Moshiokuri, or explaining what one did to one's successor before calling it a day, has long been regarded as a practice indispensable for the smooth continuation of nursing business. However, there has been much to be done in terms of efficiency. In our hospital, moshiokuri was taken up as a problem because it took long and prevented nurses from getting down to work by bedsides without delay. In 1994 the nursing record committee started to examine the practice and improvedthe roster. Later, the card indexing system for individuals was abolished. In 1998, the nursing department made the abolishment of moshiokuri practice its chief aim to improve nursing efficiency. For the attainment of the aim, the nursing record committee played an important role as a prime mover. While exchanges of information between wards were being promoted, study sessions were frequently held to enrich nursing records and improve the efficiency of nursing work. Thus, moshiokuri was partlydiscontinued and abolished totally in March, 1999. Now, the nurses have plenty of timecaring bed-ridden patients. Improvement has been made on the nursing record.

The aim of this study was to determine the current situation in a rural community that is actively engaged in establishing a community-based integrated care system, especially for dementia, despite the community being at risk of becoming a marginal village. Six medical, longterm care, or welfare professionals in a rural area of City A, Gifu Prefecture were interviewed from May to September 2017 on the current status and challenges faced in establishing a community-based integrated care system for dementia. Qualitative data was structured by thematic analysis. Volunteer activities by long-term care facilities and an Osekkai (unsolicited) network comprising community specialists, social workers, and residents appeared to be foundational to the community-based integrated care system in the area. The key shared concept was that the intentional and proactive involvement of active elderly individuals as volunteers in community activities helps to prevent them from becoming dependent. Challenges to be addressed were providing these elderly individuals with opportunities to discuss their ideal final stage of life and to understand advanced care planning.