Factor structure of satisfaction in daily life of elderly residents in Kitakyushu

The purpose of this study was to investigate what items elderly persons living at home consider important for satisfaction in daily life and what factor structure is obtained by a principal components analysis. Two percent of the residents 60 years old or over of Yahatanishi Ward, Kitakyushu, were randomly sampled as subjects. A questionnaire asking residents to select items considered important in daily life was sent by mail, and 722 responses (72.5%) were eligible for analysis. "Health", "social security and pension" and "self-care" were considered important in daily life with the highest selection rates. A five-factor solution for 25 items with a selection rate greater than 4.5% was obtained by an oblique rotated principal components analysis: "health and disability", "social environment and activity", "socio-economic condition", "emotional stability in marital and family life" and "social intercourse and companionship". These factors appeared to be the fundamental framework of the subjective domain of health-related quality of life of elderly persons living at home.     

A study of associations between daily-social activity of elderly people living at home and symptoms of forgetfulness. Screening for dementia risk

PURPOSE: Functional decrease in brain activity as a factor inducing dementia is due not only to aging but also to decrease in social exchange, loss of something to live for, and decrease in physical activity with indoor confinement. It might therefore be possible to use these parameters to screen for risk of dementia in community care programs. In the present study we evaluated the association between decreased daily-social activity and symptoms of forgetfulness. METHODS: The subjects were 6,486 people aged > or = 65 years living in 3 municipalities in Yamanashi Prefecture. A survey table concerning daily-social activity and symptoms of forgetfulness was produced, and a whole-sample survey was performed by mail. Cluster analysis of items such as symptoms of forgetfulness was performed, and clusters were obtained. Associations between these clusters and daily-social activity were then analyzed by the Mann-Whitney test. RESULTS: Of 5,556 replies (recovery rate, 85.7%), 3,067 with all items filled out (effective reply rate, 55.2%) were analyzed. None of the 21 items for forgetfulness was applicable in 600 of the subjects (19.6%). Cluster analysis of the other 2,467 subjects with 1 or more symptoms revealed the following 5 clusters: "common forgetfulness symptoms" consisting of 2 items, "decreased will to live" consisting of 8 items, "amnesic symptoms" consisting of 4 items, "emotional responses" consisting of 2 items, and "difficulty in daily life" consisting of 5 items. There were 31 types of cluster combinations in the subjects, and the most frequently applicable cluster was "common forgetfulness symptoms" (658 subjects, 21.5%). Comparison of the daily-social activity between the cluster groups showed significant differences in many of the items for daily-social activity with reference to the "decreased will to live". CONCLUSION: Among forgetfulness symptoms, items classified as related to "decreased will to live" were most associated with daily-social activity. This suggests utility for evaluation of daily-social activity, including intellectual and social activity frequency in elderly people in communities to select people for care programs for prevention of secondary dementia.     

Items regarded as important for satisfaction in daily life by elderly residents in Kitakyushu, Japan

The objective of this study was to determine what items were important for satisfaction in the daily life of elderly Japanese people living at home. The subjects consisted of 996 persons living in Yahatanishi Ward, Kitakyushu City, Japan, two percent of residents aged 60 years or over, who were randomly selected from the official register of voters. A questionnaire was sent to the subjects to determine their profiles and asking them to select the five items they considered most important for satisfaction in daily life from 35 predetermined items. The items with a significant difference using a chi 2 test between age groups, gender, place of residence, living conditions and level of disability were analyzed by logistic regression analysis. The top five items selected were "good health" (86%), "social security and pension" (47%), "self-care independence" (45%), "marital satisfaction" (34%), and a "good relationship with relatives" (33%). Logistic regression analysis showed gender, age group, living conditions, and level of disability significantly affected the preference for selection of 12 items. Men or younger persons regarded "health" and a "good relationship with a spouse" as very important, whereas women, older persons, or persons with a disability considered "self-care independence" and the "ability to walk" as important. The items selected for satisfaction in daily life and the order of preference yield important information about rehabilitative and social welfare services for elderly persons living at home.     

