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2012年9月 3日 (月)

認知症急増 在宅ケアの態勢作りが重要だ

The Yomiuri Shimbun (Sep. 3, 2012)
Promote at-home care for dementia sufferers
認知症急増 在宅ケアの態勢作りが重要だ(9月2日付・読売社説)

As the number of elderly people suffering from dementia continues to rise rapidly, it is crucial for all sectors of society to create a system that will enable such people to live at home.
 急増する認知症の高齢者が、自宅で暮らし続けられる仕組みを社会全体で築く必要があろう。

According to estimates released on Aug. 24 by the Health, Labor and Welfare Ministry, more than 3 million elderly people across the country suffer from dementia. This is one out of every 10 people aged 65 or older.
 厚生労働省の推計で、認知症の高齢者が300万人を超えた。65歳以上の人の10人に1人にあたる。

The ministry estimates the figure will reach 4.7 million in 2025. The growth in the number of the aged with dementia is alarmingly faster than projected.
 2025年には470万人に達するという。従来の予測を大幅に上回る勢いだ。

The faster pace is due both to the rapid graying of society and to the increased number of people who are examined and diagnosed because of successful programs to raise awareness of the problem.
急速な高齢化に加え、啓発が進んで診断を受ける人が増えたことも背景にある。

Advanced dementia can lead to such symptoms as wandering away, incontinence and even violence.
 認知症が進行すると、徘徊(はいかい)、失禁、暴力といった症状が出ることがある。

In many cases, family members of people suffering from dementia have become physically and mentally exhausted taking care of them and have opted to put them into mental hospitals. Such hospitalization tends to be long-term, averaging two years and seven months.
家族は介護に疲れ果ててしまい、精神科の病院に入院させるケースも多い。入院期間は平均2年7か月と長期にわたる。

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Support teams envisaged

The symptoms of people suffering from dementia are often aggravated after hospitalization, apparently due to such causes as changes in living environment and inadequate medication.
 環境が変わったことや不適切な薬物治療で、かえって状態が悪化する例もある。

It is necessary to shift the priority in supporting elderly dementia patients from hospitals to home care.
 入院重視の対策から、在宅支援策に重点を移すことが必要だ。

Sixty percent of the approximately 52,000 people currently hospitalized with dementia could be discharged if arrangements were put in place to support them, including a system to promote home care.
 認知症で精神科に入院している患者5万2000人のうち、6割は「自宅などで支援態勢が整えば退院可能」とされる。

Those who are hospitalized for dementia must feel frustrated that they cannot be at home, where they accustomed to being.
本来なら住み慣れた家で過ごせるはずなのに、本人も不本意だろう。

To help avoid longtime hospitalization of dementia patients, the health ministry plans to implement a new set of measures to promote their care at home, starting in fiscal 2013.
 長期入院を避けるため、厚労省は来年度から、自宅での支援を主体とする新対策を実施する。

Under the program, the ministry will set up support teams nationwide that will comprise such experts as nurses, public health nurses and rehabilitation therapists for intensive care of people in the early stages of cognitive decline.
 発症初期のケアに当たるため、看護師、保健師、作業療法士ら専門職で組織する「初期集中支援チーム」を設ける。

The support teams will visit the homes of the elderly to hear from them and their family members, while providing suggestions about how to deal with dementia symptoms at home.
高齢者宅を訪問し、本人や家族からの聞き取りや相談、助言を行う。

In Britain, where a similar system was introduced in 2009, the number of people hospitalized for dementia has begun to decrease sharply. We hope to see such a favorable effect in this country, too.
 09年に同様の仕組みを導入した英国では、認知症による精神科への入院が大きく減り始めた。日本でも成果を期待したい。

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Securing personnel urgent

To deal with elderly people with advanced dementia, the ministry plans to designate about 300 medical institutions as dementia centers. To facilitate quick responses to urgent requests from the families of dementia sufferers, the ministry is studying ways to enable doctors to make house calls on short notice.
 症状が悪化した高齢者への対応としては、拠点医療機関を300か所ほど確保する。家族からのSOSに対処するため、医師が迅速に往診する態勢を整備する。

The biggest obstacle to such measures remains a shortage of personnel. It is a matter of urgency to secure medical doctors, nurses and caregivers who are well versed in caring for patients with dementia.
 これらの対策を実施するうえで、最大の問題は人材の不足である。認知症に習熟した医師、看護師、介護士らの育成が急務だ。

Securing budgetary appropriations needed to implement the envisioned programs is also difficult.
 必要な予算をどう確保するかも課題となろう。

Although people suffering from senile dementia tend to be viewed as unable to perform everyday activities, in many cases they remain emotionally stable and can engage in a range of activities.
 認知症は、何も分からなくなる「恍惚(こうこつ)の人」というイメージが強かったが、実際は感情や様々な能力が保たれることが多い。

Many people with dementia serve as volunteer workers, hoping to help others in spite of their own problems.
 「認知症でも、人の役に立ちたい」とボランティアをする人もいる。

People providing medical and nursing care to those with dementia are urged to pay due attention to them to help them live in a way suited to their needs.
その人らしく過ごせるよう配慮するケアが、医療・介護スタッフに求められている。

Efforts in local communities to establish frameworks that will facilitate helping the aged are also important.
 地域で高齢者を支える仕組みづくりも大切だ。

To this end, some local governments have taken the initiative in enhancing support for the elderly, such as encouraging members of shopping district associations to learn about dementia.
商店街ぐるみで認知症の知識を学ぶなど、独自の施策に取り組む自治体もある。

Attention should be paid to such examples.
そんな事例を参考にしたい。

(From The Yomiuri Shimbun, Sept. 2, 2012)
(2012年9月2日01時45分  読売新聞)

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