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論文名 |
地域と老人：在宅，施設，病院の連携による地域老人福祉の確立をめざして
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| 著者名 |
塚本哲人,藤咲暹,市川礼子,門脇義江,吉田孝志,山家清,武永親雄,小松絋,佐藤千栄子,高階憲司,長門乙彦 |
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
： 4-44，
1984
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| 抄録 |
This paper is the summary of a panel discussion,“
Local Community and the Aged People”, held at the 25th Meeting of
Japanese Society of Gerontology. The target of this
panel discussion was to clarify the problems of welfare for the
aged through discussion among the participants, including administrative
workers in the local community.
Several approaches have
been made from the perspectives of livelihood, life worth, and health to
the problems of welfare for the aged.
Now, an alternative
approach is also possible. It is necessary to understand the aged
individual as a person living in the community. Thus, welfare for the aged
should be reorganized from the viewpoint of comprehensive personality,
Spatial range of activities, and chronologic life phases.
In reality, policies
and actual activities for the aged welfare have been pursued
enthusiastically, in spite of many difficulties. Nevertheless, the effects
of these activities are not sufficient. To improve the welfare situation
for the aged, we must systematize these policies and activities.
This panel discussion
was arranged consider the systematization of community care for the aged.
Discussion dealt with methods and problems in generating comprehensive
cooperation among various groups the family, the home for the aged, the
hospital, and the local community, while focusing on central health
problems. Four panelists pointed out some problems. The panelists were a
health nurse from a Health Center with a visiting nursing programs for the
aged at home, a hospital nurse engaged in clinical nursing for the aged,
the head of a home for the handicapped aged, and the chairman of a senior
citizen club.
With the help of discussants from the
professional fields of social welfare, psychiatry, other medical systems,
the welfare administration for the aged, and community care for the aged,
participants were involved in discussions on various subjects. The topics
ranged from problems relating to the view of death and care for the aged
facing death, to practical quantity-oriented problems of administrative
policies, and problems in co-ordination between the Public Health
Department and the Public Welfare Department, between the infirmary and
the hospital, between the hospital and the local community.
Of
couse, this panel discussion, a practical systematization conclusions for
establishing a network system of welfare for the aged in the local
community cannot be achieved, However, discussion did clarify the problems
and suggested the directions for establishing consistent care. It is
important to continue the study of the relationships among the fields
involved in welfare for the elderly, with the goal of systematization of
care, and also to customize network systems meet the needs of local
characteristics.
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論文名 |
地域老人利用施設の今後のあり方に関する研究
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| 著者名 |
木下茂徳,石田道孝,大野武男
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
45-63，
1984
|
| 抄録 |
We have examined how the community service center for the aged should be in future by analyzing both of the current situation of those centers and of the needs of regional people.
The aim of this thesis is to certify necessity of the community service center which should present a good occasion for the aged to make various social activities.
1) How the welfare centers in special ward of Tokyo have been used are clarified by the investigation of the facility and service program actually carried out.
2) We have compared the character of people taking advantage of centers with that of people not taking advantage of it through the social investigation of the aged in "G ward". This comparison was of help to extract factors to increase frequency of utilization, which are currently examined by us.
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論文名 |
低所得・過密住地域における独居老人の健康問題
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| 著者名 |
大國美智子,由良晶子,三宅智恵子,石川清美,緒方律,清水一二三,玉村真由美,原田祐子,吉村裕美
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
64-75，
1984
|
| 抄録 |
During the period of high growth of the economy in Japan since 1995, outskirts of large cities rapidly grew in population, and new densely-populated cities were formed. In these areas the problem of old people is apt to be overlooked due to their low rate in population. We believe that the problem of old people is becoming a serious task so we conducted a survey and analysis.
Out of 133 subjects in a survey of old people living alone in a representative densely-populated area (area A) and other two areas (area B, C) in K City, we selected 66 who " had some troubles in leading healthy and worthwhile lives." Of these, 64 lived in area A, and two lived in area B.
A detailed 'survey on life and health' was conducted on these old people, and, using 41 items in this survey, multi-variate analysis was made by means of 'Hayashi's quantification genus Ⅲ.' The result was that residential, economic, and living conditions were seen to be closely related to health. Governmental policies and other conditions were little involved in producing a worthwhile life.