Individual interviews with elderly in a rural area: expectations for medical care services

INTRODUCTION: As intensive health care users, the elderly contribute significantly to rising health care cost in Japan. This research sought to elucidate the decision making processes elderly use when seeking medical care and their expectations of medical facilities and physicians. METHODS: We conducted qualitative individual interviews with rural elderly, over 65 years old, who had access to private physician offices, community, regional, and university hospitals. Interview questions elicited participants' experiences in seeking medical care; their most memorable experiences in hospitals; and their expectations for medical services. After the individual interviews, we surveyed the participants to verify the results. RESULTS: A total of 19 individuals participated in these interviews. These 19 individuals and an additional five individuals who met eligibility criteria were surveyed by mail after the interviews and verified the results. The participants identified "a feeling of intimacy" and "receiving kind-hearted treatment" as the most important attributes of medical facilities. Other important factors included: accommodating patients' preferences; being close to home; earning the patient trust; and having a well organized infrastructure. Comparatively important element were: "technology and skill", "opinion and reputation of third person", "length in the latency", "continued medical treatment by the same doctor", "actual feeling of improvement", "introduction to a higher order medical facility", "multiple medical departments", and "medical judgement by multiple doctors". These factors fall into three categories: emotional expectations; expectations of the health system; and convenience in daily life. The survey data confirmed these findings. DISCUSSION: These results suggested that elderly expect "supportive" and "accommodating" health care services in which the medical activity does not cause problems for daily life. However, these vague expectations for the medical system need translated into practical steps. Still, it is important for health care providers to consider these expectations and the relationships among them. These findings corroborate the results of a previous investigation that used focus group interviews.     

Factors associated with participation in medical checkups of the elderly at home comparison of 3 regions with different social backgrounds

PURPOSE: Annual medical checkups are presumed to be important with the well-being of aged individuals. The purpose of this study was to investigate factors related to participation in medical checkups of elderly persons at home. METHODS: A survey was performed targeting so-called young elderly persons living at home in 3 regions in Hokkaido Prefecture, a large city (Sapporo), an ex-coalmining town (Yubari) and a small farming town (Takasu). The study populations were asked about medical checkups, economic status, self-rated health status, activities of daily living (ADL) and basic characteristics such as age, sex and occupation. We used the Mantel-Haenszel method for statistical analysis. RESULTS: 1) Elderly males who received medical checkups within the last 1 year (participants) had a shorter period of education, were less likely to have or to have had the smoking habit, undertook more physical activity, had better eating habit, more often rated their own health as good or normal, and had a better physical ADL & instrumental ADL, than those who had never received medical checkups (non-participants). Regionally, the items that showed significant differences included: "live with the spouse", "do not smoke" and "do not have physical pain or disabilities" in Sapporo; "enjoy physical activity", "have good eating habit" and "have good instrumental ADL" in Yubari; and "engaged in agriculture/fishery work" and "had outpatient visits in the last three months" in Takasu. 2) Elderly female participants who had outpatient visits in the last three months had anxiety about their own health, significantly different from non-participants. Regionally, the items that showed significant differences included: "often drink alcohol" in Sapporo; "still working right now", "was engaged in agriculture/fishery work in the past" and "had outpatient visits in the last three months" in Yubari; and "have own house", "do not smoke" and "pay attention to eating habit" in Takasu. 3) The item which showed a significantly high rate both for male and female participants was "still working right now". CONCLUSIONS: This study indicates that medical checkups should be recommended to the elderly, taking into account not only their basic characteristics such as sex and occupation, but also lifestyle, self-rated health status and ADL, which are associated with medical checkup participation.     

