1.Effective Improvement in Living Environment and Physical Conditions through Social Support by Medical Staff for a Home-care Patient with Behavioral Disorders Who Was Disengaged from Social Resources: A Case Report
Akihiro MINE ; Hiromichi NAKAO ; Katsuko TAMURA ; Ken GODA ; Kazuki MATSUSHIMA ; Morihiro MATSUDA
An Official Journal of the Japan Primary Care Association 2025;48(2):44-49
The importance of addressing social determinants of health (SDH) in clinical practice is widely acknowledged. However, managing SDH becomes particularly challenging when patients exhibit psychological deficits and behavioral disorders. The present case involved a woman in her 80s who lived on public assistance and exhibited multiple co-morbidities. Following the initiation of home medical care, her condition deteriorated due to an interruption in necessary medical treatment after the electricity in her house was disconnected for nonpayment. The patient had strained relationships with the public assistance officer and other support personnel. As her primary physician, I convened all relevant parties to address the situation, evaluated her psychological and behavioral issues, and provided financial management support. Within six months, she paid her overdue electricity bill, following which her symptoms showed notable improvement. This report details the challenges healthcare workers face while addressing multiple SDHs such as the patient's financial hardship and severed connections with social resources. Our findings suggest that interventions tailored to a patient's psychological and behavioral needs improve their health.


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