痴呆患者の食事中に見られた“奇異な”動作・行為—2名の患者の予備的研究から

"Queer" actions and behavior found in geriatric patients with dementia while feeding: A preliminary study of two subjects

要旨：痴呆患者の食事場面で，第三者に奇異の感を抱かせる動作・行為特徴とは何かを明らかにするために，患者2名の食事場面をビデオ録画し，動作・行為の質的分析を試みた．ビデオ映像を文章化し，奇異な動作が見られたシーンを抽出し，それを内容に基づいて分類した．その結果，利き手のみで食べる，食器・道具の把持フォームが未熟，道具の使用を誤る，道具操作の不器用，食材・道具の所在に気づかない，周囲に気をとられ咀嚼が長引く，食材をこぼす等の特徴が抽出された．これらの中には，失行の行為特徴や幼児の特徴と類似していると思われるものもあり，今後さらに詳細に痴呆患者の動作・行為特性を調べてみる必要があると思われた．

　The purpose of this paper is to describe the characteristics of "Queer" actions and behavior demonstrated by two demented people, while feeding themselves. Two elderly demented patients were videotaped while having a meal. The whole videotaped records were transcripted into precisely written descriptions of the performance of each patient. Among the transcriptions, "Queer" actions were extracted and then categorized. Each category was given a name representing its characteristics. Then, the characteristics of "Queer" eating actions and behavior of each subject were examined by using these category-names as cues. The results of these characteristics are as follows: only using one's dominant hand, immature holding form of dishes and utensils, misuse of utensils, clumsy manipulation of utensils, unaware and inattention to some part of food or utensils, long chewing time by not focusing one's attention, disorder of dishes and utensils, spill during conveying food to mouth, spill out from mouth, obscure completion of own meal time. Some of the results are similar to apraxic syndromes found in the brain injured, and to signs of regression of normal brain function. Further research should include more thorough qualitative analysis in order to comprehend the characteristics of action and behavior patterns of demented people.