Around-the-clock nursing care for the elderly in Japan

The effectiveness of the around-the-clock in-home care system: did it prevent the institutionalization of frail elderly?

This study compares two communities in Japan from the perspective of community health care resources and their use by the elderly during 1992-98. In one community, programs of home care services for the elderly were reorganized to provide around-the-clock in-home nursing and home help services seven days a week (ACC). Official records were the major sources of data. Evidence from the analysis indicated that ACC might contribute to less use of institutionalization as an alternative to home care, even though, in some instances, institutionalization is the only appropriate alternative.

Evolving values in community-based long-term care services for Japanese Americans

This study used grounded theory to explore how long-term care services are perceived and what factors influence family caregiving and long-term care service utilization choices among Japanese Americans. Family and generational perspectives elucidated a dialectic between forces of integration into the broader culture, and reconnection with the culture of origin within the context of powerful ethnically based historical and generational experiences. This study describes the evolution of the values underlying service delivery and family expectations and demonstrates the dynamic relationships among cultural expectations, historical context, and service evolution for a group of members involved in the caregiving experience.

Attitudes toward community-based services among Japanese American families

PURPOSE

This descriptive study explored attitudes toward community-based long-term care services and factors influencing service utilization among Japanese American families.

DESIGN AND METHODS

Using grounded theory methodology, the Japanese American sample included 26 family caregivers, 4 persons receiving care, and 14 professional providers (n = 44).

RESULTS

Attitudes toward services were identified along six dimensions: ability to meet care needs, autonomy in daily life, quality of care and staff, cost, emotional connotations, and social and physical environment. Participants used formal services in a dynamic manner, meeting both episodic and chronic needs. Families played an active role in sustaining and augmenting the caregiving situation, regardless of living arrangement.

IMPLICATIONS

This research highlights the range of criteria included in attitude formation about services and the dynamic nature of the interplay between families and formal services.

The meaning of public health nursing: creating 24 hour care in a community in Japan

This case study describes the strategies and activities of public health nurses to increase the availability of services in a municipality of 36,000 and to transform community attitudes so that those needing services would feel free to use them. Strategies and activities are seen in the context of Japan, Minakuchi Town and the leadership of the chief public health nurse. Practicing in partnership with members of the community, strategies of public health nurses include technical activities (conducting needs assessment and framing program alternatives) and information sharing and health education (e.g. 75 meetings organized with health promoters for residents in the districts of the town). On the basis of the results of Minakuchi Town, viewed as an example of expert public health nursing practice, a general model for public health nursing practice is presented.