Community General Support Center Research Articles

Care needs of caregivers of the elderly with early-stage dementia.

This study aimed to identify the care needs of family caregivers of elderly patients with early-stage dementia and examine support measures. We conducted a self-administered questionnaire survey with 115 primary caregivers of outpatients who visited A City Community General Support Center or B University Hospital Department of Neurology for memory loss consultation. The questionnaire content included demographic characteristics, the care needs scale for caregivers of the elderly with early-stage dementia (Care Needs Scale), and the Japanese short version of the Zarit Burden Interview. The Medical Ethics Committee of Fukuoka University approved this study (approval number: M047). Of the 115 participants, 104 were included in the analysis after excluding 11 respondents with missing data. We divided the participants into a young group (under 65 years of age) and an old group (65 years of age or older) and compared the variables and each scale score using the Mann-Whitney U test. We also compared the correlations between the total score and subscale scores of the Care Needs Scale and each variable, in addition, we performed multiple regression analyses using the total score of the Care Needs Scale as the dependent variable. The young caregivers wanted to know how to take care, prevent deterioration, and deal with symptoms of early-stage dementia. They were trying to balance caregiving with work and housekeeping and reduce the stress and burden of long-term care. Older caregivers were confused about caregiving and wanted someone to talk about their situations. Both groups shared that the family's lack of understanding about caregiving and personal and role strains were associated with the care needs of caregivers of the elderly with early-stage dementia.

Characteristics of ethical dilemma and behavior in the support process of older adults and their families among nurses at a community general support center in Japan

Objectives This study was aimed at clarifying characteristics of ethical dilemmas and behaviors in the support process of older adults and their families among nurses at community general support centers.Methods A self-administered questionnaire survey was mailed to 449 nurses at community general support centers in Tokyo. Question items enquired their age, employment license, years of experience as a nurse, the presence of ethics-related organizations, number of cases in which nurses faced difficulties in supporting older adults and their families in decision making over the past year, the ethical dilemmas they experienced and their situations, and ethical behavior in the process of supporting older adults and their families.Results From the 143 responses (response rate: 31.8%), 135 (valid response rate: 30.1%) nurses were analyzed. Overall, 43.0% and 27.4% of the participants were in their 50s and 40s, respectively. Of these, 77.0% and 23.0% were nurses and public health nurses, respectively. In total, 52 (38.5%) respondents had an ethics-related organization. The average number of cases in which the respondents faced difficulties in supporting older adults and their families in decision making over the past year was 8.3 (standard deviation, 12.5). Of these, the average number of cases in which they faced difficulties in making ethical decisions was 4.1 (standard deviation, 6.0). Regarding the perception of ethical dilemmas, 113 (83.7%) answered "often" or "sometimes." Ethical dilemma situations included "the intentions of the user and family were different, and I had trouble deciding what to respect" 95 (84.1%); "the user's intention was different from my judgment as a professional, and I had trouble deciding what to respect" 64 (56.6%); and "the intention of the user and neighbors were different, and I had trouble deciding what to respect" 56 (49.6%). Ethical behaviors included "I observe the management rules in my organization regarding personal information data" 116 (85.9%); "I provide easy-to-understand explanations appropriate to the user's situation" 115 (85.2%); and "I decide on a support policy with several staff members when self-decision making is difficult due to the user's situation" 113 (83.7%).Conclusion More than 80% of the nurses perceived ethical dilemmas. Characteristics of the situations were that users and their families, users and professionals, and users and their neighbors had different intentions. Further research should be conducted on ethical issues related to community-based integrated care.

The expected role of Dementia Support Doctors in dealing with complex cases of older people with dementia

The present studyinvestigated the roles expected of Dementia Support Doctors (DSDs) in dealing with complex cases. The participants were attendees of the education programs organised by the Center for Promoting Dementia Support and the Medical Center for Dementia at the Tokyo Metropolitan Geriatric Hospital from April 2021 to March 2022. A self-administered postal questionnaire survey was conducted. The questionnaire included items on the basic attributes of the participants, their experiences with the issues associated with complex cases, and role expectations of consulting/collaboration partners when dealing with complex cases. The valid response rate was 49.3%. DSDs were expected by primary physicians, Community General Support Center staff and administrative staff to diagnose dementia and give advice on support strategies for complex cases. Primary physicians further expected them to initiate pharmacotherapy with anti-dementia drugs and address the pharmacotherapy needs for managing Behavioral and Psychological Symptoms of Dementia. It was also found that DSDs' experience with complex cases was comparable to that of the staff at the Medical Centers for Dementia. Of note, DSDs were mentioned less frequently as consulting/collaboration partners than Medical Centers for Dementia and primary physicians. The study showed that DSDs play an important role in dealing with complex cases. The roles of DSDs and ways to collaborate with them need to be communicated through interprofessional education.

Building Relationships Between Community Care Professionals and Convenience Stores in Japan: Community-Based Participatory Research.

