重度知的障害者への個別支援評価・計画法の試作─知的障害者デイサービスにおける利用者中心の作業選択（第二報）

Creating personal evaluation and support plans for persons with severe intellectual disabilities: Client-centered occupational choice in a day-service for persons with intellectual disabilities (2nd report)

要旨：集団活動が主体のデイサービスになじめず，不適応を起こす重度知的障害者が安心して楽しく過ごせるよう，利用者中心支援の評価・計画法を試作した．認知症ケアのセンター方式やカナダ作業遂行測定からの援用を基に作成し，ケア職員との事例検討のなかで改訂する方法をとった．評価法は職員側視点と，職員が利用者の思いや願いを代弁する利用者側視点とを対比させる「三人称・一人称比較集団評価法」とし，計画法は両者の思いを統合して協働するための「個別支援計画作成シート」とした．これらを用いることにより，作業が皆でやるべき義務的なものから本人がやりたいと思えるものになり，重度知的障害者が安心して楽しめる活動が増えた．

　Purpose: In this research, new client-centered evaluation and personal support plan method was designed for persons with severe intellectual disabilities in the day-service center A-en. The clients were not able to adapt to group activities, fell into maladjustment, and became uncomfortable and unpleasant. Method: This evaluation and support plan were prepared from a person-centered care for persons with dementia and the Canadian Occupational Performance Measure, and were revised through the case conference with caregivers. Results: The evaluation method became a “group comparing the third person with the first person method” which compares the point of view between caregivers and clients. The support plan became a “working sheet for personal support plan” which integrates the point of view between caregivers and clients and leads to collaboration. Finally, in A-en the activity became a personal desire from a group duty, and the clients became comfortable and pleasant.