Mika Mitsumura, Fujiko Someya*
* School of Health Sciences, College of Medical, Pharmaceutical and Health Science, Kanazawa University
[Purpose] In elderly daycare facilities, services are provided according to independence support, which is the basic philosophy of Long-Term Care Insurance, to maintain and improve the users activities of daily living (ADL). However, the efforts aimed at independence support and methods of service vary from facility to facility. In this study, we examined the relationship between the administrations system of the facilities and the users independence of ADL, comparing two types of elderly daycare that provide different methods of service. Facilities that allowed the users to select the programs and time provided were classified into Group A, and those that provided predetermined sets of services were classified into Group B.
[Methods] The subjects were elderly daycare facilities in three prefectures in the Hokuriku region of Japan ; 46 users in two facilities in Group A, and 40 users in three facilities in Group B. Evaluation of ADL at home and at a facility was performed using the Functional Independence Measure (FIM).
[Results] There was no significant difference in the total FIM score at home between Groups A and B. In Group A, the total FIM score at the facility was significantly higher than that at home, while it was significantly lower in Group B. When the scores for each item in FIM at home and at the facility were compared, the scores for bladder control, bowel control, bed/chair/wheelchair transfer, bath/shower transfer, stairs, comprehension, and expression were significantly higher at the facility than those at home in Group A. In Group B, scores for grooming, dressing upper body, dressing lower body, bed/chair/wheelchair transfer, comprehension, and expression at the facility were significantly lower than those at home, while score for bath/shower transfer was significantly higher at the facility.
[Conclusion] When the users were allowed to select the contents of the program and when the program was offered at elderly daycare facilities, voluntary actions were promoted, which may have increased users independence. The results indicated that when the program contents and the time provided were
predetermined, assistance for the users might reduce the independence of the elderly.
Key words: independence support, elderly daycare facility， administration system, ADL, FIM