What needed for home health care of the elderly in their residential environment.

日本的人口老龄化正在明显加速。适合日本老年人的有效和高效的家庭保健的实用指南正在等待着。本研究的目的是确定日本家庭保健系统所需的居住条件和居住环境。我们选择了来自医疗护理、建筑和社会福利领域的研究人员，因为所有这些领域都是全面研究这一问题所必需的。首先，我们进行了邮寄访谈调查(调查对象为8000名分层随机抽样的城市老年人)，以调查影响养老院的环境因素。其次进行功能评定(肌力、步行速度、日常生活活动能力、日常生活工具活动能力等)。和居住环境(住房设备、房间布置、社会支持网络、家庭功能等)通过走访、访谈、调查等方式进行进一步评价。Third…更确切地说，我们对失能老人房改后的身体功能进行了跟踪调查。最后，我们分析了过度拥挤的大城市东京的社会指标和健康指标(包括按城市死因划分的年龄死亡率：来源数据经日本统计局批准)。根据各自的研究成果，委员们从健康城市居住环境的角度对存在的问题进行了探讨。最后，明确了以下4点作为建议。1.帮助开发适合老年人的设备，不仅在屋内，而且在公共空间也是必要的。2.对于严重残疾的老年人来说，照顾者的发展至关重要(住房改革本身对改善他们的功能的贡献较小)。3.对于中度残疾的老年人来说，适当的体育锻炼建议和充足的社会资源，包括住房改革，是不可或缺的。4.社会支持网络，如果灵活利用现有的社会资源，就能有效地开展高效的家庭保健工作。较少

The aging of the population in Japan is accelerating markedly. A practical guideline for effective and efficient home health care suitable for Japanese elderly is awaited. The purposes of the present study is to define the desirable housing conditions and environment of residence for Japanese home health care system. We selected research members from medical nursing, architecture, and social welfare fields, because all of these fields are necessary for comprehensive research on this issue. Firstly, we performed a mail interview survey (subjects were 8,000 stratified random sample of urban elderly) to investigate the environmental factors affecting institutionalization. Secondly, we assessed the functions (muscle strength, walking speed, activity of daily living, instrumental activity of daily living, etc.) and environment of residence (housing equipment, arrangement of the rooms, social support networks, family functions, etc.) by visiting interview survey for further evaluation. Third … More ly, we followed up physical function of the disabled elderly after the housing reform. And the lastly, we analyzed social indices and health indices (including age-specific death rate by causes of death by municipalities: source data were approved by Japanese Statistics Bureau) in an overcrowded huge city, Tokyo. Based on each research result , members filly discussed on the problems from the perspective of environment of residence for healthy cities. In conclusion, the following 4 points were clarified as the recommendation. 1. Aid development of suitable equipments for the elderly, not only inside of the house but also in the public space is necessary. 2. For the severely disabled elderly, development of caregivers is essential (housing reform itself less contributed to the improvement of their function). 3. For the moderately disabled elderly, suitable advices for physical exercise and adequate provision for social resources including housing reform are indispensable. 4. Social support network, for efficient home health care works effectively, if the eidsting social resources were utilized flexibly. Less