Problems of Nursing Care
In Japan, longevity and aging have progressed, and now,it has
become a very aging society where one in four people is the
elderly.
It goes without saying that we are facing the serious lack of
manpower.
Here, I will introduce general problems in nursing care.
◯Nursing Care Insurance System
At the same time as the nursing-care insurance law was enforced in 2000, the nursing care insurance system was started. Nursing care services have become familiar, On the other hand, we are facing problems such as
- Increased nursing care expenses
- Unequal user burden
- Increased burden on caregivers and deterioration in the quality of nursing care
Furthermore,
· The issue of dignity of the elderly
From the point of this view, it is necessary to promote physical and mental independence. Mental independence means that elderly people can work on health improvement themselves and actively participate in society.
How to reduce the burden on caregivers or how to provide nursing care services while maintaining the dignity of the elderly is an issue for elderly care.
◯Facility Nursing Care or Home Care
As a measure of degree of nursing care, criteria such as
nursing care and necessary support are established. (table 1)
If you apply for nursing care certification, care manager
creates care plan based on this degree of care.
However, whether to actually enter the facility depends on the household environment and the economic situation that you are in.
Table 1
| Independent | There is no necessity of support by nursing care service, being able to live independent life. |
| Support Requiring 1 | There is no hindrance in daily life, but some support is necessary so that it does not become a state of long-term care needs. |
| Support Requiring 2 | Anxiety is seen in walking, etc. Although some assistance is necessary for excretion, bathing etc, there is a possibility of improvement in physical function. |
| Nursing Requiring 1 | The rise is unstable. There is a case of walking a cane. Partial partial assistance is required for excretion, bathing etc. |
| Nursing Requiring 2 | It is difficult for himself to get up and on his own, excretion, bathing, etc., always requires part or all assistance. |
| Nursing Requiring 3 | Rising and getting up can not be done by oneself, lifestyle using wheelchairs can be seen, partial or total assistance is necessary for excretion, bathing, clothes removal and so on. |
| Nursing Requiring 4 | All bedside care is necessary for daily life in general, such as excretion, bathing, attaching and detaching clothes, in the state of bedridden close. |
| Nursing Requiring 5 | All assistance is necessary for daily life in general, and communication is also difficult. |
◯Elderly Care
Elderly nursing care is that elderly people aged 65 and older
take care of elderly people. Many cases are forced to do so
due to the fact that families live far away due to nuclear
families. According to statistics of Heisei 28, households of
elderly are 27% of all households, and 49% of households have
people over 65 years old.
As long as you take care at home, you must always be careful to prevent elderly people with dementia from going out or wandering by yourself. In other words, there is a problem in that elderly people doing nursing care can not rest for a while.
One of our members actually experienced home care. This is an
example of old-age nursing care, the problem in this overlaps
with the problems in general home care in recent years. For
details, please see "Ophelia's
Experiences."
Although it is actually seen also in the experience story,
there are the following problems in home nursing care.
- We can not take a rest for a while (especially in elderly nursing care)
- Wandering, trying to go out alone
◯Elderly People Living Alone
How about elderly people living alone without family support?
Required supporters are often doing their own personal work as
much as possible while receiving nursing care insurance
services on a regular basis. However, in recent years when
such elderly people living alone are increasing, incidents
accompanying it are also increasing. In particular, the
problem of wandering as cited as a member's experience talks
is getting worse. Currently, more than 10,000 people are
missing due to wandering.
(Document 1. Nikkei Newspaper)
There are also possibilities to meet various problems on the
go. For example, 10 years ago, there was a lawsuit in which a
wandering man died after being hit by a train and seek damages
from the bereaved family.
(Document 2. Asahi Newspaper)
Families and
nursing staff have limitations on watching.Even
so,banning out is a matter of dignity. Now, the way of
"watch over" of elderly people in home nursing care is
questioned.
Document 1 (2017 6. 15 Nihon Keizai
Newspaper)
According to the summary of the National Police Agency on 15th
that the missing person who was notified by the police
nationwide in 2016 was 26,4% increased by 26.4% from 2016, It
was. It has increased for the fourth consecutive year since
the start of statistics of 12 years and continues to update
the past record. With police and family members, 98.8% have
been confirmed within the year, and early response is
important.
Document 2 (2016.3.1 Asahi Newspaper)
In 2007 in Ohtsu, Aichi Prefecture, JR Tokai asked for damages
of about 7.2 million yen for the family, surrounding the
accident that a man (91 at the time) who was drowning
(dangerous) in dementia was hit by the train and died On the
first appeal trial decision of the lawsuit, the Supreme Court
's third small court (presiding judge Kiyoko Okabe) said that
it is the first time that it is decided on comprehensively
considering the living conditions etc whether the family
caregiver who is taking care is liable I showed my judgment.
| 2.Nursing←Back | Next→2-2 Our Awareness of the Issues |
