超高齢者の作業機能障害の改善を目指した作業に根ざした実践の有用性—認知機能に相違がある2例へCAODを用いて

Usefulness of occupation-based practice to improve occupational dysfunction among the oldest-old: Using CAOD in two cases of differing cognitive functions

今回，回復期リハビリテーション病棟に入院した超高齢の2事例へ，CAODを用いた作業機能障害の改善を目指した作業に根ざした実践を行った．2事例は整形疾患を受傷し，ADLに介助が必要な状態であった．認知機能が良好なA氏は目標共有がしやすかった．一方，認知機能の低下を認めたB氏はA氏より作業の意味に気づきにくく，作業機能障害の改善にも時間を要した．視覚的な情報を用いて作業の再認識をすることで，A氏と同様に作業機能障害の改善を認めた．CAODを用いた作業機能障害の改善を目指した介入は対象者の作業の問題を捉えやすくし，超高齢事例の作業療法を展開するうえで有用な視点の一つになると考えられる．

　In this study, we conducted occupation-based practice to improve occupational dysfunction using CAOD in two oldest-old patients in a convalescent rehabilitation ward. The two cases have orthopedic disease and require assistance with ADL. Mr. A, who had good cognitive function, was able to share his goals easily. On the other hand, Mr B, whose cognitive function had declined, had difficulty sharing his occupation goals as easily as Mr. A, and took time to improve his occupational dysfunction. Mr. B showed improvement in his occupational dysfunction after re-recognition occupational therapy using visual information. Interventions aimed at improving occupational dysfunction using CAOD can help us to understand the subject's occupational problems, and may be a useful perspective in developing occupational therapy for oldest-old patients.