熊本県八代市における失語症者向け意思疎通支援者派遣の現状と今後の課題

Dispatch service of communication supporters for persons with aphasia in Yatsushiro city, Kumamoto prefecture:The present state and future issues

　平成30年度より失語症者向け意思疎通支援事業が都道府県単位で開始されている．熊本県では同年度より支援者の養成を開始し，令和2年度より八代市で支援者の派遣を開始した．派遣事業は2回実施し，いずれも病院受診に対する個別支援であった．熊本県で支援者の養成，派遣ともに早期に可能であった要因として，県言語聴覚士会内に事業を行える体制が備わっていたこと，地域の言語聴覚士と行政との連携が事前に図れていたことが関与していたと考えられた．また，派遣対象者と関係性のある言語聴覚士が支援者として実施にあたったことで導入がスムーズになったと考えられた．今後の課題として，運営の面では支援者の事故や災害時に対応できる体制作りが必要であると考える．また，支援者と利用者の信頼関係を構築するとともに，活動時のリスク管理を徹底する必要がある．さらに，当事業に加えて失語症そのものの啓発活動も必要であると考えられる．

　In 2018, courses to train communication supporters for persons with aphasia were started as a public service in several prefectures in Japan. Once such course was started that year in Kumamoto prefecture, and two years later, in 2020, the city of Yatsushiro, in west Kumamoto, was able to introduce a service to dispatch trained communication supporters. In its first year, the dispatch service was used twice to help the hospital visits of one user. The prefecture was able to start its dispatch service earlier than most other prefectures because the prefectural speech-language-hearing association already had a team to carry out the project, and the local speech-language-hearing therapist (SLHT) had established a cooperative relationship with the Yatsushiro city government before the initiation of the program. Also, in this first case, an SLHT who had a good relationship with the user served as the supporter, contributing to the smooth start of the dispatch service. In the future, a system to provide against accidents and disasters will be needed. It will also be necessary to build a trusting relationship between supporters and aphasic users. Furthermore, it is considered necessary to raise the public awareness not only of the communication support program but also of persons with aphasia.