Abstract

The long-term care insurance system in Japan covers at-home medical/nursing care services and nursing care home services. Nursing care homes include intensive care homes accommodating the frail elderly, long-term healthcare facilities for the elderly providing nursing care and training allowing users to live independently at home, and private residential homes for the elderly. The most commonly used facilities are the intensive care homes. There are 8,000 such homes accommodating 520,000 residents, of which nearly 80% have dementia and 70% require intensive nursing care level, and supporting those who cannot live independently at home. Intensive care home employees include care workers, nurses, residential social workers and et.al. Though mocked as ‘Jacks of all trades,’ residential social workers conduct a variety of tasks. The purposes of this study are to summarize the tasks they perform and their ideal tasks, and to propose what their ideal tasks should be.

Questionnaire surveys were posted to 400 residential social workers on March 2014 and 107 valid responses were obtained. We asked residential social workers about both their ideal tasks and the tasks that they actually carried out. They were asked 41 questions derived from the results of a previous study, and answers were graded on a five-point scale. A factor analysis yielded eight factors for the residential social workers’ scope of work: admission support, life consultation related, operation management, care plan making, welfare education center related, everyday life support, assessment, and coordination with external organizations, and for the ideal scope, the analysis yielded the following eight factors: operation management, rights advocacy, admission support, care plan making, welfare education center related, everyday life support, assessment, and coordination with external organizations. The actual vs. idealistic situation for each factor was scored out of five, according to the attributes of the residential social workers. A t-test indicated significant differences (p<0.05) in the following factors: actual and ideal levels were high in ‘operation management’ as years worked as social workers and age increased; actual and ideal levels were high in ‘operation management’ and ‘care plan making’, and the ideal level was high in ‘assessment’ when the social workers doubled as care managers. These findings revealed the ideal tasks for residential social workers were to support admission, design care plans based on assessments, provide support in daily life and protect residents’ rights, operation management, welfare education, and collaboration with other organizations, though in reality, the assessment tasks were unclear even when the social workers had been involved in making care plans, as was the protection of residents’ rights. Meanwhile, a variety of categories exist in the current ‘life consultation related tasks’, creating their image of ‘Jacks of all trades’. It also clarifies that doubling as care manager facilitates the work in the social work area of tasks, since the assessments and making of care plans for residences are cited as their ideal tasks. And the more the facility required experience or age, the more the levels increased in operation management; it is necessary to investigate if this task requires experience or if young, capable, social workers can perform it. The quality of life of residents at intensive care homes will be improved by clearly defining residential social workers’ tasks and by cultivating human resources according to the relevant needs.

Slides