Poor conditions included：
1. Residential condition：apartment house or tenement house, less than three hours of sunlight in building, communal toilet, no bathtub, one or two rooms for living, residential space not exceeding 4.5 tatami mats, poor ventilation
2. Economic conditions：monthly income not exceeding 80 thousand yen, rent not exceeding 10 thousand yen, welfare supported, medical need also welfare supported.
3. Living conditions：desultory life, one or two meals a day doesn't cook for himself or herself, receives few visits from relatives, doesn't enjoy frequent baths, has long years of living alone.
Further study of these conditions showed that old people living alone in densely-populated areas were not those who could afford health and financial setbacks. In a pinch, they had no other help but neighbours or welfare policies.
We consider this problem not limited to area A in K City, but it is common to all rapidly-urbanized areas. We intend to pursue further comparative surveys.
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論文名 |
定年退職後夫婦の伴侶性
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| 著者名 |
都築佳代
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
76-90，
1984
|
| 抄録 |
R. O. Blood and other sociologists assert that companionship is not related to marital happiness for Japanese couples. The purpose of this study was to examine that assertion.
Mail surveys were conducted by the Division of Family Relations, Ochanomizu University in 1979 and 1983. The original sample was compiled from lists of retired local government employees, retired Japan National Railway employees, and retirees who had a deposit in a bank in the Tokyo and Niigata areas. The sample consisted of 1,900 names. From these 1900 names, those men whose wives were still alive and those who showed a willingness to cooperate with survey were selected. The size of the sample in 1979 was 832 couples. Separate questionaires were sent to these 832 couples. A total of 601 couples responded. To these 601 couples the same procedure was applied in 1983, and 325 couples were then selected as the sample.
The data to be analyzed here is compiled from questionaires of 278 couples in which both the husband and wife responded in 1979 and 1983. These couples were, for the most part, in good health and highly educated. They also received higher incomes in comparison with average couples in which the husbands were in the same age group (60-64 years) in 1979.
The results are as follows：
1. The companionship of these couples increased after the retirement of the husband.
2. The greater the companionship, the greater the marital happiness；marital happiness was highly correlated with an increase in the degree of communication.
3. The correlation between companionship, and marital happiness was greater among wives than husbands.
The findings of our study show that companionship is highly related to marital happiness of retired couples in Japan.
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論文名 |
二世帯専用住宅における息子夫婦同居および娘夫婦同居の特性
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| 著者名 |
長谷川紀子
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
91-106，
1984
|
| 抄録 |
This survey was conducted from May to July, 1982, to investigate the characteristics of 40 families of mothers-in-law living together with their sons and daughters-in-low in houses suitable for two households in Tokyo and Kanagawa Prefecture (type A), and 30 families of mothers and married daughter's families living together in the same house in Tokyo and Osaka (type B).
The initial results are as follows：
1. (1) 28 families of type A began to live together and later larger accommodations were obtained in order to have two separate households.
(2) 20 families of type B began to live together as a result of the daughter's marriages.
2. Type A parents are independent economically from the cohabitent couples.
3. Type B parents as the care of type A bought the land where they now live.
4. Reason for cohabitation.
(1) Daughters-in-law said "It's natural", or "To obtain support from parents."
(2) Daughters answered "It's natural," or "parents' help was necessary,
(3) Mothers-in-law and mothers answered that they felt comfortable living together with the younger couple.
5. Almost all type A families are satisfied with their present condition.
6. The percentage of couples having private furniture is very high in type A and very low in type B.
7. The incidence of having supper together and spending time in social talk was few in the case of type A, and frequent in type B.
8. As for Housework.
(1) In type A the women did housework separately.
(2) In type B daughters did it all or the women did it together.
9. Concerning the care of grandchildren
(1) Mothers-in-law were not likely to participate.
(2) Mothers and daughters consulted each other.
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論文名 |
老人の心身機能と施設適応；養護老人ホーム入所後5年の追記調査
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| 著者名 |
柄澤昭秀,小林充,矢富直美
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
107-123，
1984
|
| 抄録 |
The purpose of this study was to evaluate changes in psycho-physical measures over 5 years in a sample of institutionalized elderly and to examine the relationship between those measures and their adaptation to the circumstances following admission. Those persons admitted to an old people's home during the period from May, 1973 to April, 1976 were administered medical checks at the time of admission, and 5 years later a follow-up interview was carried out on each of them.
