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Home Care for the Frail Elderly Based on Urinary Incontinence Level

Authors

  • Setsu Shimanouchi Ph.D., R.N.,

    1. Setsu Shimanouchi is a Professor, Community Health Nursing, Department of Nursing Science, School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Tomoko Kamei is an Associate Professor, Gerontological Nursing, St. Luke's College of Nursing, Chuo-ku, Tokyo, Japan. Masayuki Hayashi is a Professor, Department of Epidemiology and Information Science, Fukushima College of Nursing, Fukushima-shi, Fukushima, Japan.
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  • Tomoko Kamei Ph.D., R.N.,

    1. Setsu Shimanouchi is a Professor, Community Health Nursing, Department of Nursing Science, School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Tomoko Kamei is an Associate Professor, Gerontological Nursing, St. Luke's College of Nursing, Chuo-ku, Tokyo, Japan. Masayuki Hayashi is a Professor, Department of Epidemiology and Information Science, Fukushima College of Nursing, Fukushima-shi, Fukushima, Japan.
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  • Masayuki Hayashi Ph.D.

    1. Setsu Shimanouchi is a Professor, Community Health Nursing, Department of Nursing Science, School of Allied Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Tomoko Kamei is an Associate Professor, Gerontological Nursing, St. Luke's College of Nursing, Chuo-ku, Tokyo, Japan. Masayuki Hayashi is a Professor, Department of Epidemiology and Information Science, Fukushima College of Nursing, Fukushima-shi, Fukushima, Japan.
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Address correspondence to Setsu Shimanouchi, Community Health Nursing, Department of Nursing Science, School of Allied Health Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113–0034, Japan. E-mail: shima.ns@med.tmd.ac.jp

Abstract

Incontinence is a common problem in the frail elderly. We conducted interviews focusing on urinary incontinence with 249 elderly clients in the home care setting, and studied differences of the needs among three (mild, moderate, and catheter) groups based on incontinence level. The mild group had the highest number of professional care needs, although their problems were not as serious as the other two groups. The moderate group required the highest amount of daily care by caregiver. A similar need pattern was shown in the moderate and catheter groups, while more diversified needs were required in the mild group. Portable toilet, rehabilitation, and short-stay services were frequently used in the mild group. The use of telephone consultation was the highest in the moderate group, and the use of doctor visit and bathing service were higher in the catheter group. The most important challenge was significantly different in each group: preventive efforts to maintain activities of daily living (ADL) in the mild group, interpersonal relationships in the moderate group, and infection control in the catheter group. Education was necessary for caregivers in all three groups. These findings help to project realistic care needs for each client based on his or her incontinence level.

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