The effect of the will of the bedridden elderly to be self-reliant on their life prognoses in Japan.

The purpose of this study was to establish the relationship between the will of bedridden elderly people to be self-reliant and their life prognosis, and to clarify the factors related to the will to be self-reliant of such persons.The cohort consisted of 274 bedridden elderly persons aged 65 years and over who lived at home and were observed continually over ten years. Data were obtained from observation records done by four public health nurses who visited the subjects at least once a year and assessed their state of health. The variables studied were demographic variables, activities of daily living, the cause of being bedridden, the strength of the will to be self-reliant and the date of having become bedridden. Cox's proportional hazard model, the Kaplan-Meier method and discriminant analysis were used for statistical analysis.Of the 274 subjects, 107 subjects (39.1%) were male and 167 (60.9%) female, with a mean age of 82 years. The subjects who lived with their families accounted for 96.7%. The mortality hazard ratio for subjects with a weak will to be self-reliant to those with a strong will was 1.64, which was statistically significant. Discriminant analysis demonstrated that the will to be self-reliant showed a significant relationship with age, level of activities of daily living and refraining from expressing one's own feelings in consideration of the family's feelings.Bedridden elderly persons with a strong will to be self-reliant had a significandy better life prognosis than those with a weak one. A strong will to be self-reliant among the elderly is related to age, level of activities of daily living, and refraining from expressing one's own feelings in consideration of the family's feelings.This study clearly points out the need for home care service personnel to work in cooperation with families to emphasize encouragement to build the will to be self-reliant for the elderly in Japan.