「老年社会科学」 Vol. 8

   

論文名


老人医療(病院)の立場から(これからの老人保健施設体系:いわゆる「中間施設」論をめぐって)

著者名

青木信雄

雑誌名
巻/号/頁/年
老年社会科学, 8 : 4-11, 1986
抄録
In this article, we discussed the following three points concerning medical care for the aged:(1) the current status of medical care for the aged:(2) intervening institutions between nursing homes and hospitals , and (3) long term care facilities. First, We pointed out that the actual needs of the aged have been ignored in medical care research. Second, we criticized current considerations of intervening institutions which focus only on financial problems without considering other real needs of the elderly. Finally, we pointed out several defects of long term care systems.

 

論文名


研究の立場から(これからの老人保健施設体系:いわゆる「中間施設」論をめぐって)

著者名

冷水豊

雑誌名
巻/号/頁/年
老年社会科学, 8 : 12-23, 1986
抄録
It should be noted that the idea of "intermediate care facilities for the elderly who require intensive care" proposed by the Advisory Council on Social Security in January, 1985 is primarily based on the governmental policy aimed at restraint of national expenditures for health and social welfare services. However, in planning the system of care for the elderly, the question of what kind of service should be provided for what kind of needs of elderly persons should take precedence over all others. The question of financing the care system, which, needless to say, is very important, must be subject to it. From this standpoint, the following system of care facilities should be developed in the future.
(1) Long-term care facilities:
Clients・・・severely physically and/or mentally impaired elderly persons who do not need acute or convalescent care but cannot receive care in their private homes.
Functions・・・to provide:1) environmental conditions suitable for human life space, 2) opportunities for activities and interactions basic to human life, 3) intensive personal care necessary for the severely impaired elderly, 4) medical and nursing care for chronic illness
(2) Geriatric hospitals or geriatric units in general hospitals:
Patients・・・elderly persons who need assessment and treatment for acute and convalescent illness
Functions・・・geriatric medicine and rehabilitation services for acute and convalescent illness
It is important that reform should not be confined to the reorganization of long-term care facilities, but should include the development of geriatric services.

 

論文名


福祉の立場から(これからの老人保健施設体系:いわゆる「中間施設」論をめぐって)

著者名

小国英夫

雑誌名
巻/号/頁/年
老年社会科学, 8 : 24-35, 1986
抄録
This report discusses the problems of new type of long-term-care institutions, Health Institutions for the Aged, which the Ministry of Health and Welfare is planning to establish in the near future.
Major problems are:1) The increase of long-term-care facilities may cause delays in the development of community-based services, 2) The further classification of long-term care facilities will bring about much difficulty in selecting an appropriate facility for the elderly, 3) The diversion of unoccupied beds in hospitals and clinics to those in Health Institutions for the Aged may possibly lead to an increased financial burden for medical care, 4) The demand for institutional care services will be increased unless community care services are expanded, 5) The establishment of Health Institutions for the Aged is not appropriate for principles of Normalization and Care.
In addition to the above-mentioned problems, there are several noteworthy issues. The emphasis should be placed on enhancing community-based services rather than on institution-based services, welfare services rather than medical ones, and preventive services rather than after the fact services in terms of principle care and financial policies.
It is certainly true that medical cure services should be involved in long-term care services for the elderly and disabled persons, but medical care services provide physical cure and tend to neglect the essence of care (assistance with the difficulties of daily living).
General revenues and budgets of pubic pension programs should be alloted to the care of the difficulties of daily living, not budgeted for medical insurance. There are a lot of problems if money for Health Institutions for the Aged depend only upon medical insurance, as is seen by the excessive financial burden of geriatric hospitals.
Most important now, systematic social policies for enterprise, labor, housing and other fields should be improved, and comprehensive community-based services such as "financial relief for care" and "sheltered housing with care" should be advanced. The training of staff is also urgently necessary.
To some extent we still have "reserve power" to cope with the problems of the elderly in modern Japanese society. It is certainly necessary to maintain " reserve power " in the coming aging society. All those in the field of social welfare services are expected to join in an all-out effort to improve community-based services to meet the increasingly serious needs of the aging.

