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Table 2 Cases of intervention refusal encountered by PHNs in Japan and characteristics of their support (elderly)

From: Cases of intervention refusal encountered by public health nurses in Japan and characteristics of their support– qualitative analysis of described mother-child and elderly cases

 

(1) Self-neglect

n = 27

(2) Abuse by a family member, etc. n = 11

N = 38

Described cases of intervention refusal

  

With dementia

With mental disorder

Other

Subtotal

With dementia

Other

Subtotal

Total

 

Total

7

6

14

27

4

7

11

38

Refuser

The elderly

The elderly living alone

5

6

10

21

  

0

21

(multiple answers)

 

The elderly living with others

1

 

4

5

2

1

3

8

 

Both husband and wife

1

  

1

 

1

1

2

Cohabiters

Spouse

   

0

2

2

4

4

 

Children and their family

  

1

1

3

2

5

6

 

Any other cohabiter

   

0

1

 

1

1

Relatives living separately

    

0

 

1

1

1

Intervention refused (multiple answers)

All human relations

 

1

1

5

7

1

3

4

11

Administrative services

Visit, support, and advice from PHNs

2

3

2

7

3

3

6

13

Involvement of public agencies

2

 

1

3

1

 

1

4

Medical services

Treatment

 

2

4

6

 

2

2

8

 

Consultation and house call

2

3

4

9

  

0

9

Nursing care services

Use of nursing care services

1

 

5

6

 

3

3

9

Recommendation of institutionalization

  

3

3

1

 

1

4

Community support

Advice from neighbors

3

1

 

4

 

1

1

5

Person/ agency involved in support (multiple answers)

Administrative agencies

PHN

7

6

14

27

4

7

11

38

Other local government departments

4

4

7

15

1

4

5

20

Police

1

2

1

4

 

1

1

5

 

Fire station/emergency services

 

1

1

2

  

0

2

 

Family court

   

0

1

 

1

1

Medical agencies

Medical institution

1

3

4

8

 

3

3

11

 

Personal doctor or visiting physician

2

2

4

8

1

4

5

13

 

Home-visit nursing (NS, PT, OT)

  

1

1

 

3

3

4

Welfare-related organizations

Community general support center

3

2

7

12

3

1

4

16

Care manager or home care support office

1

1

5

7

1

2

3

10

 

Care facilities (including group homes and day service)

2

1

3

6

2

 

2

8

 

Attendant service (caretaker)

1

1

2

4

 

2

2

6

 

Other relevant organizations

  

3

3

2

1

3

6

 

Social welfare council

1

 

3

4

  

0

4

Rights protection-related

MSW, PSW

 

2

2

4

 

1

1

5

Rights advocacy center

 

1

1

2

  

0

2

 

Disability-related office

 

2

 

2

  

0

2

 

Judicial scrivener

   

0

 

1

1

1

 

Bank staff

 

1

 

1

  

0

1

Relatives

Family member living separately

3

3

2

8

 

2

2

10

 

Distant connection or relative

1

1

4

6

 

1

1

7

 

Friend or religious group

1

1

2

4

  

0

4

Inhabitants

Welfare worker

3

1

6

10

1

1

2

12

 

Neighbor

2

2

2

6

2

2

4

10

 

Landlord

  

2

2

  

0

2

 

Head of neighborhood association

  

1

1

  

0

1

Category of support (multiple answers)

Direct support (daily life)

Home visit (individual or team)

5

5

13

23

4

7

11

34

Arrangement of communication with family members or relatives living separately (telephone, letter, e-mail)

2

4

9

15

1

2

3

18

 

Safety confirmation (visit in turns or meal delivery)

1

3

5

9

 

2

2

11

 

Comprehensive observation or observation of daily life

3

2

3

8

1

1

2

10

 

Information gathering (from neighbors or friends)

2

1

1

4

2

 

2

6

 

Interview or attentive hearing

1

 

1

2

 

3

3

5

 

Health check

1

 

1

2

  

0

2

 

Support for end-of-life care

  

2

2

  

0

2

 

Approach to family by letter following refusal of visit

   

0

1

 

1

1

 

Ambush interview

   

0

1

 

1

1

Direct support (treatment and institutionalization)

Hospitalization support (emergency transportation, pickup or persuasion)

2

4

6

12

 

2

2

14

Support for medical consultation or home visit

2

4

5

11

 

2

2

13

Compulsory measure or protection

2

 

1

3

2

 

2

5

 

Support or arrangement for institutionalization

 

1

2

3

2

 

2

5

Team approach

Team support through information exchange and collaboration

6

4

10

20

3

5

8

28

 

Consultation and arrangement for contact with doctor

2

2

4

8

1

1

2

10

 

Contact with welfare worker, etc.

2

1

3

6

 

1

1

7

 

Ongoing care conference

2

1

 

3

1

1

2

5

 

Contact with police or fire station

1

1

1

3

  

0

3

Use of social resources

Arrangement for, or introduction of home care service

3

1

3

7

2

4

6

13

 

Application for long-term care insurance benefit

3

1

3

7

  

0

7

 

Introduction of caretaker

2

1

1

4

 

2

2

6

 

Arrangement with personal doctor

1

 

1

2

 

3

3

5

 

Introduction of home-visit nursing care

  

1

1

 

3

3

4

 

Application for welfare benefit

  

2

2

  

0

2

Rights protection-related

Respect for personal preference or intention

1

1

1

3

  

0

3

 

Financial management (in coordination with relevant institution)

 

2

 

2

 

1

1

3

 

Action to address accumulation of garbage at home

2

 

1

3

  

0

3

 

Procedure or arrangement for selecting guardian

   

0

2

 

2

2

 

Family court

   

0

1

 

1

1

 

Support for will writing (not in time)

 

1

 

1

  

0

1

 

Action to address too many pets

  

1

1

  

0

1

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BMC Nursing

ISSN: 1472-6955

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