Judging from the features of senile dementia, it is desirable for the demented elderly to receive care at their places to which they are accustomed and to be surrounded by affectionate families, if possible. Year by year, however, sufficient intrafamilial care is becoming more and more difficult because of increasing numbers of nuclear families, women's into society, the deteriorating housing situation and the like. Accordingly, the importance of community care is increasing; an integrated care system with close cooperation of medical facility services and at-home services needs to be established. Three important measures; i.e. home helper dispatching, short stay activity and day service activity as well as close cooperative work for health activities, medical care and welfare are still far from satisfactory, though these problems have begun to be tackled actively. Various types of advanced models and regional network systems exist fulfilling several necessary conditions for effective functioning. The need of a three-layer structure was emphasized based on a practical study of Matsubara City, Osaka.

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