Thresholds of physical activities necessary for living a self-supporting life in elderly women

BACKGROUND: To decide the minimal levels (thresholds) of physical activities necessary for a self-supporting life using discriminate analysis between community-dwelling elderly individuals and daycare-service-receiving elderly individuals in Japan. METHOD: A total of twenty-six elderly women, including twelve living a self-supporting life and fourteen using a daycare service, were recruited in this study. The parameters examined were physical performance, activities of daily living, exercise capacity. Discriminate analysis was used to determine the thresholds of physical activities needed to live a self-supporting life. RESULTS: Muscle masses, grip strength, lower-extremity muscle force, gait ability and balance function in elderly individuals living a self-supporting life were significant higher than those in elderly individuals using a daycare service. A threshold of physical ability over 75% classifies accurately using the methods of discriminate analysis indicate total body muscle mass, thigh muscle mass, knee extension force, 6 min walking distance (6MD), 10 m obstacle walking time, Activity of daily living (ADL) index and daily steps. CONCLUSIONS: The present study indicates that thresholds of physical activities including gait abilities, muscle force, and muscle mass are very important factors in maintaining a self-supporting life for elderly individuals. Thresholds of physical activities were more effective than standard values of physical activity for elderly individuals using a care service in meeting the goals of rehabilitation.     

Correlation between interactions of younger elderly women with close non-family friends and neighbors and health-related QOL

OBJECTIVE: This study was conducted to examine the correlation between interactions of younger elderly women with close non-family friends and neighbors and their health-related QOL, in order to expand understanding of social relationships of the elderly and their health perceptions. METHODOLOGY: Questionnaires were mailed to 1,000 randomly selected women aged 65 to 74 living in City A (population: 180,000; elderly: 14.9%), a bed town community outside a metropolitan area. From 602 valid replies, analysis was limited to self-reports from 525 women who were independent in daily life and interacted with close non-family friends and neighbors. For this purpose the Daily Mutual Caring Interactions (DMCI) scale was applied--its items indicate aims and reciprocal acts in interactions of younger elderly women with close non-family friends and neighbors (Cronbach's alpha = 0.85)--and the Japanese Version SF-36v2, a widely used measure of health-related QOL (Cronbach's alpha = 0.93). Structural equation modeling analysis examined the four constructs of DMCI and their correlations with the physical and psychological health-related components of SF-36v2. RESULTS: The conceived meaning of a correlation among DMCI constructs in the final model (GFI = 0.930, RMSEA = 0.045) is that there is "an appropriate distance between individuals" by holding "mutual concern for each other's daily lives" and "sympathetic mutual understanding", and through these mutual actions one is able to "confirm one's own identity." An extremely weak positive correlation was found between "sympathetic mutual understanding" and the physical and psychological components of SF-36v2. However, no significant correlations were found for "confirmation of one's own identity," the objective of interaction, with either physical or psychological components. An additional finding was an extremely strong correlation between SF-36v2 physical and psychological components. CONCLUSION: From our study of the interactions of younger elderly women with close non-family friends and neighbors and their health-related QOL, there are no clear direct links that would support the idea that social relations enhance physical or psychological health perceptions. Even so, because the model fits the data for younger elderly women aware of irreversible changes brought on by aging and irrespective of their degree of perceived health, it is possible that interactions with non-family friends and neighbors help these women to share an understanding of existing conditions and live their lives actively and positively. From the perspective of the QOL of the elderly, this suggests the necessity for further discussion about effects of supporting elderly people's own health enhancement efforts that focus on the social aspects of daily life.     

