Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system

Aim: This study examined the factors that allow elderly individuals to stay at home continuously by considering the roles of the family caregiver, the use of services and characteristics of the elderly individual. Methods: We analyzed 432 elderly individuals living at home with family. The outcome was that participants remained at home continuously over a 24-month period. The participants were stratified into two care-needs levels, and then multiple logistic regression analyses were carried out to examine relationships between staying at home and the Japanese version of the Zarit Burden Interview (J-ZBI), public Long-term Care Insurance (LTCI) service use, family caregivers' characteristics and elderly peoples' characteristics. Results: Low scores on the J-ZBI were related to outcome in both care-needs subgroups (low care-needs subgroup: OR 2.11; 95% CI 1.31-3.43, high care-needs subgroup: OR 5.03; 95% CI 1.04-31.1). Regarding LTCI services, the use of home-visit nursing (HN) service was related to staying at home continuously in the high care-needs group (OR 37.39; 95% CI 3.31-879.1). Conclusions: Alleviation of caregiver' burden was essential for continuous stay at home of elderly people regardless of care-needs levels. Also, the HN service was founded as the relevant LTCI service factor for staying at home continuously. The HN service use might affect the outcome when we consider the causal relationship. Therefore, the policy for the promotion of HN service use will be important to achieve the ultimate goal of LTCI, which is to allow elderly people to live in their communities for as long as possible. Geriatr Gerontol Int 2013; 13: 764-773.