記憶障害のある独居高齢者の服薬自己管理のための支援―アラーム付き薬入れを用いて─

Aiding an elderly person with memory deficit living alone in the self-management of medication: Using a reminder device

要旨：記憶障害のある独居高齢者への服薬支援機器の効果を測定し，適用のための評価について検討した．80歳女性で高血圧症と脳血管性認知症と診断されたClinical Dementia Rating 0.5，Mini Mental State Examination 21の人にアラーム付き薬入れを用いた．使用前の服薬自立度，主観的遂行度，家族負担度を1，3，6ヵ月後と比較した．使用後に服薬自立度が17／21（3回×1週間）から21／21に向上し，ユーザや家族の主観的評価も改善した．評価では，適用する薬・服薬時間やアラーム時刻やフォローアップ計画の選択に加えて，機器使用の意思やアラームを手がかりにした薬入れ探索能力の評価において専門的関与が必要であった．

　We examined the efficacy and method of application of a medication reminder device for an elderly person with memory deficit who was living alone. An alarm pill box was provided to an 80-year-old female who had been diagnosed with hypertension and cerebrovascular dementia. Her Clinical Dementia Scale and Minimal Mental State Examination scores were 0.5 and 21, respectively. Scores on self-administration medication, subjective performance, and family burden prior to using the device were compared with the scores measured 1, 3, and 6 months after using the reminder device. The self-administration rate increased from 17/21 (3 times per week) to 21/21 after using the device. The outcomes of the other subjective ratings of the user and family members also improved. Regarding the method of application, the focus of evaluations to fit the device to the user was discussed. The results suggest that selecting an appropriate alarm time and follow-up procedures were important for fitting the device. In addition, evaluating the user's willingness to use the device and his/her skills in utilizing cues to begin the search would require expertise.