Factors Related to Positive Feelings of Caregivers Who Provide Home-Based Long-Term Care for Their Family Members in Japan

Background. The objective is to elucidate the factors related to the positive feelings of family caregivers who are engaged in home-based elderly care. Methods. The study utilized the data of a cross-sectional citywide survey in Japan. The survey was conducted with 1,821 subjects and the final analysis was performed on 435 subjects. Questions for recipients such as those on their care levels, causes of care, whereas the primary caregivers were asked about whether they had positive feelings toward caregiving, and whether their opinion was reflected in care policies. Results. The factors s that showed a positive association with positive feelings were “the caregiver’s opinion is reflected in care policies” (OR: 5.05, 95% CI: 2.60–9.87) and “the caregiver is in good health condition” (OR: 2.02, 95% CI: 1.02–3.93). The factors that showed a negative association were “the caregiver is a daughter-in-law of the care recipient” (OR: 0.42, 95% CI: 0.21–0.82) and “the care recipient is an elderly person with cognitive impairment” (OR: 0.36, 95% CI: 0.18–0.70). Conclusions. The study suggests the necessity of providing support for caregivers in terms of empowerment and health management. Furthermore, they suggest that special attention should be paid to caregivers at risk of being unable to sustain positive feelings toward caregiving

Family empowerment and associated factors in Japanese families raising a child with severe motor and intellectual disabilities

ObjectivesFamily caregivers raising children with severe motor and intellectual disabilities (SMID) experience the enormous burden of care. The concept of family empowerment is one of the important assessment indexes of family nursing from the perspective of providing comprehensive support for these families. The objective of this study was to identify the factors associated with the empowerment of families raising a child with SMID in Japan.MethodsWe conducted a nationwide questionnaire survey involving 1659 primary caregivers raising a child with SMID through 89 special schools. We assessed the main outcomes using the Family Empowerment Scale (FES). We then conducted a multiple linear regression analysis to reveal the factors associated with family empowerment.ResultsIn total, 1362 primary caregivers were included in our study. Our results show that factors contributing to high FES scores are higher age of the primary caregiver, higher education, greater recognition of regional support, lower childcare burden, higher utilization of home visit services, higher usage of a childcare institution, higher household income, and stronger family bonding.ConclusionHealthcare professionals should carefully assess the state of family empowerment of the primary caregivers who are younger and those who have low education, low household income, high childcare burden, and fragile bonding with the family. Second, they should encourage such families to use regional support resources for childcare. That is, policy makers should consider ways to promote home visits and institutional services for the care of children with SMID, aiming especially for the provision of well-coordinated care and services

Family caregiving problems of suspected elderly neglect: A review of forensic autopsy cases in Japan

Background. Elder abuse is a severe violation of human rights, and the most recent domestic violence issue to gain the attention of public and medical communities especially highly aged country like Japan. Methods. To clarify family caregiving problems related to elder neglect in Japan, we reviewed 178 autopsies conducted between 2000 and 2003 at one centre. Results. Of the 178 cases (134 males and 44 females), 53 involved people were 65 years old and over (30%). A careful investigation of these 53 autopsy reports (39 males and 14 females) allowed us to exclude obvious causes of death, such as traffic and other accidents, drowning, poisoning, alcoholism, and clear disease pathology. We were left with nine cases of suspected neglect (three males and six females). The mean age of victims was 82.1 years (range, 68–91). According to the autopsy reports, two were severely starved, two were putrefied or mummified, three had pressure sores, two had dementia and three would have had difficulty in performing the activities of daily living. Each victim had lived with one family member; their sons in five cases, and a grandson, brother, wife or husband in each case. The caregivers’ ages ranged from 27 to 76 years, and five were unemployed; in three cases, the family incomes were very low. Of the caregivers, two were depressed, one was an alcoholic and one had dementia. Conclusions. This investigation indicated that elderly parents living with their sons are a high-risk group for neglect. A family support system is needed to target male caregivers who are likely isolated from social services. Autopsy cases provide valuable information for public health to prevent similar cases in future. Keywords: Elder abuse, Elder neglect, Male caregivers, Family caregiving, Autopsy records

