認知症を合併した急性大動脈解離Stanford A型の高齢者に余暇活動の楽しさを提供して退院となった事例

The effect of leisure activities on acute aortic dissection Stanford type A complicated by dementia upon discharge from the hospital: A case study

要旨：急性大動脈解離Stanford A型の偽腔開存型のAさんは，BPSDと息みのある更衣動作や排泄動作で血圧が上昇し，認知症で会話が成立しない状態であった．そのAさんに過去の楽しさの語りを促進する用途のある高齢者版・余暇活動の楽しさ評価法を行うと会話が成立し，不安な表情も消失した．そこで，血圧上昇が生じない生活を実現させるために，編み物の〈達成感の楽しさ〉と〈現在に想いを広げる楽しさ〉を提供してBPSDを減少させ，息みのない更衣・排泄動作をめざして作業療法を実施した．その結果，AさんはBPSDが改善し，声かけで息みのない更衣・排泄動作も可能となり，グループホームに戻ることができた．

　An elderly woman with acute aortic dissection Stanford type A with pseudo lumen opening was treated conservatively and had elevated blood pressure with BPSD. The patient had difficulty dressing and toileting and was unable to speak due to dementia. The elderly version of the Leisure Activity Enjoyment scale, which is used to promote narration of past enjoyment, indicated her ability to recall past enjoyment, thus leading her to converse, and a disappearance of her anxious expression. To decrease BPSD we offered the “enjoyment of a sense of accomplishment” and the “enjoyment of expanding thoughts to the present.” Her knitting led her to acquire dressing and toileting movements without strain. Thus, BPSD improved, and she was able to perform dressing and toilet activities without strain by talking to others and was able to return to her life in the group home.