The number of elderly diabetic patients has continued to increase year by year. Home-visit nursing care is beneficial to homebound elderly diabetic patients and there is a large number of senior citizens utilizing this form of health service. We conducted a questionnaire survey of home-visit nursing care of elderly diabetic patients. Those queried were participants in the diabetes workshop. Eighty-five of them responded to our questionnaire.The results showed that 87% of the respondents experienced care of diabetic patients and acute complications of hypoglycemia and hyperglycemia as well. It was also found that many home helpers extended assistance in drug compliance, indicating that home helpers play an important role in the medical care of elderly diabetic patients.On the other hand, many problems became apparent such as lack of observation of foot care, lack of knowledge of methods of treating hypoglycemia, and inadequate observation of drug compliance due to the limited availability of home visit time.Training and collaboration of local home-visit nursing care personnel are considered necessary in the future in order to improve on the home care of elderly diabetic patients.
Elderly ; Care given by nurses ; Questionnaires ; Home ; Surveys

To nurses who are doing the actual hands-on work on shifts, the daily conference is indispensable for sharing information among them, working as a united body and addressing the problems of patients accurately. Up until some years ago, however, the conference in our ward had been somehow devoid of continuity and substance. So, by the use of a crosswise chart (a radar chart?), analyses were made to find out what was wrong and what the staff thought about the conference, and an effective approach to making the conference fruitful was sough. A new set of rules were laid down, which resulted in helping the conference become animated. A check of nurses' logs showed a great deal of improvement in terms of the inspector's scores.
Conferences ; chart ; Care given by nurses ; workforce ; seconds

This paper proposes a method for evaluating and scoring the activities of rehabilitation service users in order to pinpoint the problems with the health service of this kind and set the adequate targets for each user. Sincs the Nursing Care Insurance System was introduced in Japan in 2000, it has been argued that home-visit rehabilitation services should be excluded from home-nursing care services. However, the methods of certifing that nursing care is required are not fully established yet for setting the rehabilitation targets for service users. As things stand, it is recommended that such a method as the Functional Independence Measure (FIM) or the Barthel Index (BI) should be utilized. However, these methods only evaluate “performing activities” (the activities that a user usually performs). In order to set the users' targets, we thought it necessary to establish a method for evaluating “possible activities” (the activities that a user is able to perform at his/her full capacity). We have established a method called Functional Scoring (FS) which evaluates and scores the both performing and possible activities based on the same evaluation items. We conducted experimental evaluations on the home-visit rehabilitation users for one year from October 2005 to September 2006. When the first evaluations in 2005 were compared with the second evaluations in 2006, the total score of the performing activities significantly increased from 44.1±13.7 to 47.8±14.2 (P<0.05). Although the total score of the possible activities did not significantly increase, it demonstrated an upward trend from 49.6±13.2 to 51.6±13.5. The result suggests that our method is useful for distinguishing between the performing and possible activities. The proposed method enables us to adequately recognize the problems each user has, and to set the rehabilitation target for each user, which can be shared between the user, care personnel, and care service provider.
Rehabilitation aspects ; Functional ; FS ; Care given by nurses ; Published Comment

In April 2000, the nursing care insurance law was enforced in Japan. From April 1999 to March 2005, 162 residents including those receiving short-stay services in the Kamitsuga geriatic health services facility visited the hospital because of injuries resulting from falls. Thirty-one cases were diagnosed as fractures of femur, 13 as fractures of spine, 10 as fractures of upper extremities, 10 as fractures of rib and 3 as subdural hematomas. Fracture accounted for 48% of all cases, and femur accounted for 40% of all fracture cases. Annual hospital visits and hospitalization frequencies kept increasing up to 2001, then turned flat after 2002, and decreased in 2004. After 2002 we took the following measures, (1) individualized care, (2) small group care and (3) analysis of the behavior of inmates with an action chart for the first seven days. These measures resulted in the decrease of falls. After 2002 injuries to lower extremities decreased, but injuries to trunk increased. Generally Fractures of lower extremities prevails in the elderly of high-ADL (activity of daily life), and fractures of trunk prevails in the elderly of low-ADL. The above-mentioned three measures were effective for those of high-ADL, but ineffective for those of low-ADL. Other measures for those of low-ADL are necessary in the future.
Activities of Daily Living ; Fall, NOS ; Legal system ; Care given by nurses ; Insurance