(1) At the time of the follow-up study, 54.1% of 503 subjects still remained in that home (the residing group), but 19.1% had died (the dead group), 14.3% had been moved to nursing homes (the nursing home group), 4.4% to hospitals, and 8.2% to other environments.
(2) Retrospective analysis suggested that, at the time of admission, those in the dead group had a higher mean age, poorer performances in psychological testing, and they suffered more frequently from hypertension, post apopletic sequalae, heart desease and dementia than the residing group. In the nursing home group slightly higher mean age and poorer performances in psycholosical testing were observed compared with the dead group.
(3) At the time of the follow-up study, the residing group included 136 males and 136 females (mean age = 75.2 years). 30.5% of them manifested decline in physical functions, and 31.0% showed decline in intellectual functions. Because of remarkable decline in psycho-physical functions, 9.9% of them could manage only the basic activities such as taking meals, baths or toilet functions. Although the residing group should have been most active in daily living, 15.8% of the residing group were quite inactive, 36.4% took part in social affaires only passively, and the rate of those who engaged in full activities reached only 37.9%. It was suggested that the level of psycho-physical functions and ADL at the time of the follow-up study were in some degree correlated with the measures of age, psychological test performance, and EEG findings at the time of admission.
(4) In everyday life, 22.4% of the residing group manifested some maladaptive behavior or trouble due to personality, mental disorder, or drinking.
(5) Though there were only a few subjects who expressed obvious dissatisfaction with life in the institution, perhaps there were more subjects who left such dissatisfaction. They often pointed out the advantages of institutionalized life：for example, they were guaranteed fulfilment of daily needs of clothing, meals and a dwelling. Bothersome personal relationships associated with co-operative living were most frequently pointed out as unfavorable defects.
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論文名 |
寝たきり老人の異常精神症発現の要因；知力低下と介護者との人間関係
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| 著者名 |
大井玄,深山智代,甲斐一郎,武長脩行,山崎信行,市川伸一,鈴木重任,中川正宣,柄澤昭秀,山本俊一
|
雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
124-138，
1984
|
| 抄録 |
Our previous study on the bed-fast elderly in Suginami, Tokyo has led us to propose a hypothesis that their psychotic symptoms (delusion, hallucination and nocturnal delirium) will occur when they fail to adapt themselves to the environment and that two most important factors involved in maladaptation process are intellectual deterioration and environmental stresses. Based upon an assumption that the caretaker-patient relationship constitutes the most critical part of stresses in their environment, we tested our hypothesis by collating the prevalence and number of the psychotic symptoms between the elderly who scored high in our Caretaker-Patient Relationship Score (CPR Score) representing less environmental stresses and the elderly with low score (greater environmental stresses) in three regions-Suginami (Tokyo), Saku (Nagano) and Yomitan (Okinawa). Each group was matched on ADL, level of intellectual deterioration and age. Within each region, the prevalence and number of psychotic symptoms were significantly greater in low score group than in high score groups (p<.05～.001). Conversely, the groups with psychotic symptoms scored less in CPR score than a symptomatic groups (p<.05). These findings strongly suggest the validity of our hypothesis.
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論文名 |
アルツハイマー型痴呆の知能障害
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| 著者名 |
一原浩,加藤伸司,本間昭,長谷川和夫
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
139-151，
1984
|
| 抄録 |
The purpose of the present study is to clarify characteristic patterns of intellectual impairment of Senile Dementia of the Alzheimer Type (SDAT) by using the Wechsler Adult Intelligence Scale (WAIS). It is essential in establishing early diagnosis and diagnostic scales.
Subjects were 118 patients referred to the Dept. of Neuropsychiatry, St. Marianna University School of Medicine from Jan., 1974 to March, 1983. They comprise 37 patients with clinical diagnosis of SDAT, 14 patients with vascular dementia, 40 patients with functional disease and 27 patients with organic disease. All of them were fifty years old and over. We carried out 11 subtests of the WAIS. Among the four groups of patients, the following items were evaluated：(1) total IQ, verbal IQ and performance IQ, (2) scaled scores of 11 subtests, (3) characteristics of profiles of individual patient's subtests and (4) passing rates of total items.
