Current Nursing Systems in Group Homes for Elders with Dementia : Focusing on Use of Visiting Nurse Services

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  • Katahira Nobuko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Honda Akiko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Ueno Mari
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Kitaoka Hideko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Hirokawa Seiko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Watanabe Tsukiko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Takeda Yumiko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Hatanaka Takako
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services
  • Bessho Yuko
    School of Nursing, Faculty of Health & Social Work, Kanagawa University of Human Services

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Other Title
  • 認知症高齢者グループホームにおける看護体制 : 訪問看護の利用に焦点を当てて

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Abstract

Objectives : This study investigates current conditions and problems regarding health care provision for residents of group homes (GH) for elders with dementia, staff responses to changes in residents' medical conditions or accidents, and nursing systems. Methods : Survey questionnaires were mailed to 442 GH facilities in Kanagawa prefecture, Japan. Results : We collected survey questionnaires from 175 facilities (response rate, 39.6%). More than 70% of the facilities had residents who needed regular visits to physicians or physician home visits. Regarding daily medical treatments in GHs, 49.7% of the facilities provided dermatological treatments, and 19.4% of the facilities offered enema or stool extraction. In the previous three months, there were about 460 cases of changes in medical conditions or accidents, and 76 facilities (43.4%) requested ambulance transport. There were 65 facilities (37.2%) that had nursing staff, and 80 facilities (45.7%) used reimbursement for medical coordination systems. Facilities that used reimbursement for medical coordination systems to contract with visiting nurse stations comprised 14 facilities. The following were found as effects of visiting nurse services: improvement in responses to medical care needs, and availability for consultation when assessing symptoms. A problem to be addressed concerned the occasional differences between nurse and physicians judgments, which resulted in confusion. Discussion : While GH resident needs for medical and nursing care were assumed to be high, less than half of the facilities used reimbursement for medical coordination systems. This suggests that GHs should seek adequate nursing services through medical coordination systems.

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