 

論文名


中年期および老年期自殺死亡率の都道府県格差と関連する要因

著者名

黒田研二,藤林千春,朝倉新太郎,上島弘嗣

雑誌名
巻/号/頁/年
老年社会科学, 8 : 36-49, 1986
抄録
Suicidal death rates (SDRs) of the middle-aged (40 to 59 years old) and the aged (65 years old and over) in 1980 were calculated by sex and by prefecture. Correlations between individual SDRs and between SDRs and 34 socio-economic indices were investigated. The main results were as follows:
1. There was no correlation between the SDRs of middle-aged men and that of aged women.
2. The SDRs of middle-aged men correlated significantly with indices indicating poverty ("rate of persons receiving livelihood assistance", etc) and those indicating rural characteristics ("percentage of persons engaged in primary industries", "homehelpers per 100,000 persons 65 years old and over", etc).
3. The SDRs of aged men and middle-aged women correlated with fewer indices than did the SDRs of middle-aged men. This suggests that the effect of these social factors on the suicidal deaths of aged men and middle-aged women is less strong than that on the suicidal deaths of middle-aged men.
4. The SDRs of aged women showed an inverse correlation with poverty, and were positively correlated with such indices as "the number of mats (living space) per person in a household" and "the percentage of households other than nuclear families and one-person households". It was considered a possibility that households with three generations would tend to generate conflicts between family members and would therefore become a risk for suicide by aged women.

 

論文名


在宅福祉サービスとしての日常生活用具給付事業

著者名

藤林千春,黒田研二,多田羅浩三,朝倉新太郎

雑誌名
巻/号/頁/年
老年社会科学, 8 : 50-61, 1986
抄録
The records of programs to provide equipment to facilitate daily living were examined for 32 municipalities in Osaka Prefecture that have welfare offices. The actual situation as well as the reasons for the difference in the extent of benefits provided (provision rates) were analyzed wit the following results.
In programs to provide equipment to facilitate daily living for the aged, the provision rates correlated with the activity of home visits by public health nurses (PHNs). Closer cooperation between home care providers such as PHNs and case workers appears to be necessary.
In programs for the handicapped, provision rates were closely correlated to the number of domiciliary welfare programs implemented by municipal authorities. This service is provided regardless of the income of the recipient. It is important to give accurate information to the persons who are in need of these benefits.
Whether municipalities give priority to health and welfare programs and whether they are flexible in adapting these programs to various needs influences both the provision rates and the number of programs.

 

論文名


特養における痴呆性老人の入所前介護状況についての一考察

著者名

川村耕造

雑誌名
巻/号/頁/年
老年社会科学, 8 : 62-76, 1986
抄録
So far, we presented nine reports at this Society's Annual Meetings on the familial background of those aged people living at our Welfare Nursing Home and on the treatment for the aged with senile dementia. With regard to the care of the aged with senile dementia, we paid special attention to function and treatment based on the experience of the Second Oyamada Welfare Nursing Home, a special facility for the aged with senile dementia.
In the present report, we would like to introduce the results of a recent study concerning welfare and medical services for the aged with senile dementia living in their own homes, conducted as we investigated the pre-entry process by which patients came to live in this facility.
We conducted our survey on the basis of questionnaires which were mailed to the families of 240 aged persons of which 140 live at Oyamada Welfare Nursing Home-a general nursing home and 100 live at the Second Oyamada Welfare Nursing Home.
The questionnaires concerned the care, these old people received during the period from the time they first needed help until the time of their entry into the facility. The questions were grouped in five categories as follows;1) Medical care they received before entering the nursing home, 2) Welfare services, 3) Consultation and advice, 4) Cooperation and assistance from neighbors and relatives, 5) Awareness of medical treatment and welfare service agencies.
The result of our survey shows a number of problems. Services for the aged with senile dementia are still quite primitive, and those who have to look after the patients often do not know where to go to consult with experts about nursing or about the utilization of medical and welfare services.
Few people actually consult with psychiatric specialists who are the real experts. In fact, they show a tendency of avoiding those professionals altogether.
As for welfare services, we noticed that practical assistance is not readily available and that come to the Welfare Nursing Home only because they have exhausted all other resources.
Services to bed-ridden old people have long been emphasized so the knowhow of care as well as the utilization of facilities appear to have reached a certain level. However, social response to the aged with senile dementia is still far from sufficient, and measures for coping with them are not fully functioning yet.
We believe that there is an urgent need to construct a social network of treatment for the aged with senile dementia including the improvement of facilities. This task should be pursued by municipal welfare agencies, health centers, hospitals, nursing care facilities, social welfare cooperatives, and other organizations. Special measures should be taken to provide tangible services such as visiting nurses, short stays at nursing homes, day-care services and home helpers. At the same time, it is important to work out means of promoting visits to psychiatrists or geriatricians, and to improve the capability of general hospitals and practicing physicians in dealing with the aged with senile dementia.

