Sagara Tomoya, Takase Mai, Sugiura Keiko, Nakamoto Isuzu, Ma Panpan, Muto Youko, Higashi Kentaro, Fujiwara Yoshinori, Murayama Hiroshi
The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology.
Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology.
Nihon Koshu Eisei Zasshi. 2024 Mar 19;71(3):177-185. doi: 10.11236/jph.23-052. Epub 2023 Dec 21.
Objectives To support care workers, some care facilities employ older individuals as care assistants for peripheral, non-professional tasks. However, the size of the facilities influences their employment needs and support systems for older care workers. Therefore, this study examined the rationale for employing older assistant care workers; the challenges they face; educational systems; and the efforts to facilitate continued employment based on facility size.Methods Initially, a fax survey was conducted with 3,591 facilities associated with the National Association of Geriatric Health Services Facilities to determine the proportion of older assistant care workers employed. Thereafter, a questionnaire survey was administered to gather more information. Out of 3,591 facilities, 2,170 responded to the survey, and 1,261 responded to the questionnaire. In this study, care assistants aged ≥60 years were classified as older care assistants. The facilities were categorized based on admission capacity into two groups: "small/medium facilities" (≤99 residents) and "large facilities" (≥100 residents). A chi-square test was conducted for data analysis.Results Of the all geriatric health services facilities, 31.7% employed older assistant care workers. Moreover, the questionnaire survey responses showed they are employed by 687 facilities. Further analysis revealed that larger facilities employed a higher number of older care assistants than small/medium facilities. Small/medium facilities tended to have fewer training systems for older care assistants than larger facilities (30.0% for small/medium facilities vs. 21.6% for large facilities; P=0.014). Furthermore, the work of older care assistants in small/medium facilities was more susceptible to family circumstances than those in larger facilities (15.7% for small/medium facilities vs. 10.2% for large facilities; P=0.033). Compared to small/medium facilities, larger facilities were more likely to state that their employment objective was to reduce the risk of care accidents (19.8% for small/medium facilities vs. 26.3% for large facilities; P=0.046) and provide psychological support, such as periodic interviews, to older care workers to ensure continued employment (24.1% for small/medium facilities vs. for large facilities 37.3%; P<0.001).Conclusion Larger facilities employeda higher number of older care assistants than small/medium facilities. Furthermore, small/medium facilities were less likely to provide psychological support and had a less structured training system, compared to larger facilities. Additionally, the work of older care assistants in small/medium facilities was more susceptible to family circumstances and other factors, which could affect their work performance. Thus, developing adequate support systems in small/medium facilities is crucial to promoting the employment of older care assistants.
目的 为了支持护理人员，一些护理机构雇佣老年人担任护理助理，从事外围的非专业性工作。然而，机构的规模会影响其对老年护理人员的雇佣需求和支持体系。因此，本研究探讨了雇佣老年护理助理的理由、他们面临的挑战、教育体系，以及基于机构规模促进其持续就业的举措。
方法 最初，对与全国老年保健服务设施协会相关的3591家机构进行了传真调查，以确定雇佣老年护理助理的比例。此后，进行了问卷调查以收集更多信息。在3591家机构中，2170家回复了调查，1261家回复了问卷。在本研究中，年龄≥60岁的护理助理被归类为老年护理助理。这些机构根据收容能力分为两组：“中小型机构”（≤99名居民）和“大型机构”（≥100名居民）。采用卡方检验进行数据分析。
结果 在所有老年保健服务机构中，31.7%雇佣了老年护理助理。此外，问卷调查回复显示，有687家机构雇佣了他们。进一步分析表明，大型机构雇佣的老年护理助理数量多于中小型机构。中小型机构为老年护理助理提供的培训体系往往比大型机构少（中小型机构为30.0%，大型机构为21.6%；P = 0.014）。此外，与大型机构相比，中小型机构中老年护理助理的工作更容易受到家庭情况的影响（中小型机构为15.7%，大型机构为10.2%；P = 0.033）。与中小型机构相比，大型机构更有可能表示其雇佣目的是降低护理事故风险（中小型机构为19.8%，大型机构为26.3%；P = 0.046），并为老年护理人员提供心理支持，如定期面谈，以确保其持续就业（中小型机构为24.1%，大型机构为37.3%；P < 0.001）。
结论 大型机构雇佣的老年护理助理数量多于中小型机构。此外，与大型机构相比，中小型机构提供心理支持的可能性较小，培训体系也不够完善。此外，中小型机构中老年护理助理的工作更容易受到家庭情况和其他因素的影响，这可能会影响他们的工作表现。因此，在中小型机构中建立适当的支持体系对于促进老年护理助理的就业至关重要。
