視覚障害によってCharles Bonnet症候群を呈した高齢者の経験

Experience of Elderly People with Charles Bonnet Syndrome Due to Visual Impairment

要旨

　目的：視覚障害によってCharles Bonnet症候群を呈した高齢者の経験について，身体知覚の側面から解釈することである．

　方法：視覚障害とそれに伴う幻視・抑うつをもつAさんに対して参加観察と非構成的インタビューを行い，AさんのナラティヴをMerleau-Pontyならびに伊藤の身体論に依拠して解釈した．

　結果：Aさんの経験を解釈することで，視覚障害に伴う幻視の特徴や喪失体験の苦悩を受容する過程として【視覚に対する思考や感情の影響と幻視のはじまり】【重なる喪失体験による侵襲的な幻視と抑うつ】【感覚の代償】【他者を通して芽生えた生きる力】【喪失したものの現れ】【運命の引き受け】という6テーマが導き出された．

　結論：視覚には当事者の思考や感情が関与しており，状況によって幻視・抑うつが変化することが示唆された．そのため，当事者の苦悩を理解した上で，生きることの意味の探求や生活の再構築などを支援しながら，障害や喪失の受容のプロセスを支えていくことが重要である．

　Purpose: To interpret the experience of elderly people with Charles Bonnet Syndrome (CBS) due to visual impairment from the perspective of embodied perception.

　Method: Participant observation and unstructured interviews were carried out with Patient A, who had visual impairment complicated by hallucinations and depression. The patient's narratives were then interpreted based on Merleau-Ponty's theory and Ito's theory of embodiment.

　Results: By interpreting the experience of Patient A, the following six themes were derived as processes for accepting the characteristics of hallucinations accompanying visual impairment and the distress of experiencing loss: (1) “the impact of thoughts and feelings on vision and the onset of hallucinations,” (2) “invasive hallucinations and depression due to repeated experiences of loss,” (3) “sensory compensation,” (4) “an incipient ability to live vicariously through others,” (5) “the manifestation of what has been lost,” and (6) “acceptance of fate.”

　Conclusion: These results suggest that vision is subject to the thoughts and feelings of those affected by impairment, and that hallucinations and depression can be transformed as a result of sensory compensation, connections with others, and the acceptance of impairment and loss. Thus, after understanding the distress experienced by those affected, it seems important to support the process of accepting impairment and loss while aiding in the reconstruction of lifestyles and the quest to find meaning in life.