An Intervention Study on Effect of Care Program for Prevention to a Decline of ADL of the Bed-Ridden Elderly at Home

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  • Tadaka Etsuko
    Department of Community Health Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo
  • Kanagawa Katsuko
    Department of Community Health Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo

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  • 在宅寝たきり高齢者のADL低下予防のためのケアプログラムの効果に関する研究

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The purpose of this study was to evaluate the effectiveness of an intervention care program to prevent decline of physiological function, ADL (activities of daily living), communication and non-lying time in bed among the bed-ridden elderly at home. Subjects were 82 community-living bed-ridden elderly 65 years and older in a rural district in Japan (41 intervention group, 41 control group). The intervention was conducted by care program of sitting tolerance training and the program was performed by a home care nursing during three months. On the other hand, to control group, We didn't enforce care program and observed progress. Results were as follows : In stratified analyses, There seemed to be a difference between the intervention group and the control group about reach test. The intervention group didn't decline of its score, but the control group was apt to decline. And there were significant differences between the intervention group and the control group about ADL and non-lying time imbed, After three months from baseline, ADL scores were significantly higher for intervention group than for controls ; intervention group maintained their functional status, while control group experienced during the follow up month (grooming = p < 0.001, dressing-upper body = p < 0.001, dressing-lower body = p < 0.001 and the total self-care score = p < 0.001). And non-lying time in bed per one day increased significantly among intervention group, but not among control group(p < 0.01). Furthermore, a change of the total self-care score of ADL had positive correlations with a change of non-lying time in bed per one day (r = .47, p = 0.009), But in communication, there was not significance between the intervention group and the control group. The intervention care program suggests effective to prevent decline of ADL mainly on self care activity of the bed-ridden elderly. For the bed-ridden elderly, even if it is assumed that their locomotion is inability, it is very important to expand sitting tolerance and non-lying time in bed from a standpoint of prevention for a decline of ADL.

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