地域で多職種がかかわる食支援のかたち—地域一体型NSTと社会連携の構築

Community-based multidisciplinary approaches to food support : Developing regionally integrated Nutrition Support Teams (NSTs) and cross sector collaboration

　本稿では，超高齢社会における食支援について，山形県鶴岡市で実践されている地域一体型栄養サポートチーム（以下，NST）「南庄内・たべるを支援し隊」と，異業種連携による「鶴岡の食材を使った嚥下食を考える会」の取り組みを報告する．在宅NSTによる多職種介入は，低栄養リスクの高い高齢者のBMI改善や食環境整備に寄与し，病院から在宅へのシームレスな支援を可能にした．また，料理人や行政と連携した嚥下調整食の普及活動は，医療的安全性を確保しつつ，外食や旅行といった「食のバリアフリー化」を通じて障害者の社会参加を促進している．これらの実践から，言語聴覚士には専門的評価のみならず，多職種・異業種をつなぐコーディネーターとしての役割が求められる．持続可能な地域包括ケアの構築には，こうした有志による水平連携を公的に評価する制度的基盤の整備が不可欠であり，食支援を医療から地域社会の文化・経済活動へと拡張させる視点が重要である．

　This paper describes community-based food support initiatives in Tsuruoka City, Yamagata Prefecture, including the community-integrated Minami-Shonai Eating Support Team and a cross-industry association for developing dysphagia diets by using locally sourced ingredients. Home-visit NST interventions improved BMI and eating environments for older adults, who are at high risk of undernutrition, by supporting smoother transitions from hospital to home care. Collaboration with local chefs and government authorities has promoted “barrier-free eating,” ensuring medical safety while enabling social participation through dining out and traveling. These initiatives demonstrate that speech-language-hearing therapists should serve not only as clinical specialists but also as coordinators who connect diverse professions and industries. To provide sustainable community-based integrated care, institutional frameworks are needed in order to formally evaluate and to provide support for such voluntary horizontal networks. Reframing food support as a part of the community's cultural and economic activities, rather than solely a medical intervention, will be essential for building a resilient and inclusive local system.