Two main initiatives were introduced in 2012. The first
was regular home visits and as-needed long-term
care and nursing visits, which required close collaboration
between long-term care and nursing services.
There are regular visiting patrols both day and night,
and quick response visits on an as-needed basis. The
second initiative was the creation of a composite service,
which added health care to the ‘small-scale multifunctional
in-home care’, which was established in
2006. Both initiatives are ‘community-based’ services:
with the funding of long-term care insurance, the local
administration hires a service provider for a fixed
monthly fee. These newly introduced services play an
important role in supporting the daily home lives of people
with intense long-term care and health care needs.
The long-term care and nursing staff responsible for
home visits work from one location in order to provide
stable, yet flexible, service. These home visits were
proposed when it was evident that, as the user’s
need for long-term care grew, nurses and health care
workers would be required, often only for a short time,
to maintain daily life at home. Under the earlier regime
of long-term care home visits, only a small number of
visits were made per day. This made it difficult to provide
medical care and nursing on an as-needed
basis [20].
The second initiative arose from the fact that the ‘smallscale
multifunctional in-home care’ service created in
2006 had encountered certain problems. It was
assumed that the users would require relatively intense
long-term care, roughly equivalent to those living in
facilities. However, many people failed to register as
users, so the average long-term care requirement was
considerably lighter than originally anticipated [20]. Better
health care and nursing functions were necessary in
order to make the service easier for people with intense
long-term care requirements