Family caregivers and care manager support under long-term care insurance in rural Japan.

Care managers are expected to coordinate care services for the elderly and to function as a source of social support under the Long-term Care Insurance programme in Japan. Thus far, however, little attention has been paid to the social support function of the care manager. To clarify the role of care manager support, we evaluated how care manager support ('social talk,' 'information giving' and 'reassurance') affects the burden of family caregivers categorised by caregiver gender and living arrangement. The interaction between 'information giving' and 'memory and behaviour problems' had a negative effect on 'social activity' among females living with elderly relatives (p < 0.05). 'Information giving' had a direct negative effect on caregiver burden among males living with elderly relatives (p < 0.05). Although 'social talk' had a moderating effect on caregiver burden (p < 0.05), the interaction between 'social talk' and 'memory and behaviour problems' had a negative impact on caregiver burden among females living with elderly relatives (p < 0.05). These results indicate that care manager support is only effective for female caregivers living with elderly relatives, and is ineffective or works poorly for female caregivers living separately and male caregivers living with elderly relatives. We concluded that the social support function of care managers would be improved by ensuring that they have adequate time for each case, and the skills to assess psychosocial needs. To achieve these goals, it is necessary to improve the work environment and introduce systematic training for psychosocial needs assessment.