Search

A multidisciplinary Japan–UK Network identified cross-cultural and cross-national lessons for research aimed at improving the design of homes for people living with dementia. Previous research has suggested that improved, multidimensionally sustainable design may improve quality of life for people living with dementia and meet societal challenges of increasing populations of people with the condition. Adopting a social citizenship perspective, the paper argues that people living with dementia are considered equal citizens with rights to enjoy the life they choose. On this basis, research on home design must be underpinned by understanding the concept of home. The definition of good outcomes should be led by people living with dementia. Conceptualisation of costs of design innovations is complex and will involve judgements from a societal perspective. Methodologically, an ethnographic approach is desirable, underpinned by co-production. These points are suggested to inform further research. In conclusion, the paper confirms the value of cross-cultural insights.

Abstract Background Although people with cognitive impairment highly value social participation in out-of-home activities, their families typically perceive concerns and experience anxiety over such activities. This study aimed to elucidate the underlying concerns and factors associated with family caregivers’ anxiety over the individual’s unaccompanied out-of-home activities. Methods In December 2021, we conducted a cross-sectional e-survey of family caregivers of individuals with early-stage cognitive impairment. Caregivers’ concerns about ten common risks related to out-of-home activities were cross-tabulated by specific anxiety levels to examine trend associations. With the variables of caregivers and their individuals across the five domains, we ran logistic regression analyses to determine explanatory models for anxiety. Results The study participants were 1,322 family caregivers of people whose cognitive function varied from intact to possible mild dementia according to the Dementia Assessment Sheet for Community-based Integrated Care System 8-item. Significant associations were found between the prevalence of concerns and the degree of anxiety, even without actual experience with the issues of concern. Among the five domains, individual dementia characteristics and social behaviors were the predominant factors attributed to caregiver anxiety. Caregivers’ no anxiety state was significantly associated with: younger age (OR 4.43, 95% CI 1.81–10.81), no detectable cognitive decline (OR 3.34, 95% CI 1.97–5.64), free from long-term care (LTC) (OR 3.52, 95% CI 1.72–7.21), no manifestation of behavioral and psychological symptoms of dementia (BPSD) (OR 13.22, 95% CI 3.06–57.01), and not engaging in unaccompanied out-of-home activities (OR 3.15, 95% CI 1.87–5.31). Their severe anxiety was positively associated with being on LTC (OR 3.39, 95% CI 2.43–4.72) and minor BPSD (OR 1.43, 95% CI 1.05–1.95), and negatively associated with engagement in unaccompanied out-of-home activities (OR 0.31, 95% CI 0.23–0.43). Conclusions The study found that family caregivers’ anxiety was associated with concerns about behavioral issues, regardless of actual experiences. There were two significant associations in opposite directions between caregivers’ anxiety and the individual’s engagement in out-of-home activities. In the early phase of cognitive impairment, caregivers may intuitively interpret the individual’s behavior and feel anxious. Educational support may provide reassurance and enable caregivers to facilitate out-of-home activities.

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.

Introduction: Reflecting the rapidly aging society, there has been a worldwide increase in the number of health cafés and dementia cafés which can provide a variety of support to people with illnesses and their families in the community. Nevertheless, health cafés organized by primary care physicians are rarely reported, and the social value of these activities has not yet been fully elucidated. Objectives: This study was aimed to investigate the value and impact that the health café organized by the primary care physician, brings to the visitors, the clinic, and the community. Methods: Conversations between the author (YO), who belongs to a medical clinic that has been operating for many years in Shizuoka City, and visitors of the health café were qualitatively analyzed using Steps for Coding and Theorization (SCAT), which is a sequential and thematic qualitative analysis technique consisting of 4 steps. Results: Sixteen people participated in the study. The values and impacts of holding a health café were social support, opportunities for cognitive and behavioral changes, complementary functions to outpatient care, advantages for medical care, the creation of encounters with diverse individuals, connections with local community organizations, and motivating visitors to become proactive actors. Conclusion: It was considered valuable for physicians in community-based medical clinics to have opportunities to interact with patients and local residents outside the clinical settings. Because they can potentially enhance their role as primary care physicians in the community. In addition, the impact on the community is that local residents can receive social support, increase community ties, and make people more proactive about their health.

In Japan, where the population is aging at a speed unequaled by any other country in the world, there has been a rapid increase in the use of long-term care services, following the adoption of the Long-Term Care Insurance System. The increase is seen mostly in home-visit care services, and the need for such services is expected to increase even further in the years ahead. This paper reviews previous studies on long-term care insurance service market in Japan, focusing especially on home helpers. The first section of this paper introduces the framework of the Long-Term Care Insurance System and the current state of the long-term care insurance service market. The second section examines the systems and working conditions regarding home helpers. Finally, the third section analyzes the job performance skills of home helpers and development thereof. Through these observations, this paper aims to introduce the measures proposed to be effective for maintaining and improving the quality of long-term care services, and for consistent provision of such services, by focusing mainly on employment management that enables helper skill development. [ABSTRACT FROM PUBLISHER]