1.Development of Dementia Workshop Program for Commissioned Welfare Volunteers in Local Communities
Journal of the Japanese Association of Rural Medicine 2012;61(2):113-117
Commissioned welfare volunteers (CWVs), who constitute indispensable part of health resources, play an important role in improving the environment so that those aged with dementia can live comfortably. They give advice to local residents and survey for enhancing their wellbeing voluntarily, while working hand in hand with district welfare offices. They are also expected to have a role-playing ability to support the living of aged people with dementia from a holistic point of view. In this study, we shed light on the needs of study for CWVs in order to mark one step forward toward the development of a dementia workshop program for local people, especially CWVs. Based on the findings, a program was worked out by way of trial and implemented. Lasting two hours and half, it comprises several sessions: “What is the workshop?” “Prevention of dementia,” “Difficulty in treating wih demented old men and experience of their families,” “Affliction case study1” and “Affliction case study 2." A questionnaire survey of the participants revealed that more than 90% of the program contents were understandable.
3.Interoprofessional Workshop on Elderly Care: Report
Journal of the Japanese Association of Rural Medicine 2014;63(1):76-82
Nagoya has seen various educational activities through workshops to build a large-city- type interprofessional network. In this paper, we reported the depth of 21 people’s feelings toward the activities. They took part in the June, 2013, workshop and were all concerned in eldercare. We invited them to a one-hour meeting and talked freely about a workshop with the participation of people engaged in different type of occupation. The arguments were summed up by KJ method. It was suggested that the workshop not only provided an opportunity to learn a lot but also helped promote exchanges of views and ideas between participants. Some argued that whether a workshop ends in success or not would depend on compatibility with other participants.. The author thinks that how to nurture talented people concerned in the planning and management of the workshop and how to invite as many people as possible from various fields are subjects to be grappled with.
4.Working on Compilation of Model Written Requests From Care Managers to Physicians
Journal of the Japanese Association of Rural Medicine 2014;63(1):83-85
The number of geriatric care managers is on the rise. This tendency has given rise to concerns in some quarters over the widening communication gap between care managers and medical professionals. The problem is that already many care managers are taking too much time writing requests to physicians because they do not know how to write them. The situation is such that in concert with care managers we had a workshop to improve in writing to physicians on a case-by-case basis. Cases were presumed by participating care managers. For examples: cases where instructions from doctors concerning home care are needed as bed-ridden patients had serious bedsores;where hard-to-manage behavioral and psychological symptoms of dementia developed in patients have to be reported and at the same time thedoctors’ advice is needed as to whether the patients should be referred to clinics specialized in Alzheimer’s disease; and where it becomes necessary to ask permission from doctors for reduction in the number of times of internal use of prescription medicines by reason of forgetfulness on the part of the patients. With these and other hypothetical cases included, a sort of manual was worked out by the first author of this paper in cooperation with two nurses. We hope that this work will help care managers build up their writing skill and facilitate communication between care managers and physicians.
5.Anger Management Workshop for Caregivers
Journal of the Japanese Association of Rural Medicine 2014;63(2):151-153
Stress that care workers are experiencing inevitably has bad influence on the quality of life of those old people who need nursing care. It is, therefore, a matter of urgency to work out some effective measures to deal with the mental health problems of care workers and others engaged in nursing care services. In view of the circumstances, we hold a workshop for caregivers with an aim at increasing their power to get anger under control. The workshop had four main sessions; (1) Free discussion on anger in general; (2) Distortion of thought; (3) 10 frequently observed irrational convictions; and (4) analysis of anger. Prior to the main sessions, all participants introduced themselves and told their stories about how they work off stress. In the free discussion, a world-cafe style was adopted. In the session (2) on distortion of thought, participants pondered on irrational convictions which had been formed in them on the basis of their experience. In the session (3), each participant gave his or her convictions apt to cause anger and replaced them with rational convictions. In the analysis of anger session (4), participants were asked to recall the scene in which they fumed, and role-play. The questionnaire survey taken after the seminor found that the anger management workshop had a beneficial effect on all the participants.
