郡部に居住する独居高齢者の生活実態と手段的支援の状況─介護保険未申請者を対象にして─

Living conditions of the elderly living alone in rural areas and the influence of instrumental support on individuals without long-term care insurance

要旨：本研究では，郡部に住み，介護保険未申請の独居高齢者の生活実態と手段的支援の状況を調査した．その結果，独居高齢者にとっては「セルフケア」と「排泄」の自立が生活の基盤であり，独居生活を継続するには「移動」の低下予防と「認知」の維持が重要であることが示唆された．また独居高齢者の中には基本的ADLは自立しているのに応用的ADLを手段的支援に頼る者がいた．このような独居高齢者は日常生活の改善と悪化のどちらにも変化しやすいため，作業療法士は他職種と連携して，介護保険未申請の独居高齢者の生活実態を把握し，必要に応じて予防的介入を行えるような体制作りをする必要がある．

　We surveyed the elderly living alone without long-term care insurance regarding their living conditions and instrumental support. The results showed that “self-care” and independence in “toileting” were fundamental to their lives, and that the prevention of reduction in “locomotion” and maintenance of “cognition” were important in maintaining their independent lifestyle. Our results also showed that some of the elderly living alone were independent in basic ADL but relied on instrumental support to perform applied ADL tasks. As their daily life is liable to change for the better or worse, occupational therapists must work in conjunction with other medical and welfare professionals to understand the actual living conditions of elderly individuals who do not utilize long-term care insurance, and to create an environment that facilitates preventive intervention as needed.