Convenience stores play an important role in supporting community-dwelling older adults' lives. We started community-based participatory research (CBPR) in Nerima City, Tokyo Metropolitan area in Japan to develop a collaborative relationship to support older adults in the community-based integrated care system. This study aimed to describe the CBPR process and evaluate building face-to-face relationships between health/social care professionals and the owners/employees of convenience stores. Using CBPR, health/social care professionals in community general support centers (CGSCs) directly approached convenience stores based on the public support agreement between the convenience store chain company and the municipality. To evaluate the face-to-face relationship building between convenience store owners/employees and CGSCs' staff, we administered questionnaire surveys to convenience stores in Nerima City and two control cities from 2017 to 2019, and about 100 convenience stores completed the survey each year. Statistical analyses showed significant improvements in their knowledge for relationships with the CGSCs in Nerima City, including "knowledge of the CGSCs' function" (P = 0.001), "knowing individual professionals in the CGSCs" (P = 0.023), and "knowledge of when to contact the CGSCs" (P = 0.002), compared with control cities. Helping behavior for older adults at convenience stores also increased significantly in Nerima City (P = 0.034). The CGSCs' direct approach based on the public support agreement would effectively promote building relationships at convenience stores, leading to an age-friendly community.

Current Situation of the Business Continuity Plan Preparation in Japan: Community General Support Centers

Objective: This study aims to clarify the actual situation of the business continuity plan (BCP) preparation in the community general support centers in Japan. Method: In September 2021, a survey was administered to 5,391 community general support centers all over Japan using a self-input Web questionnaire. Results: 577 responses were obtained, for a response rate of 10.7%, among which “BCP has been created” accounts for 9.5%; “BCP has not been created, and there is no plan to create any,” 22.0%; “it is currently being examined whether to create BCP,” 47.0%; and “BCP is now being created,” 21.5%. The community general support centers that “have not determined the division of roles” with their municipalities in responding to disaster account for 64%. Conclusions: This study clarifies the situation of the community general support centers in Japan, based on which they cannot be said to be prepared for a disaster. From the word network of answers to our questionnaire, we can see reasons why the BCP has not been created: lack of knowledge and busy work. Centers that have not prepared a BCP, understand the need to create one, but they are too busy and are unaware of how to do so. We discuss measures to promote the creation of BCPs by community general support centers in the future, given the current situation.

Forensic Characteristics of Physical Elder Abuse and Current Status and Issues of Collaboration between Forensic Medicine Departments and Related Institutions in Japan.

This study sought to clarify the characteristics and trends of physical elder abuse and the status of collaboration between forensic medicine departments and related institutions in Japan. Questionnaires were sent to 82 forensic medicine departments and 2857 institutions randomly selected from hospitals, municipalities and public community general support centers. The survey period was February to June 2021, including an extension period for collection. Responses from 675 facilities were analyzed. The most common finding in cases of physical elder abuse at forensic medicine departments was subcutaneous hemorrhage on the head (85.7%), with mixed old and new injuries most commonly observed in the lower limbs (70%). There were few cases in which there was collaboration between forensic medicine departments and other institutions. Among the issues identified, there is a need to provide related institutions with information obtained in forensic medicine departments. A new collaboration system is needed to achieve this.

Coordination Practice for and Issues Encountered by Public Health Nurses in Community General Support Centers Regarding Life Support Provided to Older Adults with Dementia

Coordination Practice for and Issues Encountered by Public Health Nurses in Community General Support Centers Regarding Life Support Provided to Older Adults with Dementia

Effects of Recommended Consultation Practice Using Fracture Risk Assessment Tool and Fracture Evaluation Questionnaire for Early Detection of Osteoporosis at Community Pharmacies

As one of the strategies for the early detection and treatment of osteoporosis, we have recommended visiting a hospital, based on the Fracture Risk Assessment Tool (FRAX®) and evaluation questionnaire for osteoporotic fracture risk. In this study, we evaluated the impact of intervention by community pharmacists by integrating our data for the FRAX® and questionnaire. The measurement of FRAX® and the questionnaire survey were conducted through participation in health seminars organized by a community general support center from June 2018 to December 2019. Participants with a FRAX® score more than 15% and at least one item in the questionnaire were considered to have "suspected osteoporosis" were recommended medical consultation. The medical treatment status for the participants considered to have "suspected osteoporosis" aged 40-90 years were analyzed. Of the 84 participants, 54 had a FRAX® score more than 15%, and 44 participants fulfilled at least one item in the questionnaire. Medical consultation was recommended to 26 of these 44 participants, excluding 18 under treatment. Of the 25 participants, six (excluding one who disagreed) received consultation, and medical treatment was started for four of them (66.7%). However, consultation with the attending physician was recommended to five of the 18 participants who were initially on treatment but discontinued it at the time of the survey. Consequently, two participants resumed their osteoporosis treatment. Our data suggest advantages of community pharmacists' intervention using FRAX® and a questionnaire for osteoporotic fracture risk measurement for early detection and medical treatment.

