Based on the assessment of the home health care services provided by our hospital over the past five years and the results of a survey of the people concerned, we studied the problems of home care and dwelt on what it should be in the future. An alarming fact was brought to light: Many of those who look after patients in their homes are stress-ridden. Even among those who said they are satisfied with the present care system, not a few expressed uncertainty about the future. Many were of the opinion that without option of putting the patients in hospitals or nursing homes if need be, the home health care system would not hold water.
Our hospital admits only those patients who are badly in need of hospital treatment, and technically many cases cannot be referred to general practitioners. To add to the development of home health care, it is necessary to establish a coll aborative system between hospitals and neighborhood clinics. Under the system, patients will be screened according to the degree of their need for medical care, and visiting nurses will be able to show their skill fully and provide care confidently while keeping close contact with physicians.

We investigated the relationship between lifestyle and cognitive function in elderly subjects who had their checkups at a memory clinic. The 136 elderly study subjects included 51 with Alzheimer’s disease, 22 with vascular dementia, 23 with frontotemporal dementia, 25 with mild cognitive impairment, and 15 healthy control. The patients’ lifestyles were assessed using the Frenchay activities index (FAI), and their cognitive functions were assessed by neuropsychological tests, such as the mini-mental status examination and the frontal assessment battery (FAB). The FAI score was lower in the demented patients than in the control subjects. Strong correlations were observed between the FAI scores and the scores in the neuropsychological tests. The FAI scores did not correlate with the educational level or the duration of disease. The fi ndings from the stepwise regression analysis indicated that the FAB score, the number of family members, gender, and age were factors independently affecting the FAI score. The results indicated that the lifestyles of the elderly people might be affected by not only their age and family organization but also their cognitive function. We concluded that cognitive function could play a role in the lifestyle of elderly people.