[A study on health and caregiving status of the elderly over age 75 living in urban Tokyo--social services and caregiving for the bedridden and senile elderly].

Interviews during home visits were used to assess social services and caregiving status for the bedridden and senile elderly living at home in urban Tokyo. In Chuo ward 197 bedridden and senile elderly were identified from 3,409 mailed surveys (response rate 5.8%). This study analyses data from 110 subjects who were followed up with interviews during home visits. As indicated by the Karasawa senile scale, 70% of the respondents have communication problems with the elderly person in their care. Incontinence problems are reported in 56.7% of the frail elderly. There is no significant association between incontinence problems and decisions by caregivers to institutionalize the elderly. The mean age of the main caregiver is 61.9 +/- 12.7 years. There are 55.5% of the families with secondary caregivers. The mean period of care is 6.3 +/- 8.2 years. Even the families who take care of their elderly relative for longer periods of time have no one to consult about caregiving. Caregiver strain was measured by the Family Maslach Burnout Inventory. The subscale, emotional exhaustion, occurs most frequently. Only 25.0% of caregivers indicate willingness to accept social services, on the other hand 63.5% of the caregivers desire family care. The questionnaire listed twenty five resources currently available for families in this ward for social services. Only 52.2% know about resources for social services. Only 8.5% of the respondents use social services. Respondents know about and use social services for direct care of their elderly relative more than they use support for adapting the home environment for the care of the elderly. These findings suggest the following: (1) In order to promote effective use of social services a systematic case finding and assessment plan is needed. (2) Development of services from the viewpoint of prevention and emotional support are needed. (3) Case management is needed to achieve a mix of both the family care and social services.