老嚥，フレイル，サルコペニアを考慮した地域リハビリテーション

A Community-based Integrated Care System that includes consideration of presbyphagia, frailty, and sarcopenia

　わが国が目指している地域包括ケアシステムの構築は，自分らしい暮らしを人生の最期まで続けることができるよう，地域の包括的な支援・サービス提供体制を確立させるものである．その実現に向けた，各職種の専門性や立場・役割を最大限発揮した体制づくりが急務となっており，言語聴覚士も役割を果たすべきである．つまり言語聴覚士は，地域の中にもリハビリテーションを展開していく必要があり，摂食嚥下のかかわりにおいても，「心身機能」だけでなく，「活動」と「参加」にもバランスよく働きかけることが重要である．さらに予防や健康管理にも介入して，『自立支援』を積極的に進めつつ，早期からサルコペニアやフレイル，ロコモティブシンドロームにも取り組んでいかなければならない．言語聴覚士は，医療機関を中心としてきたかかわりを，地域に発展させていかなければならない．

　The purpose of establishing a Community-based Integrated Care System is to build community environments which can provide comprehensive support to senior residents so that they can continue living in the way they want until the final stages of their life. In order to build such a system in the community and to offer comprehensive support and services, many different professionals must be involved to contribute their professional strength in a concerted effort. Speech-language-hearing Therapists (SLHTs) should also play their part, not only in medical institutions but also in the community. When working on eating and swallowing, SLHTs should aim for improving at “activity” and “participation” levels as well as “body functions and structures” level of International Classification of Functioning, Disability and Health (ICF). Furthermore, SLHTs must work on sarcopenia, frailty, and locomotive syndrome at an early stage in the preventive care and health care, and thus contribute to supporting independent living of community residents.