Perception of use of interpreters for foreign older adults among care providers working at community general support centers

Perception of use of interpreters for foreign older adults among care providers working at community general support centers

Nationwide Survey Rerated to the Implementation Status of Bereavement Supports by Community General Support Centers in Japan: Characteristics of Community General Support Centers that Provided Bereavement Support

Nationwide Survey Rerated to the Implementation Status of Bereavement Supports by Community General Support Centers in Japan: Characteristics of Community General Support Centers that Provided Bereavement Support

Conduct and Evaluation of Case Conference Training to Promote Interprofessional Collaborative Support in Community General Support Centers

Conduct and Evaluation of Case Conference Training to Promote Interprofessional Collaborative Support in Community General Support Centers

Support Provided by Nurses at a Community General Support Center for Older Adults with Suspected Dementia Who are Living Alone

Support Provided by Nurses at a Community General Support Center for Older Adults with Suspected Dementia Who are Living Alone

Dementia education is the first step for cooperation: An observational study of the cooperation between convenience stores and community general support centers.

The dementia supporter training program is conducted by community general support centers (CGSCs) to raise dementia awareness. Convenience stores are widespread throughout Japan, and they play an important role in the daily lives of older adults. We examined whether participation of convenience stores in the program promotes cooperation between the stores and CGSCs. Using data from a nationwide survey, we conducted a longitudinal observational study. Participation of stores in the program and cooperation with CGSC were measured. The proportion of cooperation with CGSCs in 2017 and 2018 were compared between stores that had already participated in the program in 2016 (participation group) and those that did not (non-participation group). Of the 14 884 stores, 542 stores participated in the program in 2016. In 2017 and 2018, 8.1% and 7.2% of the participation group cooperated with CGSCs, while 3.2% and 4.0% of the non-participation group did. Dementia supporter training programs could be an opportunity to promote cooperation between convenience stores and CGSCs to support older adults. Geriatr Gerontol Int 2020; 20: 956-960.

地域包括支援センターにおける高齢者の支援困難事例に関する文献レビュー ―2005～2017年に発表された論文に焦点を当てて―

地域包括支援センターにおける高齢者の支援困難事例に関する文献レビュー ―2005～2017年に発表された論文に焦点を当てて―

Initial-phase intensive support team and community general support center: From the perspective of coordination and networking of social support

社会支援のコーディネーションとネットワーキングは，「認知症とともに暮らせる社会」を実現するための鍵概念である．認知症初期集中支援チームや地域包括支援センターの本来業務はコーディネーションとネットワーキングに他ならない．地域の特性に応じて，コーディネーションとネットワーキングのあり方を深化させ，現存する縦割りの事業を効果的に整理・統合していくことが，地域共生社会の実現をめざすこれからのわれわれの課題である．

Development of a Coordination Scale Focused on Life Support of Elderly People with Dementia for Public Health Nurses in Community General Support Centers

Development of a Coordination Scale Focused on Life Support of Elderly People with Dementia for Public Health Nurses in Community General Support Centers

Recognition of occupational therapists by the Community General Support Center staff through Quantitative Text Analysis

Recognition of occupational therapists by the Community General Support Center staff through Quantitative Text Analysis

Evaluation of the Collaboration between Community Interprofessionals and Pharmacists for Early Detection of Dementia

The purpose of this study is to evaluate the collaboration system between Muscat Pharmacy and community general support center by verifying the results of tests for early detection of dementia, and the early support response for the participants with suspected dementia by the center. From December 2016 to November 2018, we conducted measurement sessions using a touch panel-type test, MSP-1100 at 23 events that included health promotion classes and local community events directed by community general support center. At a later date, a visit survey was administered by the center to the participants with suspected dementia those who received a score lower than 12, and their individual records of early support responses and follow-ups were evaluated and analyzed. During the period, 597 participants had measurements taken with the touch panel-type test. Among them, 89 (14.9% of total) participants received a score lower than 12. The contents of the support by the center for the low-scoring participants were classified into nine categories. Forty of the 89 low-scoring participants were judged to have no problems. Others were cooperatively followed up with medical consultation recommendation, receiving home care management, and/or having their information provided physicians by the Muscat pharmacy and the center. The results of our study indicate that the cooperation between community pharmacy and community general support centers could allow for the early detection of dementia and follow-ups for suspected dementia.

일본 지역포괄지원센터를 중심으로 한 커뮤니티 케어(community care) 고찰

일본 지역포괄지원센터를 중심으로 한 커뮤니티 케어(community care) 고찰

The influence of types of living alone on 2-year health changes according to elderly adults' marital status: Based on the Comprehensive Regional Studies for Preventing Isolation of the Elderly Who Live in Metropolitan Area (CAPITAL Study)

Objectives The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.Methods This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.Results With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).Conclusion The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.