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Life concerns of elderly people living at home determined as by C ommunity G eneral S upport C enter staff: Implications for organizing a more effective integrated community care system. The K urihara P roject
Author(s) -
Takada Junko,
Meguro Kenichi,
Sato Yuko,
Chiba Yumiko
Publication year - 2014
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/psyg.12061
Subject(s) - apathy , psychological intervention , intervention (counseling) , gerontology , psychology , cognition , medicine , psychiatry
Background In J apan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a C ommunity G eneral S upport C enter ( CGSC ) is to provide preventive intervention based on a C ommunity S upport P rogram. Currently, a B asic C hecklist ( BC ) is sent to elderly people to identify persons appropriate for a S econdary P revention P rogram. Methods To find people who had not responded to the BC , CGSC staff evaluated the files of 592 subjects who had participated in the K urihara P roject to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) ‘no life concerns’; (B) ‘undecided’; and (C) ‘life concerns’. The relationships between these classifications and clinical information, certified need for long‐term care, and items on the BC were examined. Results The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the C linical D ementia R ating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Discussion Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for L ong‐ T erm C are I nsurance, meaning that they ‘hide’ in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care.