Background

 "Unit care", in which a small number of residents live together, has been one of the effective methods to the practice of individual care in elderly facilities. The unit care type facilities were adopted not only in the nursing home but also in other elderly facilities and welfare facilities. However, the unit type is said to have the following problems. The first is that the staff spends a lot of time alone assisting in the unit, and the second is that it is difficult to educate staff.

 So, in this survey, from the viewpoint of planning of scale in care group, we are considered improvement of working environment of staff.

 Objective

 The purpose of this study is to clarify the effects of the differences in the scale of nursing care units on the work system and nursing care contents. The subjects of the survey were: 7-8 person unit, 10-person units (2 facilities A, B), 12-person unit and 13-person unit.

 Research Method

 The survey methods were interview survey, behavior observation survey and activity amount survey of staffs. The period of behavior observation survey was 24 hours × 3 days, and the target unit were 2 units of each facility.

 Conclusions

 (1) Shift of care staffs during the daytime: The 7-8 person unit and 10-person unit B had a two-person system for early and late shift. The 10-person unit A had a three-person system for early, day, and late shift. The 12-person unit and the 13-person unit had a four-person system for early, day shift, and two late shift staffs.

 (2) Percentage of the number of staffs stayed in the unit: In the 7-8 person unit, the ratio of no staff in the unit was 8.4% (75.6 minutes). On the other hand, in the 12-person unit, the ratio of two or more staffs in the Unit was 64.2% and that in the 13-person unit was 73.3%.

 (3) Percentage of time when there was no staff in LDK: 7-8 person unit is 51% (464.6 minutes), 10-person unit A was 37% (333 minutes) and 10-person unit B was 36% (324 minutes). 12-person unit 37% (333 minutes) and 13-person unit was 28% (243 minutes). The difference between the 7-8 person unit and the 13-person unit was as large as 23%.

 (4) Characteristics of individual assistance: Regarding bathing assistance, the 13-person unit also provided assistance at night, but the 10-person unit A and the 10-person unit B provided assistance in the morning.

 As for dietary assistance, breakfast was provided at all facilities in accordance with the life rhythm of individual residents. For lunch and dinner, the 7-8 person unit, 10 person unit A, 10 person unit B and 12 person unit had a uniform meal time, but the 13 person unit had a long meal time and individual care was possible.

 Regarding excretion assistance, in the 12-person unit and the 13-person unit, the difference between the regular excretion assistance time and that in other time zones was small, and excretion assistance was frequently provided.

 (5) Information transmission such as records and business conversation: In the 7-8 person unit, there were few conversations during work, and information was communicated by meeting and recording. In the 12-person unit, in addition to records, there were long meeting time and business conversations during work, and information was shared among staffs.

The purpose of this study is to clarify the motion space when the caregiver transfer a resident "from the wheelchair to the bed" and "from the bed to the toilet" using a floor lift.
1. The motion space when caregivers transfer residents from the wheelchair and the bed were 1605mm on the head side, 2005mm on the leg side from the center of the bed, and 2687mm on the bed side from the wall.
2. The width of the frontage of the toilet required for transfer assistance to the toilet were over 1600 mm.

 Background

 In Japan, which is becoming a high-mortality society in addition to a super-aging society, the establishment of a suitable residence for older people to spend their last days is an urgent concern. In a home type hospice, which is a residence wherein home care services are provided and covered under nursing insurance, 5-6 individuals live together. Although home type hospices are expected to play an important role in the future as one of the residential options for patients to spend the terminal stage of their life, no study has assessed the actual living conditions and physical characteristics of home type hospices.

 Reserch Objectives

 By understanding the actual environment, such as resident attributes and nursing care provision system, this study aimed to clarify the characteristics of home hospices, which primarily utilize existing residences.

 Research Methods

 The target residences were 28 business establishments and 37 buildings in Japan, which were certified by the Japan Home Hospice Association. Surveys were conducted through interviews with the administrator of each business establishment.

 Conclusion

 1. There are age limitations for moving elderly people to facilities and residences providing home care services. However, home type hospices accept residents regardless of their age. While the majority of the residents are aged >80 years, there are some residents aged <60 years. 2. If we assess the reason and duration of occupancy of such facilities on the basis of disease type, cancer-centric home type hospices mostly accept patients in need of medical care, and most residents remain in the facility for a short duration, usually <1 year. These facilities provide hospice care for patients in the terminal stage of their life. Dementia-centric home hospices support patients with severe dementia. It is believed that these houses complement the insufficiency of facilities in different regions and the variety in the levels of care that is provided. Complex home hospices mostly accept patients in need of medical care and who could not live at their own residence. Thus, home hospices may accept residents regardless of the patient's age and disease type, including older people and those with malignant diseases, respectively. In addition, these facilities function as a safety net for patients with severe conditions, who are difficult to deal with in the existing system . 3. Apart from home type hospices, there were 25 business establishments that were serving as home-visit nursing agencies, accounting for approximately 90% of the surveyed facilities. Cooperation between resident staff, which is responsible for providing daily living support, and home-visit nursing agencies is necessary to provide continuous support before moving patients. Therefore, in many cases, home-visit nursing was provided in the business establishments. 4. Renovation of buildings could be classified into four types, namely "improvement in building performance, " "improvement in accessibility, " "space expansion, " and "barrier-free design." Increase in the number of bathrooms/washrooms and toilets as well as renovation to accommodate wheelchairs were the most common. To utilize existing buildings as home type hospices, emphasis should be particularly given to the barrier-free design of plumbing fixtures. 5. Introduction through acquaintances was the most common method of property selection. It tended to reflect a higher level of connection and recognition with the local residents. This must be because of the owner's connection with the region, which is shared with the new property owner.

The purpose of this study is to clarify the motion space necessary for assistance around the bed, such as excretion assistance, bed bath assistance, position change, sheet exchange, and transfer assistance from a wheelchair to bed.
1.In the cases other than transfer assistance: The motion space required when the bed is placed parallel to the wall is 3200mm × 1883mm, and when placed vertically, it is 2578 mm × 2924 mm.
2.For transfer assistance: The motion space required for transfer assistance is 3054 mm × 2361 mm.