Study motives and career choices of Iranian medical and dental students

To compare the study motives and career choices of senior undergraduate medical and dental students in Iran. A cross-sectional questionnaire-based survey study involving final year medical and dental students from 4 dental and medical schools was conducted in 2010. The questionnaire was designed in three sections (Demographic details, motivational items and career choice items) and after confirming the validity and reliability of the questions, it was distributed among the students. Data were entered into SPSS; statistical analysis included logistic regression and multiple linear regression. The response rate was 62% (n=219) for medical and 64% (n=300) for dental students. The factor analysis identified six motivational items: "Social and professional status", "Health care and people", "Others' recommendation", "personal interest and nature of occupation", "Occupational experience" and "Personal life". Medical students were more influenced by "Playing a role in community health" and "Personal interest". "Work independence" and "Social factors" however were two major influential factors among dental students. There were significant differences in important influences by age (Social and professional status, Others' recommendation), Parents' education (Social and professional status, Health care and people, Personal life) and marital status (single >married: Occupational experience, married > single: Personal life). Engaging in postgraduate studies was the first career preference among 90.9% and 89.8% of dental and medical students respectively. Medical and dental students report a wide range of motivational factors in studying medicine/dentistry and future career plans which is affected by age, parents' education and marital status.     

Individual background factors for "cannot go out alone to distant places" among medium elderly persons living alone in a metropolitan suburb

OBJECTIVE: To verify whether the statement "cannot go out alone to distant places" should be considered a risk factor for disability among medium elderly persons living alone autonomously in a metropolitan suburban environment, the present cross-sectional study was performed. METHODS: Self-rated mobility levels in elderly persons living alone were surveyed by questionnaire in 1,216 elderly people (209 male, 1007 female) aged 65 to 74 years, living in a metropolitan suburb, who had autonomy and ambulation competence. Two categories were used for evaluation of the self-rated mobility level: the A group were those who were able to go out alone to distant places and the B group were those who were able to do so in the locality, but not to distant places without help (cannot go out alone to distant places). Factors such as everyday lifestyle, self-rated health, and psychological, functional, physical and social items were investigated. RESULTS: Although the frequency of going out was nearly the same between the A and B groups, the B group showed the lower hobby and association activity in social communities. Individual factors such as self-rated health, instrumental activities of daily living (Tokyo Metropolitan Institute of Gerontology), eyesight, masticatory ability, 1 km continuous walking, pedestrian crossing walking on a green light, and fracture history, medicine intake, cerebrovascular disorder related subjective symptoms, intermittent claudication related subjective symptoms, physical pain, symptoms of depression, daytime sleep, number of meals, and no regular walking and light gymnastic exercises demonstrated significant differences in levels between the A and B groups. The B group had characteristics of lower social activities in social communities, deterioration of physical functions, subjective symptoms of sickness and depression, and a worse self-rated level of health. On stepwise multiple logistic regression analysis, individual frailty-risk factors related to "cannot go out alone to distant places", were "inability to continuously walk a distance of 1 km", "lower masticatory ability", "having depressive symptoms", and "having symptoms of intermittent claudication". CONCLUSIONS: The findings from this study show that with autonomous medium elderly persons, those who "cannot go out alone to distant places" have risk factors for a trend toward disability.     

Quality of life of a person with Parkinson's disease and the relationship between the time of evolution and the severity of the disease

Parkinson's disease can cause disability and decrease the quality of life in its sufferers. The aim of this study was to evaluate the quality of life of a group of people with Parkinson's disease and whether a relationship exists between time of evolution and severity of the disease. Secondary analysis was carried out on transversal data collected from 40 individuals with Parkinson's disease registered in the Parkinson's Association of Maringá, in Maringá-PR-Brazil. Measures: three instruments were applied: a socio-demographic questionnaire, the Hoenh and Yahr Scale and the Parkinson's Disease Questionnaire (PDQ-39). According to PDQ-39, men referred to a lower quality of life, although, statistically, there was no significant difference between the two genders. Differences were only observed in the dimensions of "activities of daily living" and "social support", in which men presented higher impairment, and "emotions" and "bodily discomfort", where women showed higher impairment. Furthermore, severity of disease tended to lead to a perception of lower quality of life regarding the dimensions of "activities of daily living" and "cognition", which is relevant to improve clinical guidance and intervention.     

