Association of the difficulty in judging the ability of older adults with dementia to continue living at home alone with care management information and interdisciplinary collaboration

This study aimed to elucidate the association of the difficulty in judging the ability of older adults with dementia to continue living at home alone, with care management information and interdisciplinary collaboration. A cross-sectional questionnaire survey was conducted with 1104 care managers (CMs) working at home-based care management facilities in Japan that cater to older adults with dementia living in communities. The items surveyed were attributes, background, difficulty in determining whether they can continue living at home, everyday life and environment, cognitive symptoms, mental and physical conditions, interactions, need for an adult guardianship system, and degree of implementation of interdisciplinary collaboration, all pertaining to the older adults with dementia living alone and cared for by the CMs. Binomial logistic regression analysis was performed with the presence or absence of difficulty in judging clients' ability to continue living at home as the dependent variable, and attributes, background, and other information on the older adults with dementia, and interdisciplinary collaboration as independent variables. Regarding the 1104 participants, 72.1% were women, mean age was 51.2 years, mean years of work experience as CMs was 9.8 years, mean number of cases of older adults with dementia handled per year was 15.9, and 40.9% had experience as a Chief CM. Among the participants, 89.0% reported difficulty in judging the ability of an older adult to continue living at home alone. Based on the logistic regression analysis, insufficient collection of information on oral function (odds ratio [OR] 2.091, 95% confidence interval [CI]: 1.341-3.259) and necessity of adult guardianship systems (OR 1.551, 95% CI: 1.036-2.324), and the absence of experience of working as Chief CM (OR 1.511, 95% CI: 1.027-2.221) were found to be significantly associated with difficulty in making a judgement. We believe that to decide whether an older person with dementia can continue living at home alone, it is likely useful for CMs to grasp the state of oral function, consider protection of their rights, understand the support system in the community, and gain experience in interdisciplinary collaboration.