Tottori J. Clin. Res. 7(1), 45-48, 2016

Team Support of Care and Education for Individuals with Severe Motor andIntellectual Disabilities Using Respirators
Shuko Ninomiya1)*, Junko Kimino1), Katsuya Maeda1), Shinjiro Akaboshi2)
1) Care and Education Support Section, NHO Tottori Medical Center2) Department of Pediatrics, NHO Tottori Medical Center＊Correspondence: ninomiya-shuko＠tottori-iryo.hosp.go.jp

Abstract
Hospital-A comprises 3 wards (B, C, and D) with 160 beds for patients with severe motor and intellectualdisabilities. The wards are classified based on patients’ levels of need for care; for example, to Ward-B, thosewith severe health conditions using respirators or monitors at all times are mostly admitted. On this ward, theCare and Education Support Section is mainly engaged in care and education activities, and daily life support
for patients and their families.
In 2012, 2 types of care and education activities were performed in the hospital for patients with severe
motor and intellectual disabilities: group care and education: 5 to 10 patients belonged to a group with common
purposes, regardless of the ward, and activities were performed by 1 to 2 patients and 1 staff member; andindividualized care and education: activities were performed by 1 patient with a higher level of need forindividualized activities and 1 staff member. Among these care and education activities, those for patients withsevere health conditions using respirators corresponded to the category of group care and education. However,they were individually performed at patients’ bedsides.
During this period, the families of patients with severe health conditions expressed their desires forout-of-bed and outdoor activities. However, due to an increase in the number of patients with a higher level ofneed for care, it became difficult to perform care and education activities at sites distant from the ward. Up untilthat time, the range of activities for patients with a higher level of need for care had been limited to their
bedsides. Therefore, deliberations were repeated to examine the feasibility of providing approaches throughcollaboration among multiple professionals involved in the consideration of patients’ and their families’ needs.
As a result, such approaches started from 2013, enabling patients with severe health conditions using
respirators to also perform care and education activities at a distance from their rooms (these activities arereferred to as “ward activities of care and education”.). This consequently extended their range of activities, andincreased their families’ levels of satisfaction. Tottori J. Clin. Res. 7(1), 45-48, 2016
Keywords: team care and education, group care and education, ward activities of care and education,individuals with severe motor and intellectual disabilities, individuals with severe health conditions using
respirators (individuals with severe motor and intellectual disabilities and medical care dependent groups:SMID-MCDG)
Introduction
In Hospital-A, there were 45 patients admitted
to Ward-B for individuals with severe motor andintellectual disabilities as of April 2013, 11 ofwhom had severe health conditions requiring
respirators (patients with severe health conditions
using respirators or SMID-MCDG). Up until thattime, care and education activities for these patients

had mainly been performed at their bedsides, andtheir families had expressed their desires for more
extensive activities, including wheelchair use andgoing outdoors in appropriate seasons. To
accommodate such desires, ward activities of careand education for all Ward-B patients to be
performed at sites distant from the ward, such as theday room and outdoors, were initiated in 2013.
1