居宅介護支援を受けた独居要介護高齢者の在宅療養開始時における訪問看護利用の有無による特徴

Characteristics of Older Adults with Long-term Care Insurance Living Alone who Utilized Visiting Nursing Services at the Start of In-home Care

要旨

　目的：居宅介護支援を受けた独居要介護高齢者の在宅療養開始時における訪問看護利用の有無による特徴を明らかにすることである．

　方法：在宅療養終了の転帰から5年間を遡り独居要介護高齢者100名の居宅介護支援者台帳と介護認定に関する書類よりデータを収集した．分析は在宅療養を開始した時点の訪問看護利用の有無の2群にわけ，独居要介護高齢者の特徴を比較検討した．

　結果：居宅介護支援を受け在宅療養開始時に訪問看護を利用した者は21名（21％），利用しなかった者は79名（79％）であり，在宅療養期間は，疾患により有意な違いがあった（p = .024）．また，訪問看護利用者の在宅療養開始時の主疾患はがんの者の割合が高く（p = .008），医療処置を有する者の割合が高かった（p = .013）．

　結論：居宅介護支援を受け在宅療養開始時に訪問看護を利用した独居要介護高齢者はがんの者であり，医療的ケアが必要である傾向が示された．

　Purpose: To identify the characteristics of older adults living alone who received in-home long-term care support, were approved for long-term care, and used visiting nursing care services at the start of their in-home care.

　Methods: Five-year data were collected from documentation related to long-term care certification and from in-home long-term care service records for 100 older adults who lived alone. In the analysis, the characteristics of those individuals were compared with those of older adults living alone who did not use visiting nursing care services.

　Results: When they first began receiving support from long-term care support providers, 21 individuals (21%) in the sample used visiting nursing care and 79 (79%) did not. There were significant differences during the home-care period depending on the disease (p = .024). Among those who used visiting nursing care immediately, a significantly higher proportion had cancer (p = .008), had undergone a medical procedure (p = .013), or needed to use visiting medical care services (p = .019).

　Conclusion: The results suggest that among older adults living alone who qualify for long-term care services, those who use visiting nursing care at the start of their in-home care with care management tend to be those with cancer or in need of medical attention.