回復期リハビリテーション病棟入院中の重度認知症をもつ人への作業の獲得支援─プール活動レベル（PAL）を用いて

Using Pool Activity Level (PAL) in occupational therapy intervention for a person with severe dementia in the recovery phase at a rehabilitation ward

要旨：プール活動レベル（以下，PAL）は認知症をもつ人への作業療法介入を支援するツールである．PALは認知症をもつ対象者の生活歴等を参考に作業を選択し，PALチェックリストを用いた日常生活の観察評価から活動能力を分類し，作業が行えるように援助方法を検討するものである．そのため，PALは認知症をもつ人へ作業療法を行う上で有用と思われる．回復期リハビリテーション病棟入院中の重度認知症をもつ本事例に対して，自宅退院後に行える活動をPALを用いて適応し，退院後も継続できるように支援した．本事例を通し，PALは作業の選択と適応を補助することができ，重度の認知症をもつ人でも意味ある作業を行える可能性があると考える．

　Pool Activity Level (PAL) is a tool which supports occupational therapy intervention for clients with dementia. At the first step of the PAL, clients' occupations are chosen with a reference to life history. Next, the abilities of the client with dementia are classified by observations of daily life with a PAL checklist. Finally, the PAL instrument leads to the idea of assistive method to perform their occupations. Therefore, there is a high possibility that the PAL could be useful for occupational therapy. This case report describes how an occupational therapist supported an occupation for an inpatient with severe dementia and continued it at home after discharge. Through this case the PAL seems to assist choice and adoption of occupations, and indicates that even a patient with severe dementia could have a meaningful occupation.