離れて生活する家族とのつながりを結ぶ支援が生活に変化をもたらした認知症高齢者の事例

Elderly suffering from dementia who are living apart from family: A case study of reconnecting through occupational therapy support

要旨：介護老人保健施設で生活していた認知症高齢者のA氏は，頼りにしていた長男の死亡によって家族との関わりが途絶え，生活範囲を狭めていた．そこで，離れて生活する長女に思いを伝え，長女と交流する機会やつながりを築く作業を支援した．結果，A氏は手紙を通じて家族間交流を促進させ，再び安心した生活を取り戻した．手紙を介した家族間交流により，A氏と長女は役割を内在化させ，役割に沿った働きかけが家族の絆を深め，生活習慣の改善にまで至った．本論では作業療法の経過を振り返り，認知症高齢者と離れて生活する家族のつながりに焦点をあて，互いに思いを伝え，施設生活に変化を与える，家族の絆をつなぐ支援の重要性を考察した．

　An elderly patient with dementia living in a long-term nursing care facility had lost connection with family members due to the death of the eldest son who the patient had relied upon. This resulted in a reduction of the environment in which she actively engaged. OT support included providing opportunities for social interactions and establishing connections with the eldest daughter through communication by the patient to the daughter about personal feelings. As a result, interactions of the patient with the family members were promoted through exchange of letters, and the patient regained a stable lifestyle. Family interactions through letter writing helped internalize the roles of the patient and the daughter, and the subsequent deepening of their mutual relationship led to an improvement in lifestyle for the patient. This study reviews the timeline of the occupational therapy program, while focusing on the family connections of elderly patients who live apart by considering the importance of family ties, changing the feelings of family members and changing the activities within the long-term nursing facility.