Caregivers to Provide Medical Services to Elderly

The Yomiuri Shimbun

June 7, 2009

Japan 

The Health, Labor and Welfare Ministry will let caregivers working at nursing homes for elderly people provide some types of medical treatment for residents. 

The government will compile a set of guidelines for ensuring the safety of the specific medical acts to be practiced by nursing caregivers at homes for elderly people requiring around-the-clock nursing care. Currently, many caregivers are believed to be administering the medical procedures illegally because of shortages of nurses at such facilities. 

The health ministry caregiver plan will take effect as early as next year after trials are conducted nationwide this year. 

The ministry is to explain the plan at an internal meeting to be held Wednesday, where it will propose starting the trials. 

The plan envisions state-certified nursing care workers who have received special training will be allowed to vacuum up sputum, monitor the progress of patients who receive nourishment by tube and clean used medical equipment. The results of the trials will be taken into account when the ministry compiles safety guidelines. 

There are about 6,000 nursing homes nationwide, housing 400,000 elderly residents. However, the facilities are officially classified as accommodations, rather than medical facilities. As such, they are required to hire only three nurses per 100 residents, less than the figure for medical institutions. 

About 75 percent of the existing facilities have more nurses than required by law, but only 2 percent have regular night nurses. 

In a health ministry survey, about 20 percent of reported sputum-vacuuming cases occurred between 10 p.m. and 6 a.m., at a time when the facilities usually did not have enough nurses available, and during a time frame in which the ministry suspects that such acts--permitted to be performed only by nurses and doctors--were done by nursing care workers. 

Many nursing homes have received administrative instructions from the ministry in connection with the administration of such medical procedures by caregivers, acts considered illegal under the Medical Practitioners Law. There are fears that such illegal acts will occur more often as the number of elderly nursing home residents increases in the nation's aging society. 

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