痴呆性老人をかかえる家族のインフォーマルな社会的支援―都市・農村・離島の比較から

Informal Social Support for Families Living with the Elderly Suffering from Senile Dementia：A Comparative Study on the Situations in Urban, Rural and Remote Islands Districts

要旨

　我々は，本研究において，孤立した人間関係が特徴であるといわれる都市－東京，過疎的農村－新潟，親族ネットワークが強いといわれる沖縄から各々調査地区を選び，これらのインフォーマルな社会的支援の実態を比較することによって，痴呆性老人をかかえる家族に対する支援の特徴と，その特徴をふまえた看護の課題を見い出そうとした．

　東京21例，新潟21例，沖縄22例の家族を対象に訪問面接調査を行った結果，都市的地区(東京)は近隣と友人が予想以上に支援メンバーとして機能していた．農村地区(新潟)は，家族が周囲の支援を受けずに介護している傾向があった．離島地区(沖縄)は，親族をはじめとするインフォーマルな支援メンバーが比較的活発に機能していた．

　痴呆性老人をかかえる家族は，周囲の痴呆に対する無理解や老人の精神症状などから社会的交流が希薄になりやすいので，看護を展開する際は家族に留まらず，インフォーマルな社会的支援の特徴を密に把握する必要がある．

Abstract

　In this study, we have selected typical districts each in urban (Tokyo), rural (Niigata), and remote islands (Okinawa) districts in order to make a comparison among those regions on the objective of this study. It is said that a major part of inhabitants in Tokyo tends to live in a state of isolation. In Niigata, we selected a farm village where depopulation was a keen problem. While a close network between families and relatives is reportedly firmly established in Okinawa. Through comparison of these districts, we have attempted to grasp the characteristics of informal social support for families living with old people who suffer from dementia. In the light of these characteristics, we have also tried to figure out the tasks and problems pertaining to nursing. The number of homes we visited and interviewed for the purpose of this study amounted to 21 in Tokyo, 21 in Niigata and 22 in Okinawa. The results of this study have brought us the following findings.

　In the urban district (Tokyo), both neighbors and friends are functioning as supporters more willingly than expected. In the rural district (Niigata), family members most often take care of their old people without receiving support from outside. In the remote insular district (Okinawa), groups of neighbors and relatives are working actively as supporters.

　Families living with members suffering from senile dementia tend to live their unsociable life because of their sufferers mental disorder. When nurses approach those families, it is necessary, therefore, to grasp closely the actual situation of informal social support.