「Home re-evaluation」の試み

A "Home re-evaluation" Trial

要旨：自宅退院した患者に対し「Home re-evaluation」を行い，家屋改造指導後に生じた問題について検討した．退院時に指導した改造が機能しているか，身体機能や屋内生活の変化，その結果として新たに問題を生じているのか，以上の点について再訪問・調査した．日常頻繁に使われるトイレや玄関等の改造はスムースに利用されているが，浴室は介助方法の変更や自宅入浴の減少で必ずしも機能しているとは言えなかった．移動，食事，排泄，入浴の各動作は顕著な機能低下は見られなかった．しかし加齢や介護者など何等かの環境再調整を要する問題を生じ，退院後に経時的に評価する定期的な「Home re-evaluation」の必要性が示唆された．

　A "Home re-evaluation" for discharged patients was performed and problems that arose after "home evaluation and home reconstruction done prior to discharge" were examined.

　We evaluated whether the "home evaluation" was appropriate or not, how physical function, and activities of daily living changed, and consequently whether home re-evaluation is necessary or not. In conclusion, the reconstructed rest room and entrance were well used, but use of the bathroom decreased due to a change of assisting methods, etc.

　No change was observed in ambulation, feeding, toileting and bathing functions.

　However, various problems arose due to aging and care givers.

　In conclusion, we must check patients' variable progression more carefully and try to regularly perform a "home re-evaluation" after a "home evaluation".