 

論文名


都市壮年における老後の生活像と準備行動 (2);準備行動

著者名

古谷野亘,井上勝也,岡本多喜子,佐藤真一,竹野下訓子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 77-87, 1986
抄録
The purpose of the present paper is to investigate the significant correlates of preparatory behavior for old age. Subjects consisted of 540 Japanese adults aged 30 to 59 years living in a suburb of Tokyo.
Logistic function analyses revealed the following results:
(1) Regarding preparatory behavior for the financial aspect of later life, the effect of age was significant. Savings and deposits for private pensions were more commonly undertaken by older subjects than younger subjects.
(2) Regarding preparatory behavior for health in old age, the effect of sex difference was salient. Undergoing of medical examination and doing physical exercise were more commonly found in men than in women, and careful dietary intake was more commonly found in women than in men.
(3) Regarding preparatory behavior for social activities in old age, the effect of educational background was salient. Hobbies were more commonly undertaken by subjects with higher education than by those wit lower education. Studying was more commonly undertaken by women than by men, by older subjects than by younger subjects, and by those with higher education than by those with lower education. Informal relationship with neighbors was commonly found in women, in older subjects, in subjects with lower education, in those with a strong tendency toward family-centralism, and in those with a strong tendency toward social participation.

 

論文名


都市独居老人の保健ニーズと福祉・保健の総合的対応に関する調査研究

著者名

橋本美知子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 88-102, 1986
抄録
The purpose of the present study was:(1) to investigate the health needs of the aged living alone, and (2) to explain the needs for comprehensive welfare service planning.
The random sampled subjects were 115 old people living completely alone and 21 old people living alone with the support of home helpers. They were all over 70 years old and living in Morguchi City, a north-eastern suburb of Osaka. The survey method was direct interviewing about their health, mental state, attitude toward life, and so forth. We conducted a one year follow-up study of the 21 old people living alone with the support of home helpers.
We outlined concrete instances of health problems caused by (1) loneliness and isolation, (2) anxiety about health, and (3) the absence of help with practical daily tasks. Particulary in the case of bedridden elderly people, it was found that health and medical services should work together with the support of home helpers. For those with failing mental powers, it is necessary to take appropriate measures for admittance to a hospital or other institution. Also positive steps for the early detection, treatment and prevention of further deterioration should be placed in effect.
To realize this role, home helpers must be properly trained and experienced. The role of home helper is an important factor in the mediation between the aged and their families, their neighbors and the community in which they live.

 

論文名


大学生の老人観

著者名

保坂久美子,袖井孝子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 103-116, 1986
抄録
The purpose of this study was to explore the attitudes of university students toward old people. Self-administered questionnaires were given to 794 university students. Semantic Differential technique with ten adjective scales and five questions were used to analyze the images and the attitudes toward the elderly.
The findings were as follows:
1. As for the images of old people, university students tend to see "warm" and "gentle" as the positive aspects, and "weak" and "stubborn" as the negative aspects.
2. Subjects have warm-hearted or sympathetic attitudes toward old people, while recognizing their negative aspects.
3. "Opportunities to talk with old people" and "Interest in old people" are two important factors which shape the images and attitudes toward old people. The personalities of subjects, as a whole , do not have a strong influence on their images and attitudes.
4. "Characteristics of subjects", "Opportunities to talk with old people", and "Interest in old people" are mutually independent. Two-way interactions were not found except between "Experience of living with grandparents" and "Opportunities to talk with old people".
5. Regarding "Experience of living with grandparents", the kind of association with grandparents is more significant in providing the images and attitudes than the physical living arrangements.

