| Budget Amount *help |
¥3,300,000 (Direct Cost: ¥3,300,000)
Fiscal Year 2006: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2005: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2004: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Research Abstract |
Many of the elderly wanted to live in the community. The basic philosophy of long-term care insurance is independence support and self-decision. A health care facility for the elderly is for supporting the elderly living at home as long as possible. However, nowadays, a health care facility for the elderly has two aspects that one is giving rehabilitation for returning home and that another is a waiting facility for the nursing home. By the survey for care facilities by the Ministry of Health, Labor and Welfare in 2003, the rate of elderly returning home from health care facilities was 39.2% that is decreasing year by year.
We investigated the factors affecting the returning home from a facility by a cross sectional study and a longitudinal study.
From a cross sectional study, the caregivers of 34.6% of the elderly who hoped to return home intended to accept them home. The conditions for accepting elderly home are self-toileting, bathing, and dressing. As the risk factors to make the intension of the caregivers to accept the institutionalized elderly home difficult were time spending in bed of a day and dementia behavior disturbances, rehabilitations for improving ADL and establishing regional caring system are important.
During the follow-up study of 2.5 years, only 10 (10.5%) out of 95 elderly returned home. About 40% are still in the facility and the rest were hospitalized or facilitated into other nursing homes. By Cox proportional hazard model, the factors affecting return home from the facility were independence of urination (HR:4.77,95%CI:1.14-20.00), independence of bathing (HR:7.19,95%CI:1.62-31.95), and the level of care need at the first time institutionalized (HR:0.45,95%CI:0.22-0.94).
It has been suggested that more training for improving ADL are necessary for return home.
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