International comparison on effective care plan to improve daily living independence of the elderly requiring assistance in home care

我们提取了有效的护理项目，以提高日常生活行为的独立性，并为在家庭护理中需要帮助的老年人制定了独立支持计划(需要帮助/护理级别1)。结果，我们为这些受试者提取了34个有效项目，在每个支持项目中建立了独立目标，并制定了具体的协议来描述技术支持。使用这项计划，显示客户结果有较大改善的项目包括“清洁”、“参与活动”和“紧急联络和措施”。在独立支持计划的基础上，在芬兰和瑞典进行了为期两个月的结果评估。在改善结果方面，特别是在国际反兴奋剂机构和紧急措施方面，日本排在第一位。可能的解释是，平均年龄在日本是最年轻的(80.1岁)，脑血管疾病在日本流行，糖尿病在芬兰流行，癌症在瑞典流行。客户与家人同住的比例在日本为82.2%，在瑞典为34.7%，在芬兰为25.5%。此外，日本老年人的视力和听力也更好。日本患者更多地接受初级团体护理、促进家务劳动和康复计划以及个人护理的组合服务，而瑞典和芬兰客户则更多地接受个人护理。结果表明，团体护理和个人护理相结合更有可能提高护理效果。考虑到这些，包括成功护理内容的护理计划是提高独立性的有效方法。

We extracted effective care items to improve independence in daily living behaviors, and developed an independence support program for the elderly who require assistance (assistance required/care level 1) in home care. As a result, we extracted 34 effective items for these subjects, established independence targets in each support item, and developed a concrete protocol to describe technical supports. Using this program, the items showing greater improvement in client outcomes included "cleaning," "participating in the events," and "emergency contact and measures".Base on the independence support program, outcomes were assessed in Finland and Sweden for two months. Japan placed in the first on the improvement of outcomes, particularly in IADL and emergency measures. As possible explanation, the average age was the youngest in Japan (80.1 years old), and cerebrovascular disease was prevalent in Japan, diabetes in Finland, and cancer in Sweden. The percentage of the clients lived with their family was 82.2% in Japan while it was 34.7% in Sweden and 25.5% in Finland. Also, Japanese elderly people had better vision and hearing. Japanese clients received more combination services of primary group care promoting house-work and rehabilitation programs and individual care while Swedish and Finnish clients received more individual care.These results revealed that a combination of group care and individual care was more likely to improve the effectiveness of care. Keeping these in mind, care plan including successful care contents is effective to improve the independence.