地域行政における言語聴覚士の認知症支援

Dementia support by speech-language-hearing therapists (SLHT) in local government

　宮城県では平成9年から県保健福祉事務所にリハビリテーション専門職を配置し，地域リハビリテーションの推進を行ってきた．言語聴覚士は長い間，県リハビリテーション支援センターに集中配置となっていたが，平成25年4月より筆者が当所健康づくり支援班配属となった．当所における認知症支援は高齢者支援班の保健師が関連事業を担当し，筆者は所内連携で保健師らとともに若年性認知症の方と家族のつどいを行っている．また，管内市町などからの地域リハビリテーション相談依頼に応じ，認知症の人と支援者への支援を行っている．地域の現状としては認知症の理解不足，認知症の人を支える家族への支援不足，若年性認知症の支援体制未整備，コミュニケーション障害の人が受ける誤解，リハビリテーション専門職が介入できていないなどがあり，言語聴覚士は“リハビリテーションの視点”と“コミュニケーション支援の視点”で支援していくことが重要であると考える．

　This report details the author's work as a speech-language-hearing therapist (SLHT) stationed at the Northern Health Welfare Office, one of the seven district health welfare offices in Miyagi Prefecture, Japan. In 2013, the author became the first SLHT assigned to work with district health welfare offices. In his district office, there is a public health nurse in charge of senior citizens and of dementia support. The SLHT cooperates with the public health nurse in conducting meetings with people who have early-onset dementia and their families. He also responds to requests from cities and community comprehensive care centers within the district to provide support for people with dementia and their carers. During the author's tenure, the main issues in the community were a general lack of understanding of dementia, lack of support for the families of people with dementia, underdevelopment of support systems for people with early-onset dementia, misunderstanding of people with communication disorders, and the existence of people with dementia who are not receiving any rehabilitation support. Based on this experience, the author concludes that it is important for SLHTs to keep in mind "the rehabilitation viewpoint" and "the communication support viewpoint" when supporting people with dementia.