 

論文名


Semantic Differential 法による老人ホームのイメージの測定 (2)

著者名

佐藤真一,井上勝也,野口由紀子,長田久雄,保坂久美子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 117-133, 1986
抄録
The purpose of this study was to examine the relations among elderly people's knowledge about residential institutions for the aged ("Knowledge"), their will to enter institutions when their living conditions changed ("Will") and their images about institutions measured by the semantic differential technique ("Image"). The subjects were 62 elderly people living in the community.
The main results were as follows:
(1) "Will" was influenced more by external changes, i.e., losing family members, residential and economical problems, than internal ones, i.e., the subject's own mental and physical disorders, or trouble in the family caused by the subject's behavior.
(2) The effect of "Knowledge" on "Image" was obvious in the image for "condominiums for the Aged". This connection may involve in overestimation of this type of institution.
(3) The effect of "Will" on "Image" of various facilities was examined. The "Nursing Home Image" was influenced by loss of family members. The "Homes for the Aged Image" was influenced by the factors of loss of family members and economic problems. The "Condominiums for the Aged Image" was influenced by residential problems.
(4) Subjects who had little interest or knowledge about institutions seemed to overestimate them.

 

論文名


呼び掛けに関する心理学的研究

著者名

野口由紀子,井上勝也,長田久雄,佐藤真一

雑誌名
巻/号/頁/年
老年社会科学, 8 : 134-147, 1986
抄録
The purposes of the present study were to investigate (1) what terms the nursing home staffs use when they address the residents, i.e., a family name, " grandfather, grandmother", or other terms, (2) what kind of impressions the residents have depending on how they are addressed, and (3) psychological effects of terms of address upon the residents.
Subjects consisted of 112 residents and 139 staff members in seven nursing homes.
The main results were as follows:
1. The residents wanted to be addressed by their names, not by the term "grandfather" or "grandmother" because they didn't want to feel they were becoming old. A few residents wanted to be called "grandfather" or "grandmother" because they felt closer to those who addressed them that way.
2. The residents had more positive feelings in general toward the "grandfather, grandmother" form of address, which sounded gentle and caring. They had more negative feelings about being addressed by their family names, which sounded nagging and severe. We found, therefore, a contradiction between the residents' general feelings about the terms of address and how they actually wanted to be addressed. The above results indicated that they didn't want to be identified with the stereotypical image of the old person.
3. There was a correlation between the resident's desire to be addressed by "grandfather, grandmother" terms and their hope to have a close relationship with the nursing home staff. We must not forget, however, that not all residents want a close relationship the nursing home staff.

 

論文名


老人におけるベンダー・ゲシュタルト・テストの遂行と知的機能の関係

著者名

矢富直美,小林充,柄澤昭秀

雑誌名
巻/号/頁/年
老年社会科学, 8 : 148-160, 1986
抄録
The purpose of this was to examine the relationship between Bender-Gestalt Test performance and intellectual function in the aged. The Bender-Gestalt Test, the Kohs Block Design Test and the Benton Visual Retention Test were administered to 373 older people residing in a home for the aged. The responses to the Bender-Gestalt Test were assessed by Pascal-Suttell's scoring method.
The results showed that 25 to 28 of the Pascal-Suttell's items correlated with scores of the Kohs Block Design Test and the Benton Visual Retention Test at the 0.001 significance level. The most highly correlated items were Distortion, Angles, Asymmetry, Asymmetry of the curve, Drawing time, Unnecessary angles, Circles showing tremor or other deviations in shape, Number of dots, Blunting, Curve and square overlapping not joined, Circles, Circles missing or extra in the column, Wavy line, and Angles missing. The least correlated items were Overlapping of the designs, Second attempt, Workover, Dashes, Rotation of the extension, Double line, Tremor, Design A, Compression, and Extension joined to curve at dot. It was found that the highly correlated items had close relation to the gross estimate of gestalt deviation in the responses.

 

論文名


高齢者のスポーツ活動と「生きがい」意識との関連

著者名

杉山善朗,中村浩,斉藤和雄,佐藤蒙,竹川忠男

雑誌名
巻/号/頁/年
老年社会科学, 8 : 161-176, 1986
抄録
The study is an analysis of the relationship between life satisfaction of the elderly and some their physical activities based on Hayashi's quantification method T.
The subjects were four hundred and fifteen elderly who had been selected from several urban and rural districts in Hokkaido.
The findings are as follows:
1. Some of the ten categories were found to be positively or negatively related to life satisfaction scores based on partial regression coefficients.
2. Physical activities of the elderly seemed to be significant not only for improving their health, but also for maintaining their social relationships.
3. Life satisfaction levels in the elderly were likely to be high because of the social relationships maintained through physical activities.
4. Some active attitudes toward physical activity were found to increase life satisfaction, while passive ones tended to produce less life satisfaction.
5. The elderly who had less life satisfaction clearly showed negative attitudes towards physical activities, and also had many more complaints about their physical conditions than those who enjoyed sports clubs.

