduct interviews with elderly people requiring long-term care, their families, and care managers and determine the data entry items before creating a website and implementing it on a trial basis.
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Hirayama, Ryo. "Who Should Make Care Arrangement for Older Adults? Heteronormative Family Responsibility in Japan". Innovation in Aging 5, Supplement_1 (1 de dezembro de 2021): 420. http://dx.doi.org/10.1093/geroni/igab046.1628.
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Abstract In Japan, despite the greater availability of public care services upon implementation of national long-term care insurance, families are still considered as primarily responsible to make care arrangement for older adults. My aim in this study was to explore (hetero)normative ideas about families that underlie Japan’s institutionalized practices of elder care. In doing so, I focused on care managers, who are certified care practitioners helping families to make care arrangement, and whether they would count older adults’ same-sex partners as legitimate family members to participate in such arrangement. Data were collected from 1,580 care managers working for officially designated in-home care providers across the nation. Preliminary analysis revealed that although most care managers believed the voices of same-sex partners should be preferably reflected in the process of care arrangement, they also thought that these partners could not participate in such process without permission from older adult’s “blood relatives” (e.g., siblings).
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Kim, Heekyoung, e John W. Traphagan. "From Socially Weak to Potential Consumer: Changing Discourses on Elder Status in South Korea". Care Management Journals 10, n.º 1 (março de 2009): 32–39. http://dx.doi.org/10.1891/1521-0987.10.1.32.
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This article explores social and political dimensions associated with providing care for elders in South Korea. We look at changes in welfare policy since the 1980s and discuss the emergence of a long-term care insurance program in Korea similar to the program promulgated in Japan in 2000. We argue that while the status of South Korean elderly is undergoing change as new policies provide opportunities for elders to move from positions of dependency to increased independence as consumers of health care services, there are some reasons for concern. The capacity of elders to function as consumers remains tied to the fact family members or elders themselves must pay supplements to their health insurance premiums as well as significant co-payments for services rendered, and government policies retain a strong bias toward requiring in-home, family-centered care of frail and bedfast elders.
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Miyazaki, Motonobu, Takuya Imatoh e Hiroshi Une. "The treatment of infectious waste arising from home health and medical care services: Present situation in Japan". Waste Management 27, n.º 1 (janeiro de 2007): 130–34. http://dx.doi.org/10.1016/j.wasman.2005.12.018.
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Kim, Junghyun, e Hyejin Nam. "Perspectives on Importing the Foreign Workers in the Care Services for Older Adults: Case Studies on Taiwan and Japan". Korean Journal of Research in Gerontology 32, n.º 3 (31 de dezembro de 2023): 247–64. http://dx.doi.org/10.25280/kjrg.32.3.5.
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In Korea, the demand of care services for the older adults is increasing significantly due to the rapid aging of the population. However, the number of caregivers who can provide the services is also rapidly decreasing, resulting in failing to keep up with the demand. Recently, the Korean government began to consider importing foreign workers into the older adults’ care sector to respond to this situation. Accordingly, this study analyzed cases from neighboring countries to seek ways to import the foreign workers into the sector in Korea. Specifically, following the analyses of the cases of Taiwan and Japan, the reason why the foreign workers were imported into the sector was the lack of domestic workers’ willing to work in that sector. In Taiwan, foreign workers in the sector who are privately employed at home are responsible for housework and nursing services at lower wages than domestic workers. In Japan, within the framework of the public nursing care (Gaeho) insurance system, foreign workers with both Japanese language and care skills are imported and dispatched to nursing facilities, and they are guaranteed equal working conditions and wages to domestic workers. After carefully examining these cases, it was suggested that Korea should actively review the current status of polices on importing foreign workers in both countries when Korea regards the foreign workers as the solution to the lack of manpower in the older adults care sector at the end of this paper.
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Yoshimatsu, Keiko, e Hisae Nakatani. "Home Visiting Nurses’ Job Stress and Error Incidents". Home Health Care Management & Practice 32, n.º 2 (13 de janeiro de 2020): 110–17. http://dx.doi.org/10.1177/1084822319899392.
