[Effectiveness of a programme to improve housing conditions for elderly requiring supportive care in Edogawa-ku,...

The programme in Edogawa-ku, Tokyo, for improvement of housing conditions for the elderly requiring supportive care, is unique in Japan in that it offers unlimited amount of benefits regardless of income status of beneficiaries. Between October, 1990, when the programme started, to March, 1992, total of 447 people utilized the programme. These 18 months were divided into three periods for comparative analysis of characteristics of users, details of improvement in housing conditions and cost (amount of benefits). The proportion of bed-ridden cases decreased during the later periods, with a corresponding increase in those who had improvements made to entrances and approaches to their residence. However, average cost of changes in housing features decreased in the later periods because there was less demand for expensive changes such as bathtub remodeling or installation of lifts on stairs. A survey by mail was conducted to find out the effect from the users' viewpoint. Valid responses were collected from 290 cases. Three aspects of improvement in housing conditions were assessed: improvement in daily activities, reduction in the care taker's burden, and reduction in the need for long-term institutional care. More than one-third of the users reported improvement in each of three aspects, and two-thirds had improvements in at least one out of the three items. There were intercorrelation among the three items, especially between improvement in daily activities and reduction of the care taker's burden. Analysis showed that improvements were reported in a greater proportion of those living alone or in a two-person household, those who utilized the programme following discharge from inpatient care, those who had their bathroom or bathtub remodeled, and those who had the more expensive changes made. Changes in entrances and approaches to the residence was correlated to an improvement in daily activities. Reduction in care-taker's burden was seen where stroke was the cause of being dependent and where a specially equipped bed was provided. Reduction in the need for long-term institutional care is related to family structure and number of rooms in the home, which are barriers to continuing home care.