May 12th is Nursing Day! Learning from Iki Island's Visiting Nursing "Ishizue Iki" on Measures for Healthcare Worker Shortages and Respite Support for Children with Medical Needs (Reducing Caregiver Burden)

In Iki Island, a remote island in Nagasaki Prefecture, social issues unique to rural areas such as population decline, shortage of healthcare professionals, and limited social resources are concentrated. Amidst these constraints, the role of visiting nursing in rural areas is growing year by year, aiming to enable home care patients to continue living in their familiar communities.

eWeLL Co., Ltd. (stock code: 5038, headquartered in Chuo-ku, Osaka), which promotes the improvement of quality and productivity in home healthcare through DX, conducted an interview with "Visiting Nursing Station Ishizue," which has been using its specialized electronic medical record system for visiting nurses, "iBow," for seven years since its opening.

This release introduces the current situation of visiting nursing on Iki Island and initiatives to improve QOL (Quality of Life) through respite care (support that reduces family burden and leads to rest) for children with medical needs.

### Background: Constraints of a Remote Island

Iki Island, located between the Korean Peninsula and Kyushu, is called "the Island of Gods" and is surrounded by beautiful seas and rich nature. 39.3% of the islanders are elderly aged 65 or older, and the population is 22,979 (as of the end of March 2026), having decreased by about half in 50 years. (※1)

Due to a structure where young people leave the island and do not return, the shortage of local workers also affects the healthcare field.

In remote and depopulated areas, it is difficult for major visiting nursing providers to enter due to factors such as a shortage of nurses, requiring ingenuity to continue supporting home care amidst limited human resources and facilities.

### Case Study: Children with Medical Needs and Respite Support, Implementing in a "Usable Form"

Children with Medical Needs and Social Resources on Remote Islands

In this interview, we spoke with Ms. Sachiko Osamura, the mother of Marii Osamura, a girl with medical needs living with her family on Iki Island.

Marii and her mother, Sachiko

Marii has a severe condition called "Trisomy 18 (Edwards Syndrome)" since birth, requiring 24-hour medical care, such as respiratory management via tracheostomy. Marii, who was told she had "about a 10% chance of reaching her first birthday," is now four years old.

The number of children with medical needs (0-19 years old) is increasing nationwide with advances in medical technology. According to the Ministry of Health, Labour and Welfare, the number of home-based children with medical needs more than doubled in 16 years, from 9,987 in 2005 to 20,180 in 2021. (※2)

After birth, it was when Marii was one year old that the mother and child could return home to Iki Island by helicopter from a hospital on the mainland. They were finally able to live with her two older sisters, who were elementary school students at the time, and the rest of the family.

The Osamura Family

Ms. Sachiko, Marii's mother, is a qualified nurse. She recounts that she collapsed many times when Marii was hospitalized in an island hospital.

"During hospitalization on Iki, at night, the attending physician was on call, and there were few nurses, so it was difficult to get immediate attention. I ended up staying with her constantly, and my physical strength gave out."

After being discharged and starting home care, they had a visiting nursing station affiliated with the local hospital come, but due to the large elderly population on Iki, visiting nursing also suffered from a staff shortage, and visits were not daily, pushing the family's burden to its limit.

Helpless, Ms. Sachiko called "Visiting Nursing Station Ishizue Iki" (hereinafter Ishizue Iki), which was still in preparation for opening at the recommendation of the Mayor of Iki.

"Please, could you accept her? I was desperate."

Ishizue Iki, which opened in March 2025, currently visits Marii's home five times a week. They collaborate with other existing stations to provide daily visiting nursing, supporting the family with a system that also diversifies risk, not relying on a single station.

Furthermore, in preparation for power outages, Ishizue Iki purchased an emergency generator to maintain Marii's respiratory equipment. They have established a system for providing uninterrupted medical care 365 days a year.

### Visiting Nursing Station Ishizue Iki

"Suddenly having an asthma attack, or being alone with her when the family is out, was scary and anxiety-inducing. They came immediately many times, and it was a huge relief. They truly feel like part of the family," says Ms. Sachiko, the mother.

Mr. Nishiyama, the administrator of Ishizue Iki, always visits saying "I'm home." Ms. Sachiko calls Mr. Nishiyama Marii's "second mother" because he rushes to them immediately whenever something happens.

"There were no facilities that offered respite care."

In families constantly providing delicate pediatric care, insufficient support increases the physical and mental burden on caregivers, making it difficult to continue home life.

Respite care is a form of support that alleviates such caregiver burden.

Until now, Iki had respite systems and municipal budgets, but there were few facilities on the island that could provide respite care.