medical profession ; Legal system

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