[Characteristics of "Tojikomori" and "Tojikomerare" among home disabled elderly: daily life of housebound elderly].
OBJECTIVE
A Japanese word Tojikomori means shutting oneself in a room or house, or generally withdrawing. It has been pointed out that Tojikomori results in a decline in mobility among disabled elderly living at home. As a result of the qualitative study, we have attempted to define two types of Tojikomori. The first type, or the narrowly defined Tojikomori, is the elderly who are housebound-inactive but have a high mobility level. The second type, Tojikomerare (the passive of Tojikomori), is the elderly who are housebound-inactive because of their low mobility. The purpose of this study is to describe characteristics of Tojikomori and Tojikomerare.


METHODS
321 disabled elderly (male: 122, female: 199, mean age 78.8) were interviewed at home by nurses in Wajima City, Japan, in 1998. The subjects were selected from the list of used in a screening survey, the Whole Wajima Elderly Survey. Mobility, life space, activity, physical function, psychosocial factors, caregiver's burden and caregiver's care to elderly were measured. The Tojikomerare subjects were operationally defined as the housebound-inactive elderly who were unable to walk. The Tojikomori were identified as the housebound-inactive elderly who were able to walk 5 yards but were unable to take a bus.


RESULTS
Results obtained were as follows: 1. Housebound were not found among elders able to go out bus. There were 16 Tojikomori (10.1%) in subjects who were able to walk 5 yards (n = 153). Among the subjects who were unable to walk (n = 72), 49 people (68.1%) were classified as Tojikomerare. 2. The physical function, autonomy and social network of the Tojikomerare subjects were lowest among subjects unable to walk. They used day care least and received least care from their caregivers. In addition, their caregivers' burdens were modest. 3. Among the elderly who were able to walk 5 yards, autonomy and social network of the Tojikomori ranked lowest, although physical function was not low.


CONCLUSIONS
Tojikomerare had lowest physical and psychosocial function, but they were cared for the least by caregivers. Tojikomori had the lowest psychosocial function among elderly who can walk 5 yards. The results suggest that it is important to evaluate the mobility, life space, and activity of the housebound elderly when providing community-based services.
Kono
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Department of Community Health, Nursing School of Allied Health Sciences, Faculty of Medicine, Tokyo Medical and Dental University.
D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D016138:Walking