[Examining the application forms of housing adaptations in the Japanese long-term care insurance system by care need level and professional type: A descriptive study].

Objectives　Statistical data on housing adaptation services provided by Japanese long-term care insurance are limited. We described the application status by analyzing the application forms of housing adaptation services based on differences in care need levels and health and social welfare professional types.Methods　We obtained data from the application forms of housing adaptation services in Hachioji City, Tokyo in fiscal year 2015. The variables were individual factors (age, care needs level, family status, primary disease, and information about housing) and detailed content of the applied housing adaptations (daily activities expected to improve, expected effects, and types of housing adaptations). We described the number and percentage of individuals according to care need level and type of professional; care managers (long-term care agencies), care manager (community comprehensive support centers), social workers, public health/registered nurses, housing environment coordinators, and certified housing renovation specialists.Results　We analyzed 1,652 participants. The participants were mostly in care needs level 1 (30.2%), and individuals in care needs level 3 (33.3%) applied for housing adaptation during hospitalization. Regarding the daily activities expected to improve, individuals requiring severe care needs likely aimed for toileting (care support level 1; 47.2%, care need levels 4/5; 57.8%) but less likely to expect to improve going outside and up and down the stairs. Individuals with care needs level 1 expected the greatest improvement in their bathing activities (58.1%). Regarding the expected effects, "fall preventions," "improved ease of activities," and "reducing the applicant's mental burden and anxiety" were crucial regardless of their care need levels, and "enabling what cannot be done" and "reducing the burden on caregivers" were more likely to be expected in individuals with more severe care needs. Regarding professional differences, the highest percentages of "enabling what cannot be done" were for care managers (long-term care agency) in toileting, bathing, and going outside, and social workers in getting up and down the stairs, and moving indoors. The certified housing renovation specialists emphasize on "reducing the burden on caregivers." The most common type of housing adaptation was the installation of handrails or grab bars.Conclusion　Housing adaptations differ depending on applicants' care needs and professional types. A system that considers the different needs should be designed depending on their care need levels and professional types and has a place in which each profession can understand the differences.