Akihisa Iguchi

Effects of home massage rehabilitation therapy for the bed-ridden elderly: a pilot trial with a three-month follow-up

Objectives: To assess the effects of home massage rehabilitation therapy on the bed-ridden elderly. Design: Alternatively allocated trial. Setting: Subjects homes, three home nursing stations, 13 visit care stations and one day service centre in Aichi prefecture, Japan. Subjects: Bed-ridden patients who were 65 years and above, no dementia, stable general condition, and receiving no rehabilitation therapy. Intervention: Thirty-minute sessions of home massage rehabilitation therapy by a massage practitioner 2 or 3 days a week for three consecutive months or usual care. Main measurements: Barthel Index (BI), Subjective Satisfaction and Refreshment Scale, Apathy Scale and Self-rating Depression Score. Results: Fifty-three subjects were recruited, 26 in the home massage rehabilitation group (HMG) and 27 in the routine care group without massage (RCG). The protocol was completed for 40 subjects, 22 in the HMG and 18 in the RCG. There were no significant differences between the baseline characteristics of both groups; age, presence of spouse, diseases associated with disabilities and use of day care rehabilitation (p / 0.76, 0.36, 0.94 and 0.71, respectively). The total BI score of the HMG (15.279=4.51) at baseline was nonsignificantly lower (p=0.03) than those of the RCG (11.449=5.90). Subjective Satisfaction and Refreshment Scale, Apathy Scale and Self-rating Depression Score of both groups at baseline were matched (p / 0.12, 0.32 and 0.89, respectively). There were no statistical differences between the intergroup changes over time in BI, Subjective Satisfaction and Refreshment Scale, Apathy Scale and Self-rating Depression Score (p / 0.35, 0.08, 0.70 and 0.55, respectively). Conclusion: Home massage rehabilitation therapy did not show a positive effect on the bed-ridden elderly, either mentally or physically. We would require large-size trials to determine whether it is effective.

End-of-life experience of demented elderly patients at home: findings from DEATH project

Background:u2002 As the number of demented elderly patients choosing to die at home continues to rise, it is important to ascertain how cognitive impairment is associated with symptom experience and end‐of‐life care received at home. A number of studies have suggested that patients with dementia often receive poor end‐of‐life care, with inadequate pain or other symptom control, so far however, very little research has dealt with community settings. The aim of the present study is to compare symptom experience and end‐of‐life care received by home patients based on cognitive function.

Age-related differences in care receipt and symptom experience of elderly cancer patients dying at home : Lessons from the DEATH project

Background:u2003 Data on the differences between older and younger elderly cancer patients dying at home is sparse. To clarify age‐related differences in symptom experience and care receipt of elderly cancer patients at end‐of‐life, we conducted a subanalysis study of the Dying Elderly at Home (DEATH) project, a multicenter study of 240 elderly aged 65 and older dying at home.

Evaluation of gender differences in caregiver burden in home care: Nagoya Longitudinal Study of the Frail Elderly (NLS‐FE)

Background:u2002 Japan is presently experiencing a growth in the number of male caregivers and this situation has given rise to some concerns over gender differences. Previous studies have suggested that there are gender differences in caregiver burden in home care, however, it is still unclear whether or not gender differences exist. We therefore conducted this study to attain a better understanding of the Japanese male caregiver burden in home care, using data from the Nagoya Longitudinal Study of Frail Elderly (NLS‐FE).

Factors associated with change in walking ability in very elderly patients hospitalized for acute myocardial infarction

Background:u2003 The aim of this substudy was to identify the predictors of a lesser ability to walk in very elderly patients with acute myocardial infarction (AMI).