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A Care Management Model for a Remote Japanese Island: A Qualitative Study on the Long-Term Care Needs
1Takao Sakai, MD , is a general medicine physician and orthopedic surgeon at Nagoya Kyoritsu Hospital. He has 2 years of clinical experience at the Sakushima Island Clinic, where he became familiar with the health care system on remote islands. His research involves community-based integrated care and addressing long-term care requirements for aging populations in rural Japan. While working at the clinic, he obtained certification as a care manager.
Purpose/Objectives:
This study qualitatively explores the long-term care needs of elderly residents on Sakushima, a remote Japanese island, to identify essential factors for maintaining independent and meaningful lives.
Primary Practice Settings:
This study was conducted in a Japanese remote island, focusing on primary care and community-based long-term care settings. In addition, it is important to note that health care and long-term care resources are gradually becoming depleted as the population declines.
Findings/Conclusions:
Three interconnected themes of needs were identified: (1) Medical Care and Rehabilitation, (2) Challenges of the Natural Environment and Living Infrastructure, and (3) The Centrality of Ikigai and Social Relationships. The findings suggest that a socially constructed care model that formally leverages the island's unique social and occupational structures is essential for supporting the well-being of elderly residents.
Implications For Case Management:
A holistic care model integrating medical, environmental, and social support is crucial for remote island populations. Case managers should consider residents' sense of purpose (ikigai) and social ties as vital components of care planning. The authors propose establishing a "Sakushima Rehabilitation Coordinator" to provide preventative, lifestyle-integrated interventions. Utilizing "Special Services for Remote Islands" can formally support and sustain existing informal care networks. To achieve proper operation of the LTCI system based on regional characteristics, flexible trials and adjustments that take cultural factors and the natural environment into account should be actively promoted.
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