[Support for and problems associated with the highly health care-dependent, single-living elderly]

As a result of trends toward nuclear families and fewer children, the proportion of elderly persons living alone has been increasing in recent years. While an expansion of regional welfare has been proposed, health care problems will intensify and complexity will increase wherever single-living elderly persons desiring treatment at home are highly health care-dependent. Our visiting nurse station is no exception, necessitating a careful consideration of support system preparation, as well as means to respond on an individual basis now and in the future. With the object of investigating a support system able to undertake appropriate health care at home for single-living elderly persons requiring some form of treatment, this study utilized case records at our visiting nurse station to study living conditions and support activities relating to the one-year period of 1997 for three particularly health care-dependent individuals among single-living elderly persons. In terms of health care support, the results include a proposal for convenient treatment regimens suited to activity schedules and degrees of dementia, adjustment of the number of visits based on patient status, efforts to cooperate with helpers and family and to share information, and emergency response preparation. Topics for future study include assessment methods for dementia and living capacity, and safety enhancement.