Practices of relationships and cooperation with the local community by community-based nursing service providers: Case study in nagasaki city

Abstract

In view of the growing number of elderly persons with dementia in Japan, community-based nursing services were established under the revised Japanese Long-Term Care Insurance Act in 2005. These services are designed to provide support for elderly persons who require nursing care so that they may continue to live with personal dignity in their accustomed communities. To achieve such safe, high-quality community living, the elderly need various types of informal care from neighborhood residents and community organizations in addition to nursing services. This requires increasing understanding of elderly persons with dementia and the creation of mutual support networks in the local community. To this end, providers of community-based nursing services need to build relationships and cooperation with the local community through contributions to community activities. This article describes a case study investigating relationships and cooperation with the local community by providers of community-based nursing service in Nagasaki City, Japan. The following main points were identified. First, an analysis of the contents of an external evaluation report on nursing service providers exposed areal variations in the implementation of relationships and community initiatives (exchange activities outside nursing care facilities, collaborative projects, etc.) through active promotion among the community by nursing service providers. In particular, nursing service providers tend to select nearby residents' associations as exchange and cooperation partners and have enjoyed a variety of positive results through such relationships, but with clear areal variations. Next a number of nursing care providers and communities that have demonstrated an active attitude toward community relationships and cooperation were investigated, assuming 1) the environmental conditions of the area and 2) the management principles of the nursing service providers as areal variation factors. The findings indicated that in addition to the motivations of nursing service providers for community relationships and cooperation being informed by their respective management principles, the actual approaches they employ are predicated to a significant extent on the environmental conditions of their area. This suggests that in order to deepen relationships and cooperation with the local community, nursing service providers not only need to establish an appropriate attitude and operational system but also need to adopt relationship and cooperation techniques designed with full consideration of local characteristics.