title: Does the Use of Nursing-Care Services Reduce the Information about Dementia Patients Provided by Their Caregivers?
abstract: BACKGROUND
  The rate of use of nursing-care services has been increasing dramatically in recent years with the upgrading of the public long-term care insurance system in Japan. We addressed how the increased use of the nursing-care services might affect the information on the patients provided by their caregivers.
  
  
  METHODS
  A questionnaire survey of 531 family caregivers caring for dementia patients at home was carried out to investigate how the use of these services might affect the information about the patients provided by the caregivers. The survey revealed that the use of the nursing-care services reduced the burden (quality, quantity, time of nursing care, and feeling) on the caregivers.
  
  
  RESULTS
  According to the observation provided by the caregivers, the patients' behaviors and activities at home tended to decrease. These results indicated that the use of the nursing-care services resulted in a reduction in the opportunity for and the time spent on observation of the patients by the caregivers, making it more difficult for the caregiver to provide an appropriate assessment of the patient's condition.
  
  
  CONCLUSIONS
  We discussed the impact of the use of the nursing-care services on the Clinician's Interview-Based Impression of Change plus (CIBIC-plus) rating. Due to the reduction in the time spent on nursing care and in the opportunity for observation of the patient's activities of daily living by the caregiver resulting from the use of the nursing-care services, it is difficult to obtain an accurate picture of the patient's clinical condition using the CIBIC-plus, probably leading to an inappropriate CIBIC-plus rating.
authors.affiliation: Department of Neuropsychiatry, Faculty of Medicine, Kagawa University, Ikenobe, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Homma