Predictors of volunteerism: A study of older adults in Japan

Volunteerism has risen steadily as a viable activity at old age in Japan for it gives older adults ways to contribute to society as well as enhancing their quality of life. It has also been addressed by the national government and adopted by many local municipalities under the long-term care insurance program as a health promotion and preventive care activity. However, studies examining why older adults volunteer and why some don’t are limited. Using a modified version of Baltes and colleagues’ model of competence, this study examines the predictors of volunteerism among older adults in Japan. Data from a city located northeast of Tokyo was used (n=703). Results indicated that basic competence does not predict volunteerism, but rather competence gained from experiences. To increase the number of older volunteers, the study suggests that civic engagement must start at an earlier age coupled with financial stability. Keywords: volunteerism, older adults, Japan, competence, long-term care insuranc

Hospital-based care utilization of children with medical complexity in Japan

BackgroundFew studies have investigated the hospital‐based care utilization of children with medical complexity (CMC) in Japan. This study examined the frequency and differences in hospital‐based care utilization for CMC according to the level of medical complexity (moderate and severe).MethodsMedical records of three pediatric tertiary hospitals in one prefecture were examined in 2014. We examined the number of outpatient visits and of admissions to the hospital for CMC in the 5 years after the introduction of home medical care.ResultsOf 92 CMC, 55 had medical complexity that was moderate (CMC‐moderate) and 37 had medical complexity that was severe (CMC‐severe). The number of CMC who had medical care introduced at home had increased year by year, especially that of CMC <2 years old; the number of older CMC (i.e. 7–17 years old) had also increased in 2010–2014. The median total outpatient visits was 20 (IQR, 13–29 visits) for CMC‐moderate and 20 (IQR, 17–26 visits) for CMC‐severe in the first year. CMC‐severe had significantly longer length of admissions in the 5 years than CMC‐moderate. The number of total visits and admissions during the subsequent 4 years (from the second to the fifth year) was slightly decreased compared with the first year, but this was not significantly different.ConclusionsCMC had high utilization of hospital‐based care, and consistently utilized hospital‐based care in the 5 years after the introduction of home medical care. Further study is needed to examine both hospital‐based and home/community‐based services use

Mothers' Experiences of Care Coordination for Children with Disabilities : A Qualitative Study

Few studies have investigated the care coordination for children with disabilities and their families in Japan. Care coordination enhances the quality of care for these children and their families. This study explores mothers' experiences of coordinated care provided to their children with disabilities and their families. We used a qualitative descriptive approach, conducting semi-structured interviews with 11 Japanese mothers/primary caregivers of children with disabilities to describe their experiences. Four main themes were identified: shared decision-making with key workers, receiving an assessment of the entire family, timely access to coordinated health care services, and a reduced psychological burden and empowerment of mothers. Our findings suggest that care coordination has multiple beneficial effects on children with disabilities and their families, including improving the outcomes. Further research should examine how high-quality care coordination can be provided for such children and their families

Family empowerment and associated factors in Japanese families raising a child with severe motor and intellectual disabilities

Objectives: Family caregivers raising children with severe motor and intellectual disabilities (SMID) experience the enormous burden of care. The concept of family empowerment is one of the important assessment indexes of family nursing from the perspective of providing comprehensive support for these families. The objective of this study was to identify the factors associated with the empowerment of families raising a child with SMID in Japan. Methods: We conducted a nationwide questionnaire survey involving 1659 primary caregivers raising a child with SMID through 89 special schools. We assessed the main outcomes using the Family Empowerment Scale (FES). We then conducted a multiple linear regression analysis to reveal the factors associated with family empowerment. Results: In total, 1362 primary caregivers were included in our study. Our results show that factors contributing to high FES scores are higher age of the primary caregiver, higher education, greater recognition of regional support, lower childcare burden, higher utilization of home visit services, higher usage of a childcare institution, higher household income, and stronger family bonding. Conclusion: Healthcare professionals should carefully assess the state of family empowerment of the primary caregivers who are younger and those who have low education, low household income, high childcare burden, and fragile bonding with the family. Second, they should encourage such families to use regional support resources for childcare. That is, policy makers should consider ways to promote home visits and institutional services for the care of children with SMID, aiming especially for the provision of well-coordinated care and services. Keywords: Caregivers, Child care, Disabled children, Family empowerment, Home nursing, Intellectual disability, Japan, Social support