Factors Associated With Health-Related Quality of Life Among an Older Population in a Largely Rural Western Region

CONTEXT: As elderly people become a larger proportion of the rural population, it is important to identify those at risk for poor health. Predictors of health-related quality of life can be useful in designing interventions. PURPOSE: One objective of the present study was to profile the health-related quality of life of community-dwelling, elderly people in a southwestern region of the United States. A related objective was to identify the principal factors associated with health-related quality of life, thereby identifying population subgroups in greatest need of health or social services. METHODS: A telephone survey of approximately 5,000 individuals 65 years and older collected data on need for assistance with activities of daily living, physical and mental health-related quality of life, and worry about health status measures. A modified version of the Behavioral Model was used to more clearly distinguish the different groups at risk for poor health. FINDINGS: Those groups of community-dwelling, elderly people in the poorest health were older than 75 years, had less than a high school education, were retired or unemployed, and had low household income. No differences were found by urban, rural, and frontier residence. CONCLUSIONS: To maintain the physical, social, and psychological health of older people residing in rural and urban areas, social services, medical care, and supportive services are needed, particularly among the most socially and economically disadvantaged.     

保定市社区老年人日常生活活动能力 及其影响因素分析

摘要:目的　探讨保定市社区老年人日常生活活动能力及其影响因素。方法　采用自制的一般情况、躯体状况问卷及日常生活活动能力评定量表（ADL）对符合要求的555例社区老年人进行一般情况、躯体状况及日常生活活动能力的调查。结果　保定市社区老年人日常生活活动能力整体得分均值为18.1045,多因素分析显示对社区老年人日常生活活动能力的主要影响因素是年龄、性别、文化程度、BMI、职业、听力障碍、视力障碍、慢性病、用药。结论　保定市社区老年人日常生活活动能力明显存在障碍,应根据影响因素进行有效干预,以提高该地区老年人的生存质量。     

河北省城乡居家老年人生活质量的危险因素分析

摘要:目的　了解城乡居家老年人生活质量现状及其危险因素。方法　采用多阶段分层整群抽样法选取河北省三地区城乡居家60岁及以上老年人6173名,进行生活质量量表（SF-36）、日常生活活动能力量表（ADL）、社会支持评定量表（SSRS）、成年人健康自我管理能力测评量表（AHSMSRS）、家庭功能评定量表（FAD）以及一般人口学资料入户问卷调查。结果　城市居家老年人除精力（VT）和精神健康（MH）两个维度外的其他六个维度评分均高于农村,有统计学意义（P＜0.01）。回归分析结果显示,性别、年龄、婚姻状况、文化程度、固定收入、日常生活活动能力、家庭功能、社会支持、自我健康管理都是影响老年人生活质量的危险因素,首要危险因素为日常生活活动能力障碍,在八个维度均有统计学意义（P＜0.01）。结论　应高度重视日常生活活动能力在城乡居家老年人的生活质量中危险作用。采取相应措施提高日常生活活动能力,从而提高生活质量。     

Development of a scale for subjective QOL common to patients with intractable diseases

OBJECTIVE: We have developed a scale for evaluating subjective quality of life (QOL) common to patients with intractable diseases. SUBJECTS: Two-hundred and forty-seven outpatients of housebound patients from 7 collaborating hospitals or institutions participated in preliminary surveys. The patients were diagnosed with one of 14 diseases targeted by the Ministry of Health and Welfare's Specific Disease Treatment Research Project. Two-hundred and fifty-seven outpatients or housebound patients of 8 collaborating hospitals or institutions participated in a second survey that targeted 15 diseases. METHODS: The concept of subjective QOL was examined, and a favorable subjective QOL score was defied as "a state in which patients accept their current condition and possess a high level of morale with no signs of anxiety, despite the presence of their disease". Sixty-six items were then identified and included in a preliminary survey. Three preliminary surveys and a second survey were then conducted. A final scale for the items was then decided, and the items were assessed for their reliability and validity. RESULTS: Nine items reflecting two factors, "acceptance" and "morale", were selected and assessed for their reliability and validity as follows: 1) The response of subjects who accepted their illness yet possessed a high level of morale showed a good fit with the proposed scale (Adjusted Goodness of Fit Index = 0.925). 2) The confidence coefficient of the re-test method for subjective QOL scale scores was r = 0.78 (95% con idence interval: 0.72-0.83; n = 226) nd the alpha coefficient was 0.822, indicating a high level of reliability. 3) A strong negative correlation (r = -0.76, 95% confidence interval: -0.82 to -0.69; n = 178) was found between the subjective QOL scale scores and self-rating depression scale (SDS) scores, and a moderately positive correlation (r = 0.35, 95% confidence interval: 0.23-0.46; n = 238) was found between the subjective QOL scale scores and activities of daily living (ADL) scores. 4) No statistically significant differences were observed in the distribution of subjective QOL scale scores when analyzed according to sex, age group, disease, or duration of illness. CONCLUSIONS: We have developed a scale consisting of 9 items for determining the subjective QOL of patients with intractable diseases. The scale was confirmed to properly reflect our concept of subjective QOL, which consists of two factors: "acceptance" and "morale" The scale was also confirmed to be stable and highly reliable.     