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The current study examined the relationship between home visiting nurses’ job stress and error incidents to provide a better understanding of risk management for home visiting nursing services. Home visiting nurses often perform patient care alone, under great mental and physical stress, increasing the risk of human error when executing tasks. A mail survey was distributed to 437 home visiting nurses working at agencies in 71 locations in Japan. The questionnaires were anonymously completed and included items on career history, experiences of job stress, and experiences of incidents. Answers were collected from 230 participants. After eliminating incomplete responses, 146 questionnaires were included in the analyses. Participants’ average age was 48.5 ± 9.3 years, and they had an average of 7.2 ± 5.6 years of experience in home visiting nursing services. In total, 21 (14.4%) were administrators, and 125 (85.6%) were staff nurses. Administrators experienced more no-harm incidents in which an error occurred but did not result in client injury than did staff nurses ( p < .05) and scored higher on three items of job stress (quantitative overload, fit to the job, and supervisor support) ( p < .05). Harmful incidents were positively associated with quantitative overload ( p < .05) and work environment ( p < .01). These results suggest that there is a limit to the extent to which an administrator can offer safe care. A less stressful working environment and active information exchange rooted in a culture of medical safety should reduce the number of incidents.
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Ida, E., M. Miyachi, M. Uemura, M. Osakama e T. Tajitsu. "Current status of hospice cancer deaths both in-unit and at home (1995–2000), and prospects of home care services in Japan". Palliative Medicine 16, n.º 3 (1 de maio de 2002): 179–84. http://dx.doi.org/10.1191/0269216302pm511oa.
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Goto, Yuko, e Hisayuki Miura. "Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study". Hospitals 1, n.º 1 (1 de maio de 2024): 32–49. http://dx.doi.org/10.3390/hospitals1010004.
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[Background] Intermediate care is a limited-time service founded on patient-centered care (PCC) that ensures continuity and quality of care during the transition between home and acute care services, promotes recovery, and restores independence and confidence. In Japan, systematic education on intermediate care for care providers is lacking. [Method] The present study explored the relationship between a Japanese scale used to evaluate individualized discharge support skills, a Japanese version of a tool for evaluating intermediate care based on PCC, and a tool that measures the shared decision making of care providers, which is the pinnacle of PCC. [Results] Clear correlations were found between the concepts evaluated using these three tools. Some concepts were not correlated between the Japanese scale that evaluated individualized discharge support skills and intermediate care based on PCC. [Conclusions] Elucidating the perspectives that help expand discharge care to intermediate care based on PCC will contribute to future education on intermediate care for Japanese care providers and to enriching patient-centered intermediate care.
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Naito, Hidemune. "The Japanese Health-Care System and Reimbursement for Dialysis". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 26, n.º 2 (março de 2006): 155–61. http://dx.doi.org/10.1177/089686080602600206.
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Like most countries, Japan is facing constraints on expansion of health system financial resources. There are almost 250000 Japanese patients with end-stage renal disease and almost all are managed by chronic dialysis. Hospital hemodialysis is the modality used by 96% of these patients. The Japanese health-care system has tended to support resource-intensive treatments because the fee-for-service remuneration system has rewarded their utilization. This has benefited hemodialysis at the expense of peritoneal dialysis. However, this may now be changing. Case management and global budget-related approaches are being more widely introduced, as are incentives to reward more efficient treatment options. The relative costs of dialysis modalities are difficult to appreciate, as center-based services, such as hospital hemodialysis, are dependent upon fixed resources, while home-based options, such as peritoneal dialysis, are dependent upon variable resources. The aim of this review is to reconcile various sources of information relevant to end-stage renal disease funding in Japan. The review will suggest that modifying the approach to modality selection could lead to more efficient allocation of future dialysis-related resources and so reduce the strain on Japan's health-care budget.
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Aung, Myo Nyein, Motoyuki Yuasa, Yuka Koyanagi, Thin Nyein Nyein Aung, Saiyud Moolphate, Hiromichi Matsumoto e Takashi Yoshioka. "Sustainable health promotion for the seniors during COVID-19 outbreak: a lesson from Tokyo". Journal of Infection in Developing Countries 14, n.º 04 (30 de abril de 2020): 328–31. http://dx.doi.org/10.3855/jidc.12684.
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The COVID-19 pandemic is novel corona virus infection outbreak that has gone global in 2020. Current prevention policies consist of hand hygiene and social distancing. Emergencies overloaded health services and shocked the logistics chains in many countries, especially Italy and China. Having more than a quarter of its population being elderly, Japan is at high risk for COVID-19 induced morbidity and mortality.
This situation cancelled schedules of all routine group exercise activities for the seniors in Japan. While the outbreak is ongoing, staying at home is safe. However, successive days of being house-ridden and limited movement can lead to excessive physical inactivity. Some elderly who are not moving much can lose a significant amount of muscle strength, flexibility and aerobic capacity. It can accelerate the frailty and dependency of the seniors, and subsequently, claiming of care and health services. Moreover, existing and new evidences showed that physical activity can promote antiviral immunity.
An alternative to usual group exercise activities is crucial to keep seniors active without affecting social distancing. While staying at home for long, functional exercises maintaining basic level of physical activity and movements are urgently required to be introduced to the seniors in Tokyo and around the world to prevent functional decline.