Results：There were significant differences in scores between patients with SDAT and without dementia on two kinds of IQ test and eight subtests. No characteristic subtest profiles specific to the four groups were obtained. Some differences among subtest profiles were found between patients with SDAT and without dementia. In SDAT, lower passing rates were found in 13 WAIS items, compared with those of the patients with functional disease.
The above mentioned results support the greater decrement of performance IQ among the aged with dementia, in comparison with the verbal IQ and suggest some characteristic intellectual impairment of SDAT, Also, present results indicate the possibility of establishing a screening scale of dementia. Further extensive studies are required with special reference to comparing SDAT with the normal aged.
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論文名 |
高齢者の心身の自覚的健康観に関する研究
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| 著者名 |
谷口幸一,大塚俊男,佐藤真一,丸山晋,松本真作
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
152-166，
1984
|
| 抄録 |
In order to investigate the personality adjustment in the second half of life in this study, we mainly examined the intercorrelationships among the indices of BODY CONCEPT, HEALTH-CONSCIOUSNESS, SELF-CONCEPT, EDUCATION LEVEL and AGE. The factor analysis, by vari-max method, was applied to find the main factors connected with these psychological indices (20 variables). The number of subjects was 80 elder adults (42 men, 38 women), who were living in their own residences.
The results were as follows.
(1) Three factors were found by the factor analysis. Factor I is concerning the ability to draw an articulated "human figure", which is thought of as an index reflecting the degree of perceptual differentiation about the human body.
(2) Factor Ⅱ is concerning the successful adjustment in old age, which is likely to reflected in the higher levels of the SELF-CONCEPT scales：self-confidence, morale, adult-characteristics of personality and personality-maturation.
(3) Factor Ⅲ is concerning the physical maladjustment in old age, which is likely to be reflected in the lower levels of HEALTH-CONSCI-OUSNESS indices：subjective health-consciousness, image of one's own body and life-events that effect physical health.
(4) AGE is likely to have significant positive burden on Factor Ⅱ, and EDUCATION LEVEL also on Factor Ⅲ.
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論文名 |
高齢者の孤独に関する因子分析的研究
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| 著者名 |
工藤力,長田久雄,下村陽一
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
167-185，
1984
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| 抄録 |
The purposes of this research were to examine the degree of loneliness in the aged, their coping style and their emotional responses. Our subjects were 129 aged, 69 males and 60 females, all 57 years old and over. We used the Loneliness Scale (Russell, et al., 1980) and the Coping Behavior Scale and the Emotional Responses Checklist (Kudo, 1983).
The results showed that the degree of loneliness was lower in the aged population than in any other age group. The 40 items used to detect their coping behaviors and the 31 items used for their emotional responses were analysed using factor analysis. The results of this factor analysis showed 8 major factors in their coping hebaviors. Concerning their emotional responses, we identified 7 major factors. The structure of the factors was different between males and females. Also the contents of each factor were different.
The aged live under a variety of conditions. We intend to study the differences that any change in those conditions promote is their loneliness, coping style and emotional responses.
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論文名 |
幸福な老いの指標とその関連要因；心理・社会・医学データからの学際的研究
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| 著者名 |
古谷野亘,柴田博,前田大作,下仲順子,中里克治,芳賀博,須山靖男,松崎俊久
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
186-196，
1984
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| 抄録 |
The purpose of the present study is：(1) to investigate the interrelationships among four indices of successful aging which have been used traditionally or may be used：that is self-rated health, social activity, morale and ego strength (2) to estimate the relationships between the four indices of successful aging and their medical, psychological and social correlates. The subjects were selected from the second panel of the Koganei Study undertaken by the Tokyo Metropolitan Institute of Gerontology (214 men and 243 women aged from 69 to 71 years).
The main results were as follows：
(1) Correlations among the four indices of successful aging were positive, and in accordance with the previous studies. Especially strong correlation was found between morale and ego strength. Correlations between social activity and the other three indices were weaker in women than in men.
(2) The results of canonical correlation analysis showed that nocturia and correct score of Benton Test were strong predictors of successful aging in both sexes, grip and amount of pocket money were strong predictors in men, and pain and education level were in women. The physical aging indicated by nocturia and the mental decline indicated by Benton Test had strong negative effect upon the successfulness of human aging.
The findings reaffirm the fact that there is interaction among physical, social and psychological aspects of aging. Therefore, interdisciplinary analysis is necessary.