Health Characteristics of Older People Who Rotationally Live With Families: A Nationwide Survey

BackgroundPopulation aging has been a critical issue around the world and people will have to face living problems when they get old. In Western countries, older people are more used to live alone or in institutions. In Eastern countries, due to filial piety of Chinese culture, the elderly prefer to live with their children or their relatives. There was no empirical study to investigate the relationship between health and living arrangement among older Taiwanese.ObjectiveThis study was designed to explore the association between living arrangement and health characteristics among the elderly in Taiwan.MethodThis study used national representative data from the Taiwan Longitudinal Study on Aging surveyed in 2007. We identified 2621 elders aged older than 65 in 2007 and categorized them into 3 types of living arrangement by the questionnaire. Linear regressions were used to analyze the relationship between living arrangement and health status (activities of daily living [ADLs], instrumental activities of daily living [IADLs], and Center of Epidemiological Studies–depression [CES-D]) among the elderly.ResultsElderly individuals who indicated they rotationally lived with family members had poorer health conditions, including IADLs (Coeff = 0.23; 95% confidence interval [CI]: –0.06–0.52) and CES-D (Coeff = 0.41; 95% CI: –0.59–1.40), than those who steadily lived with family. In contrast, elderly individuals who lived alone had better health conditions in IADLs (Coefficient = –0.38; 95% CI: –0.53 to –0.22) than those who indicated they lived steadily with family.ConclusionsThese findings reveal that this type of rotational living is not a good living arrangement for the elderly.     

Living arrangement choices of elderly singles: effects of income and disability.

Logit regression is used to explain living arrangement choice of elderly single individuals. The propensity to live independently is found to increase with income and decrease with disability; an interaction effect for females suggests that income may lessen the impact of disability on the propensity to seek shared living arrangements. Independent living is less likely for people who are not white, foreign-born males, those with at least one adult child, and those in States with higher living costs; and more likely for the ever-married and those in States with high per capita nursing home use. If home care services are preferentially allocated to disabled elderly who live alone, resources may flow to higher income individuals who have been able to maintain independent households.     

Relationship of normal levels of activity of daily living and daily habits among elderly women at home

