Background
Japan has the largest population of older adults in the world; it is only growing as life expectancy increases worldwide. As such, solutions to potential obstacles must be studied to maintain healthy, productive lives for older adults. In 2011, the Japanese government has started a policy to increase “Elderly Housing with Care Services (EHCS)”, which is one of a private rental housing, as a place where safe and secure end-of-life care can be provided. The government expect for them to provide end-of-life care by collaborating with the Home-Visit Nursing Agencies (HVNA). The purpose of this study is to clarify the situation of the end-of-life care provision in EHCS in collaboration with HVNA and to examine the factors that associate with the provision of the end-of-life care in EHCS.
Methods
A two-stage nationwide survey (fax and mail surveys) were conducted. Of the 5,172 HVNA of the National Association for Visiting Nurse Services members, members from 359 agencies visited EHCS. Logistic regression analysis was conducted with the provision of end-of-life care to EHCS in 2017 as the dependent variable, and the following as independent variables: characteristics of HVNA and EHCS; characteristics of residents; collaborations between HVNA and EHCS; and the reasons for starting home-visit nursing.
Results
Of the 342 HVNA who responded to the collaborations with EHCS, 21.6% provided end-of-life care. The following factors were significantly associated with the provision of end-of-life care to inmates in elderly care facilities: being affiliated with a HVNA, admitting many residents using long-term care insurance, collaborating with each other for more than three years, and started visiting-nurse services after being requested by a resident’s physician.
Conclusions
This study clarified the situation of the provision of end-of-life care in EHCS in collaboration with HVNA and the related factors that help in providing end-of-life care in EHCS.
AimThis pilot study aimed to analyze the cost‐effectiveness of visiting nursing care, to establish a new evaluation method considering both the quality and cost of visiting nursing care.MethodParticipants were 384 caregivers from 10 certified home‐visit nursing agencies that support patients in severe conditions in Japan. They completed a survey assessing the number of nursing care visits carried out in November 2016, visiting nursing receipt data for 1 month of study and quality of life (QOL), as measured by the EuroQol‐5 Dimension at their last visit, which took place 1 month later.ResultsWe categorized participants into low‐charge and high‐charge groups. In the low‐charge group, no relationship was found between high QOL and frequency of implementation of each type of care. In the high‐charge group, participants with high frequencies of “medicine management and instruction,” “description and guidance for diseases and treatment,” and “nutrition and diet care” had higher levels of QOL.ConclusionsThis research might contribute to establishing a cost assessment system for home‐visit nursing care in Japan, which is expected to be useful in countries where the average age of the population is increasing. Care provided by visiting nurses might be divided into care items that related or did not relate to QOL. Therefore, when evaluating the quality and cost‐effectiveness of visiting nursing care, it is necessary to construct an evaluation system that considers these aspects and obtain appropriate data. Geriatr Gerontol Int 2020; 20: 36–41.
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