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論文名 |
地域老人の食物摂取形態と身体的・社会的要因との関係；東京都小金井市の調査
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| 著者名 |
須山靖男,七田恵子,芳賀博,永井晴美,松崎俊久,古谷野亘,柴田博
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
197-210，
1984
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| 抄録 |
The purpose of the present study is to understand the interrelationship between food intake pattern and physical or social factors in the elderly.
The subjects, (387 men, 499 women) consisted of elderly persons aged 69-71, who participated in a health check-up carried out at a hall. They were further investigated by home visit (1/2 random sample of non-participants in health check-up at the hall), living in koganei City, Tokyo. The data were analyzed factor analysis.
The results obtained were as follows.
(1) The pattern of food intake in the subjects tended to be more westernized than that reported in the Japanese Nutrition Survey.
(2) 1) Educational level and intake of bread, milk, fruit were positively correlated for both sexes in the first factor. In addition, social activity was positively correlated, and living with family was negatively correlated in the first factor only in women. 2) A positive interrelationship was found between social activity, health self-rating, and functional activity for both sexes in the second factor. In the second factor, habits of drinking for men also revealed a positive correlation while history of stroke for women showed a negative one. 3) In the third factor, intake of meat, fat and living with family were positively interrelated in both sexes, the intake of vegetables and fruit being inversely related in women.
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論文名 |
看護サマリーにみる患者・家族指導内容の分析
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| 著者名 |
店橋光枝,矢野正子
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
211-226，
1984
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| 抄録 |
Tokyo Metropolitan Neurological Hospital assures continuing care for patients after discharge. For that purpose each ward has a staff member who has responsibility to instruct the patient and family on how best to carry out the continuing care program in the home.
We have conducted case studies of 45 patients who were discharged between April 1st 1982 and March 31st 1983. We analysed the nursing summary of the abovementioned 45 patients to determine whether or not the contents are useful as basic data for the health official taking over the case.
The summaries generally lacked the following：
1. Background of the patient and family information
2. Problem solving process during the patient's stay in the hospital
3.Working relationship with community health and welfare agency
4. Detailed description of discharge instructions
5. Anticipated problems in the home
6. Continuing care recommendations
7. Explanation of unsolved problems
After careful study of the continuing care program written in the nursing summary, we reached the conclusion that there is still in sufficient information about the program.
Our study produced the following reasons for this lack of information in the records.
1. The continuing care program appears to have low priority among nurses
2. Nurses have only limited knowledge of community health and welfare agencies
3. Many nurses are unable to instruct the patient and family
4. Nurses generally fail to recognize the importance of the nursing summary
5. They have not yet become accustomed to POS, and primary nursing
Conclusion：
Nurses need to be able to assess each case more carefully. More comprehensive nursing summaries should required.
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論文名 |
老年学の体系について
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| 著者名 |
大阪巳年子
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
227-236，
1984
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| 抄録 |
The purpose of this article is to evaluate a system of gerontology based on Saki Noguchi's System of Home Economics.
The conclusion are：
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論文名 |
個別ケア重視の老人医療体系化をめざして；ケアに対する報酬上の工夫の必要性
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| 著者名 |
青木信雄
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雑誌名
巻／号／頁／年 |
老年社会科学，
6
(
2
)
：
237-249，
1984
|
| 抄録 |
In 1983 the Japanese Government enacted the Health Care for the Aged Law. It gave priority to restrain medical expenses and introduced a new health maintenance scheme. But the contents of health care for the elderly and its measures seem inadequate.
Modern westernized medicine in Japan, introduced at the Meiji era, has been principally medical care conducted by medical doctors. There has been lack or neglect of nursing care. The present Medical Service System and Medical Care Insurance in Japan are influenced by these circumstances.
In the health care for the elderly, however, nursing care plays a more important role than medical care. It is suggested that the present system and regulations should be revised.
In the U.S.A. there are many experimental reimbursement systems in the field of the long term care which attach more importance to nursing care than medical care. In considering our revisions, experiences in the U.S.A. give us some useful information.
This paper introduces two typical cases as follows：
1) Maryland Medical Assistance, Nursing Home Reimbursement System started in January, 1983 for the Medicaid patients.
2) Nursing Home Payments designed to encourage appropriate care for the chronically ill；demonstration research project conducted by the National Center for Health Services Research (Nov. 1980-Apr. 1983).
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