6.Creating a Strategy for Improving Dementia Care in a General Hospital
Journal of the Japanese Association of Rural Medicine 2017;65(6):1188-1193
Inpatients with dementia are prone to delirium and aimless wandering, and they often become verbally and physically abusive. Thus, caring for these patients places considerable burden on nurses. This article reports on the creation of a strategy for dementia care in a general hospital. Subjects were staff of Konan Kosei Hospital ─ 2 deputy chief nurses, 1 section chief nurse, 3 unit chief nurses, 2 medical social workers, 1 integrated community support social worker, and 1 section chief nurse (home-visiting division) ─ and 2 independent care managers. Focus group interviews were conducted to collect data, and extracted labels were classified into subcategories and categories according to similarity in meaning. A two-dimensional development method was used to prioritize tasks in each category. The highest priority tasks were discussed and sorted using characteristic diagrams. It is necessary for a new team dedicated to dementia care to be created and for education, enlightenment, and training to be provided so as to increase understanding of dementia care and empathy among a wider range of professionals working in the hospital.
7.Qualitative Study of Spirituality in End-of-Life Care for Elderly Men Living Alone: Perspective of Care Managers
Journal of the Japanese Association of Rural Medicine 2017;66(4):455-461
Elderly men living alone are susceptible to loneliness, spiritual pain, and distress. However, previous studies of spirituality have been conducted mostly among women and cancer patients. Therefore, this study sought to structuralize spirituality and distress among elderly men living alone. Thirty care managers across Japan discussed the thoughts and feelings they had when providing livelihood support to elderly men living alone, and the content of discussion was structuralized. The data suggest that these elderly men struggle with loneliness, anxiety, and the need for affection, often living a bitter reality. Also, past events affect their present spirituality. However, many care managers still struggle daily to find ways to support elderly men living alone because some elderly men refuse to accept livelihood support and care managers cannot readily access condominium buildings with installed security systems.
8.Behavioral Tendencies of Home-Visiting Nurses
Journal of the Japanese Association of Rural Medicine 2014;63(4):679-682
It is often said that care coordinators without health care background are no good at talking with home-visiting nurses. The communication gap is wide. So, we planned to make textbooks with a view to bridging the gap. To garner some basic data, we sponsored a workshop on “home healthcare nurses’ behavior that troubles care managers.” The contents of the discussion were analyzed using the KJ method, though partially, and obtained the following seven groups: (1) demanding the same level of medical management as that of a hospital from home-visit nursing teams; (2) being not inclined to do only irreducible minimum work; (3) having not enough experience in home-visit nursing service with their knowledge inclining to medical care; (4) intending to control home care teams authoritatively; (5) do not control their emotions in front of clients and families; (6) using technical terms too much: and (7) being eager to change to special instructions. The results of the present study will provide important information to home-visiting nurses and care managers as well.
9.A Study of Originality of Dementia Day Service by Use of KJ Method
Journal of the Japanese Association of Rural Medicine 2014;63(4):675-678
The purpose of this study was to shed light on the originality of dementia day service center through focus group interviews with the center administrator and caregivers. With the participation of a total of six people, a discussion was held. The participants exchanged views ideas about what day services should be like for the benefit of the elderly with dementia. From the debate, we drew the following conclusions. (1) Given that the level of dementia day service is high in specialty and technicality, it would be possible to admit the patients who were unacceptable to ordinary day care centers. (2) Users, their families and caregivers have vicarious pleasure from the alleviation of BPSD. (3) The delight gives the care staff an incentive to learn more and contributes toward upgrading the technical level further. From the above, we concluded that the specialty and originality of the dementia day service center had been supported by a high quality of life of users, their families and the staff who had experienced in caring old people with severe BPD successfully.
10.Are eating habits effective screening indicators for anemia in elderly Japanese people? The Kyushu-Asakura Project (KAP)
Journal of Rural Medicine 2015;10(1):48-50
Objective: The aim of the present study was to explore whether the presence of unhealthy eating habits is an effective indicator of anemia among older people or not.
Methods: We used data from a prospective observational cohort study of all users who underwent an annual health checkup at a public clinic in a rural area. The subjects of the present study were 150 users aged 75 years and older who underwent the checkup between January and September 2010. The subjects were first divided by gender and further separated into anemic and non-anemic subgroups according to their estimated anemia prevalences: Hb < 130 g/L for males and Hb < 120 g/L for females. For each category, we compared the subjects’ lifestyles including eating habits between the anemic and non-anemic groups.
Results: Both among the women and the men aged 75 and over, there were no significant differences in any items including eating habits between the two anemic subgroups.
Conclusion: Our results suggest that the presence of unhealthy eating habits is not an effective indicator of anemia among older people.