Abstract
In Japan, households with multiple problems such as young caregivers and the ""80-50 problem"" are becoming a social problem, and such cases are also increasing in the field of care management for persons with disabilities in Japan. The ”80-50 problem” means that parents in their 80s live with their children in their 50s, and the parents need care for health reasons, while the children are dependent and socially isolated with financial problems.
The purpose of the present study is to analyze the structure of information that care managers should understand for households of persons with disabilities facing complex problems. In the study, households of persons with disabilities facing complex problems were defined as households in which both the clients and their family members have problems in their daily lives. We created 50 question items regarding the information that Japanses care managers should understand for households of persons with disabilities. The structured questionnaires were sent to 649 care managers at all care management agencies for persons with disabilities in Osaka, Japan. The survey was conducted in February 2024 through self-administered questionnaires. The number of questionnaires collected was 115, and the response rate was 17.7%. The statistical method of analysis was exploratory factor analysis.
The exploratory factor analysis revealed eight factors that Japanese care managers considered when assessing the needs of those who experienced ""households of persons with disabilities facing complex problems."" They included the mental and physical conditions and lifestyles of the family members living with the clients; the relationships between the clients and their family members; the feelings between the clients and their family members; the mental and physical conditions and lifestyles of the clients; the financial conditions of the clients; the general understanding and communication skills of the clients; the living environments and main needs of the clients; and the financial conditions of the family members. The Cronbach's alphas were greater than 0.75 for all factors.
The eight factors were found to be significant for care managers to assess the comprehensive needs of clients and address their households with complex challenges. In conclusion, care managers need to assess the bio-psychosocial and financial conditions of clients and co-resident family members; the relationships between clients and co-resident family members; and the connections between the household and the community in order to support clients.