認知症者に対するクライエント中心の訪問作業療法

Home-visit service based on client-centered occupational therapy for persons with dementia

要旨：認知症者に対するクライエント中心の訪問作業療法の有用性を検討するために，居宅支援事業所より身体機能障害の軽度な認知症者および家族介護者の紹介を受け，週に1回，全8回の訪問介入を実施した．生活上の困りごとを聴取しながらニーズを特定し，その実現に向けて協働した結果，認知症者にとっては意味のある作業との結びつき，自発性と意欲の向上，ADL能力の向上，BPSDの軽減といった成果が得られた．介護者には，負担感の軽減，介護に対する有能感の向上が図られた．本事例を通してクライエント中心の訪問作業療法を実施することで，認知症者とその家族がより良い在宅生活を送るための支援ができることが示された．

　We gave trial home-visit services to a person with dementia and his caregiver who were introduced by a long-term care support provider in order to verify the utility of home-visit services based on client-centered occupational therapy. The service was offered once a week, eight sessions in total. After we interviewed the caregiver about daily life issues and identified their needs, we collaborated with them to realize their needs. As a result, the person with dementia engaged in meaningful occupations, enhanced his spontaneity and motivation, improved the activities of daily living (ADL) ability and decreased the Behavioral and Psychological Symptoms of Dementia (BPSD) as outcomes. The caregiver felt decreased burden and an enhanced sense of competence. Through this case we found that home-visit services based on client-centered occupational therapy can offer support to persons with dementia and their caregivers to enhance quality of life in the community.