Home exercise is a practical option. Therefore, we made a home-version of the functional training exercise video with different sets of 10-minutes exercise for 7 days a week. This breakthrough alternative may sustain health promotion for the elderly persons to preserve their active aging and maintain optimal health.
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Haruta, Junji, Sho Tsugawa e Kazunari Ogura. "Exploring the structure of social media application-based information-sharing clinical networks in a community in Japan using a social network analysis approach". Family Medicine and Community Health 8, n.º 4 (setembro de 2020): e000396. http://dx.doi.org/10.1136/fmch-2020-000396.
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ObjectiveCurrently, use of social networking services (SNSs) for interprofessional collaboration is increasing. However, few studies have reported on virtual interprofessional interactions in community healthcare services. Revealing such structural characteristics of the networks can provide insight into the functions of the interprofessional information-sharing network and lead to smoother collaboration. Thus, we aimed to explore the structure of SNS-based information-sharing clinical networks.DesignSocial network analysis (SNA).SettingWe selected a community in City X in Japan.Data collectionWe analysed SNS-based information-sharing clinical network data linked to patients receiving home medical care or care services between January and December 2018. A network was created for each patient to allow healthcare professionals to post and view messages on the web platform. In the SNA, healthcare professions registered in a patient group were represented as nodes, and message posting/viewing relationships were represented as links in the patient network. We investigated the structural characteristics of the target networks using several measures for SNA, including indegree centrality and outdegree centrality, which reflect the number of incoming and outgoing links to/from a node, respectively. Additionally, the professions forming the most central nodes were investigated based on their ranking to identify those with a central role in the networks. Finally, to compare the networks of nursing care levels 1–3 (lighter care requirement) and those with nursing care levels 4–5 (heavier care requirement), we analysed the structural differences in the networks and investigated the roles of healthcare professionals using centrality measures of nodes.ResultsAmong 844 groups, 247 groups with any nursing care level data were available for analysis. Increasing nursing care level showed higher density, reciprocity and lower centralisation. Healthcare professions with high indegree centrality (physicians, care workers and physical therapists) differed from those with high outdegree centrality (home care workers, physical therapists, and registered dieticians). Visiting nurses and nurses in the clinic played a central role, but visiting nurses tended to have higher indegree and outdegree centrality, while nurses in the clinic had higher closeness and betweenness centrality in networks with heavier care requirement.ConclusionThe SNS-based information-sharing clinical network structure showed that different professions played some form of a central role. Associations between network structures and patient outcomes, cost effectiveness and other factors warrant further investigation.
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HAYASHI, MAYUMI. "The Japanese voluntary sector's responses to the increasing unmet demand for home care from an ageing population". Ageing and Society 36, n.º 3 (21 de novembro de 2014): 508–33. http://dx.doi.org/10.1017/s0144686x14001238.
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ABSTRACTAs Japan faces the challenge of the increasing demand for home care from its ageing population in an era of economic constraints, the expectation has evolved that the voluntary sector will fill the shortfall in statutory provision through semi-volunteers providing affordable home care. Drawing on qualitative interviews with managers from 15 voluntary organisations, this article explores their experiences in trying to meet this expectation. Even though most organisations provided supplementary home-care services, the empirical evidence indicates a limited capacity to deliver this expectation, with respondents aware of the deteriorating situation. It has been ascertained that supply mechanisms differ between the traditional voluntary – and the new hybrid – organisations. The former employ ‘cost-efficient’ labour such as ‘paid volunteers’ on below minimum pay rates. In contrast, the ‘hybrids’ use paid employees at regular pay rates, a finding that contradicts optimistic assumptions about the ideological role of ‘traditional’ voluntary organisations. This article suggests the importance of acknowledging diverse responses from the voluntary sector, including the new hybrids with their acknowledgement of voluntary and commercial imperatives. Open mindedness and a preparedness to revise interpretations of the earlier ‘models’ of the voluntary sector are essential. The conclusion proposes that the best strategy to unlock the voluntary sector's full potential to deliver supplementary home care is a multi-platformed approach, with adequate public purse funding, which pragmatically maximises resources.
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Feng, Mei, Ayumi Igarashi, Maiko Noguchi-Watanabe, Satoru Yoshie, Katsuya Iijima e Noriko Yamamoto-Mitani. "Characteristics of care management agencies affect expenditure on home help and day care services: A population-based cross-sectional study in Japan". Geriatrics & Gerontology International 17, n.º 11 (26 de janeiro de 2017): 2224–31. http://dx.doi.org/10.1111/ggi.12969.
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