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Assessment of Competency to Contract for Care Insurance in Aichi Prefecture
Author(s) -
Mizuno Yutaka,
Endo Hidetoshi,
Kakimoto Makoto,
Imai Makoto,
Shibayama Hiroto
Publication year - 2001
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/j.1479-8301.2001.tb00049.x
Subject(s) - certification , long term care insurance , test (biology) , business , dementia , nursing , volition (linguistics) , family medicine , medicine , long term care , law , political science , paleontology , disease , pathology , biology , linguistics , philosophy
Background : A nursing care insurance system went into effect in April 2000 in Japan. Under the new system, the user (person requiring care) enters a contract directly with the service provider. Hence a pertinent issue is whether or not the user has the decision‐making capacity to enter a contract (competency to contract) and the degree of that capacity. The aim of the present study was to gain an understanding of the competency to contract under the new system. Methods : The subjects were elderly residents who entered a care insurance facility after April 2000. Ten institutions from among the care insurance facilities in Aichi Prefecture cooperated in this study. The study was sufficiently explained to the elderly residents and their families, and written informed consent was obtained from both. Respective municipalities were requested to allow access to the results of the nursing care certification process of the subjects, with their consent and the consent of their families. In addition, the care manager of the facility gave the residents a Mini‐Test that we had prepared to determine competency to contract. Results : The results revealed that most subjects had little understanding of the care system, and surprisingly, that they were not in the care insurance facility of their own volition. The competency to contract in the dementia group was significantly lower than in the non‐dementia group. Conclusion : It may be unreasonable to believe that all such people are competent to enter a contract, especially those with dementia. However, the results suggest that people with a mild care grade, even if they have dementia, may have such competency. Further study including psychiatric assessment and diagnosis of the capacity to contract is necessary.