痴呆性高齢者グループホームにおける作業療法評価の試み—AMPSを用いて

An experience of occupational therapy assessment in a group home for elderly with dementia : A case study using Assessment of Motor and Process Skills

要旨：痴呆性高齢者グループホームで，作業療法士が入居者評価を通した関わりを経験する機会を得た．入居者評価には，標準化された評価法HDS-R，FIM，Assessment of Motorand Process Skills(以下AMPS)¹⁾を中心に用いた．その結果，本グループホームおいては，AMPSに基づく作業療法士の客観的な日常作業遂行上の質の提示とADL/APDL遂行能力中心とした判断が，特に入居者への介護方法，ケアプラン立案および施設管理に有用であることがわかった．作業遂行評価を行うことにより，作業療法士の入居者評価を通したグループホームへの関わりは，効果的となると考えられた．

　We occupational therapists have tried to take part in nursing care in residential homes for the elderly with dementia, mainly to perform assessment. Results of assessment suggested that knowledge and assessment techniques of occupational therapy, mainly the clarification of problems in daily work and the assessment of ADL/APDL abilities, are useful for the care of elderly people at such homes and management of the facilities. Active participation by occupational therapists in this field may be able to provide better service to elderly people and expand their fields of active participation.

　There are few studies showing effectiveness of occupational therapy in group homes for elderly people with dementia. People working in such group homes have not recognized that occupational therapists can take many roles in group home management. This study exemplifies effective intervention of occupational therapy in a group home for elderly people with dementia where an occupational therapist never worked before. Three standardized assessments, the Revised Hasegawa Dementia Scale (HDS-R), the Functional Independent Measure (FIM), and the Assessment of Motor and Process Skills (AMPS), were implemented as an occupational therapy assessment. Based on the results of these assessments, an occupational therapist not only gave some advise to care workers, with regard to caring for each person in the group home, but also provided crucial information for managing the group home (e.g., judgment of charging to or discharging from the group home). After the second assessment of their occupational therapy, the staff of the group home recognized the usefulness of assessment, especially AMPS, and effectiveness of occupational therapy intervention. Active participation of occupational therapists in this field may provide better service to elderly people and can expand our field of activities.