癌末期にあたり，希望の時間としての作業療法—在宅緩和医療における作業療法の役割

Occupational therapy as a hopeful time for a client with end-stage-cancer : A case study of occupational therapy practice in home palliative care

要旨：在宅緩和医療の作業療法において，末期癌のクライエントに関わる機会を得た．クライエントは娘たちとともに美容室を自営し，仕事の継続を希望していたが臥床状態であり，作業療法士に職業上必要な立位，歩行能力へ介入することを望んだ．経過の中で，クライエントは仕事を行うには至らなかったが，一時的に立位，歩行動作を獲得して身辺処理が可能となった．そして，美容の技術を披露する機会を持つこともできた．このようなクライエントの振る舞いは，娘たちと築いてきた習慣と役割を維持することに結びついた．在宅緩和医療の作業療法では，クライエントと家族の長くにわたる生活の経験の中で，看取りが行えるよう援助することが重要と考えられた．

　In home palliative care, an occupational therapist had a chance to intervene with a woman with endstage-cancer. The subject kept her beauty salon with her daughters, so she hoped to continue her work, but she had not been able to stand up and walk. In the therapy, she made the effort to reacquire her locomotive ability, and, as a result, she could. Moreover, she individualized her self-care, giving herself a chance to show her beauty treatment skills. Her positive approach to her situation resulted in improved relations with her family members. This case study suggested that occupational therapy practitioners should assist in and encourage patients, along with their family members, to reacquire established, positive life-style habits and rolls.