 

論文名


地域老人健康調査における参加者と非参加者の比較

著者名

柴田博,古谷野亘,七田恵子,芳賀博,永井晴美,須山靖男,松崎俊久,旗野脩一

雑誌名
巻/号/頁/年
老年社会科学, 8 : 177-186, 1986
抄録
Health status was compared between 475 respondents and 379 nonresondents aged 69-71 years in a comprehensive health survey. The nonrespondents were investigated by the door-to-door method.
The ratio of low ADL and frequency of lying in bed over the past year were significantly higher in the nonrespondents than in the respondents for both sexes. History of cerebrovascular strokes in females was significantly more common in the nonrespondents than in the respondents, while it was of border-line significance in males. Frequency of the highest grade of self-rated health was also significantly higher in the male nonrespondents.
The results obtained in the present study suggest that not only the disabled but also the very healthy elderly are apt to abstain from responding.

 

論文名


別荘地定住高齢者の実態とその問題点

著者名

田辺周蔵,黒柳昌子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 187-198, 1986
抄録
Resort villages in Japan were considered recreational places of for the bourgeois class, but in recent years the variety of problems of the elderly at such villages have increased due to the increases of nuclear families and members of aged people and changes in the Japanese social structure.
This research is based on a study of 396 aged people living in resort villages in the Izu region of Japan. Through medical examinations of aged patients, health consultations, questionnaire, home visits, and meetings attended by aged people, it was found that living in such villages were no paradise. There were serious problems for the aged, because of this special social environments. The problems include insecurity regarding health, loneliness, lack of communication, lifestyles, and isolation from relatives.
The permanent residents in resort areas are 15% (homeowners, pensioners, private homes for the aged, and so forth).
In resort villages, there are few social welfare services, and communication and transportation are inconvenient. Many problems still remain. Among the 396 aged persons investigated 39.2% complain about lack of medical care and options for bedridden aged. Some 18.5% want to have more substantial welfare services for the aged. Some 24.0% wish to have social activities, but there are none.
Resort villages receive only a little support from state or local governments. The aged are still waiting for welfare facilities planned by private enterprise. Thus, there are not enough health care facilities to satisfy the needs of village residents.

 

論文名


老年期におけるパーソナリティと掻痒の関係

著者名

中西悦子,松井清,大津ミキ

雑誌名
巻/号/頁/年
老年社会科学, 8 : 199-212, 1986
抄録
Research concerning itching in older people has a relatively long history in pruritus seniles. The purpose of the present study was to examine the relationship between itching and personality in the elderly. We sampled 132 men and 238 women with ages ranging from 60 to 96 years. As scales to assess the personality of the elderly, the Manifest Anxiety Scale (MAS) and the Yatabe-Guilford Personality Inventory (Y-G) were used.
The results were as follows:
1. Itching in the elderly is significantly related to physical stimuli (e.g., warmth, coldness, dryness).
2. Statistically significant correlations were found between itching and MAS subscales (e.g., Nervousness, Somatic Complaints). Also, there is a positive correlation between itching and Nervousness in the Y-G, and a negative correlation between itching and General Activity in the Y-G. These observations could suggest some interactions between itching and personality in older people.

 

論文名


特別養護老人ホームにおけるおむつ着用老人の排泄の援助に関する研究

著者名

土屋陽子,野口美和子,鳴海喜代子,井上幸子,前川弘美,渡辺タツ子

雑誌名
巻/号/頁/年
老年社会科学, 8 : 213-225, 1986
抄録
The state and feelings concerning elimination (fecal and urinary) were studied among twenty-five subjects in the "Wayo-En" Nursing Home.
Wearing diapers was satisfactory for them. They managed somehow with diapers so as to avoid discomfort, though all of the patients complained about fecal problems with diapers.
Before, the regular change of diapers came five times a day. At that time patients remained in wet diapers from seven to twenty hours per day (on the average 12.6 hours) in winter, and from two to eighteen hours (on the average 11.4 hours) in summer. Urine volume on the average was 882+298 ml. per day.
The period of time they now remain in wet diapers should be reduced 2.8 hours, because the regular change of diapers has been increased to eight times a day.
The voluntary changing of diapers with wet-sensors resulted in the return of bladder control to some patients.