アルツハイマー型認知症を呈した終末期の誤嚥性肺炎再燃患者・家族へのTransdisciplinary approachによる食支援

Transdisciplinary approach to food support for a patient suffering from Alzheimer's disease and terminal lung cancer with recurrent aspiration pneumonia and his family

要旨：誤嚥性肺炎により入院し自宅退院となったアルツハイマー型認知症を呈した70歳代の肺癌終末期患者に対して，作業療法士による訪問リハビリテーションを実施した．Transdisciplinary approachの概念を基に栄養，姿勢ポジショニング，食事介助，口腔ケアの方法に関する様々な食支援を実施した．結果，栄養状態に改善がみられ，褥瘡の発生なく，47日間在宅生活を過ごすことができ，妻の不安が軽減したと推察された．今回の経験から，食支援を実践するためには多職種連携を通して幅広い知識と技術を身につけること，また対象者が適切な食支援を受けられるよう地域の体制づくりも必要であることが示唆された．

　An occupational therapist provided home-visit rehabilitation to a patient in his 70s with Alzheimer's disease and terminal-stage lung cancer. The patient was discharged home after being hospitalized and treated for aspiration pneumonia. Using a transdisciplinary approach, we provided various dietary supports, including nutrition, postural positioning, dietary assistance, and oral care. Consequently, his nutritional status improved, and he could stay at home for 47 days without pressure ulcers, which reduced his wife's anxiety. This experience suggests that acquiring a wide range of knowledge and skills regarding food support through cooperation among various professions is necessary. Furthermore, a community system should be created to provide patients with appropriate food support.