PURPOSE: The relationship of activities of daily living (ADL) with daily habits and age was investigated with a focus on the results of measurements of the normal speed (ordinary level: OL) and maximum speed (maximum capacity: MC) in performing items on a functional fitness test. The significance of the measurement of the ordinary level was also discussed. METHODS: The subjects were 69 women, aged 60-90 years old, who participated in a health workshop for the elderly sponsored by a local municipality and who performed at least 4 items on a functional fitness test. Public health nurses asked subjects about habitual life style, subjective health status and degree of satisfaction in daily life. The ADL level was measured using the tests of functional fitness developed by Oida et al and partially revised by ourselves and physical fitness tests (grip strength, sit and reach, and balancing on one leg with opened eyes). OL was measured as the time needed to perform functional fitness items at normal speed, and MC as the time needed when performing these tasks as quickly as possible. RESULTS: All functional fitness items were accomplished significantly faster with MC than OL. Correlation coefficient values between OL and MC were high significant. Age was found to be significantly related to the hand working test (Hand-T) to evaluate dexterity and the rope working test (Rope-T) to evaluate self-care, except with the MC. An analysis of covariance with age as the covariant revealed that, with OL, there were relationships between Hand-T and Rope-T and the item "active at home," and between the zigzag walking (Zigzag-T) and Rope-T and "walking or riding a bicycle to go shopping." With MC, there were relationships between Hand-T and "active at home," and between Zigzag-T and "walking of riding a bicycle to go shopping." Regarding physical capacity, relationships were seen between both hands and "high level of physical fitness" and "walking fast" and grip strength (Left hand), respectively. CONCLUSION: The ADL items measured in the preset study were related to the daily activities of elderly people. As the OL and MC results demonstrated a high correlation and the ADL items related with OL were found to have almost the same link with MC, we conclude that OL is suitable for testing with the advantage of safety. However, we could not explain differences in relationships between measurements and daily activities, pointing to a need for further research. Elderly people must maintain their capacity for ADL to support a good quality of life, and we have demonstrated the utility of measurements that include normal levels of activity as indicators.     

Three-years changes in disability and mortality associated with daily life patterns among the home frail elderly

PURPOSE: The purpose of this study was to eximine 3-year changes in disability and mortality in relation to the daily life patterns among the frail elderly living at home. METHODS: Subjects were 50 frail elderly living at home who were interviewed at baseline, in July to September, 1995. By detailed time budgets, five daily life patterns were classified: Lying-rest, Sitting-rest, Hobby, Walking, and Housework. Information on ADL was obtained from visiting nurses or mailed questionnaires in June 1998 (3 years later). RESULTS: Within the 3-year period, 15 people (30%) died. At the follow up, 27 people (54%) were living at home, three (6%) were hospitalized, and four (8%) were institutionalized. In 31 analyzed samples, ADL scores significantly decreased during the 3-year period. As for the ability to perform each activity, it was found that only the elderly in Housework life pattern maintained their ADL. The elderly in Lying-rest life and Sitting-rest life patterns were more likely to die. CONCLUSION: Decline in ADL among home frail elderly was found for the 3 years. It was suggested that community health care for preventing disability progress among home frail elderly were important over a long time. Housework life patterns were seemed to be associated with physical performance.     

Subjective burdens of families caring for "frail elderly" in their homes

The purpose of the study is to measure the subjective burdens of families caring for "frail elderly" in their homes and to clarify the relationships between caregivers' subjective burdens and the health conditions of the "frail elderly", the family's conditions, the use of social services and availability of social supports. The subjects consisted of caregivers of the elderly who also were using nursing services from K Home Visit Nursing Care Station (K-Station). We mailed subjective burden questionnaires to 98 families among users of K-Station from December of 1994 to March of 1995. We used the 12 items developed by Nakatani as a scale to measure subjective burdens. Each item was stratified into 4 grade levels from "agree" to "disagree". We asked nurses at K-Station about "frail elderly" ADL conditions in detail, the extent of medical dependency and the will of families to care for the elderly. A total of 76 questionnaires were returned, of which 73 could be analyzed. The greater part of "frail elderly" were female (n = 42). The average age of the "frail elderly" was 81.1(+/- 7.6) years old. All caregivers were members of the family of the "frail elderly" and most of them were women (n = 63). From the result of principal analysis, 2 principles were extracted from the 12 items used to measure subjective burden of caregivers. We analyzed the first principle as "subjective burden of caregivers". From the result of multiple regression analysis (Stepwise method), "subjective burden of caregivers" was characterized by the caregivers' conditions only (caregivers' health status, the will to care for the elderly and anxiety of providing night care). This result suggested that support for the caregivers of the "frail elderly" was important to sustain in-home care.