家族が近隣に居住しているひとり暮らし中程度認知症高齢者への介護支援専門員の支援

Support from care managers to elderly people with moderate level dementia living alone whose family lives in the same neighborhood

抄録

　本研究は，一人暮らしの認知症高齢者を担当している介護支援専門員を研究参加者として，質的記述的研究方法を用い，一人暮らし認知症高齢者への介護支援専門員の支援を探求することを目的とした．結果，介護支援専門員は，本人のこれまでの生活や個性を尊重するために【努力して生活している本人を後押しする】関わりをしていた．一方，本人や近隣の安全を守ることも重要なことであり，認知症により判断力が減退し，本人だけでは生命や生活の安全が守れないと判断した時には，【本人と近隣の安全を守る】関わりも行っていた．これらのカテゴリは，認知症高齢者の一人暮らしが成り立つように支援していく中で，どちらに比重が傾いても一人暮らしは難しくなるという，相互にバランスをとる関係であった． そして相互のバランスをとるために，【本人への働きかけだけでは一人暮らしが困難と感じたら家族に助けを依頼する】ことや，他職種やご近所などの【支援の輪を広げて一人暮らしの限界を乗り越えていく】という支援を導入する関わりをしていた．また支援を導入するにあたって，【本人が支援を受け入れられるように配慮する】という支援を受け入れてもらう関わりをしていた．以上のような一人暮らし認知症高齢者への介護支援専門員の支援は，認知症高齢者の持つ能力を維持し，認知症高齢者の一人暮らし継続の可能性を高めていることが示唆された．

　This research intended to investigate support from care managers to elderly people with dementia living alone. Qualitative and descriptive research methods were used, with those care managers who provide care for the elderly people as the research participants. The results showed that care managers dealt with elderly people by “supporting subjects who are putting forth efforts” in order to respect the lifestyle and individuality of the subject. Meanwhile, maintaining the safety of the elderly person and the neighborhood is important. Therefore, care managers also dealt with “maintaining the safety of the elderly person and the neighborhood” when it is determined that the subject's judgment abilities worsen due to dementia and they cannot maintain safety for their life and lifestyle by themselves. These categories had a mutually balanced relationship. Living alone becomes difficult even when the relative importance is inclined to one category, when providing support to enable the elderly person with dementia to live alone. In addition, care managers worked to introduce support involving “requesting help from the family when it seems that it is difficult for the subject to take care of themselves on their own” and “exceeding the limits of living alone by expanding the support network” which includes other professions, neighbors, etc. in order to achieve this mutual balance. Care managers also dealt with having the subject allow the support through “making considerations so the subject accepts support” when introducing this support. As the above suggests, support from care managers to elderly people with dementia living alone increases the possibility of these elderly people to continue living alone while maintaining their own abilities.